Abstract:
PURPOSE OF REVIEW:This review highlights the complexity of caring for gynecologic patients who refuse blood transfusion and discusses the importance of early, targeted perioperative and intraoperative medical optimization. We review alternative interventions and the importance of medical management to minimize blood loss and maximize hematopoiesis, particularly in gynecologic patients who may have significant uterine bleeding. The review also focuses on intraoperative interventions and surgical techniques to prevent and control surgical blood loss. RECENT FINDINGS:With improvements in surgical technique, greater availability of minimally invasive surgery, and increased use of preop UAE and cell salvage, definitive surgical management can be safely performed. New technologies have been developed that allow for safer surgeries or alternatives to traditional surgical procedures. Many medical therapies have been shown to decrease blood loss and improve surgical outcomes. Nonsurgical interventions have also been developed for use as adjuncts or alternatives to surgery. SUMMARY:The care of a patient who declines blood transfusion may be complex, but gynecologic surgeons can safely and successfully offer a wide variety of therapies depending on the patient's goals and needs. Medical management should be implemented early. A multidisciplinary team should be mobilized to provide comprehensive and patient-centered care.
journal_name
Curr Opin Obstet Gynecoljournal_title
Current opinion in obstetrics & gynecologyauthors
Han ES,Arora C,Hur HC,Advincula AP,Kim JHJdoi
10.1097/GCO.0000000000000558subject
Has Abstractpub_date
2019-08-01 00:00:00pages
251-258issue
4eissn
1040-872Xissn
1473-656Xjournal_volume
31pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:The study of embryonic development through conventional microscopy has contributed significantly to the success of IVF. However, clinical pregnancy rates per transfer remain as low as 30% according to the latest records of European society if human reproduction and society if assisted reproduction. Co...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000534
更新日期:2019-06-01 00:00:00
abstract:PURPOSE OF REVIEW:To review recent literature on medical accuracy, program effectiveness, and ethical concerns related to abstinence-only policies for adolescent sexuality education. RECENT FINDINGS:The federal government invests over 175 million dollars annually in 'abstinence-only-until-marriage' programs. These pro...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e3282efdc0b
更新日期:2007-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this review is to summarize the current evidence on the safety and effectiveness of moving oral contraceptives from prescription-only to over-the-counter (OTC) status. The review also examines women's interest in OTC access to oral contraceptives, as well as potential barriers and facilitat...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000019
更新日期:2013-12-01 00:00:00
abstract:PURPOSE OF REVIEW:What controls puberty remains largely unknown and current gene mutations account for only about one-third of the apparently genetic cases of idiopathic hypogonadotropic hypogonadism. Lately important developments have occurred in this field. RECENT FINDINGS:Substantial variation in clinical expressio...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e32833bb425
更新日期:2010-08-01 00:00:00
abstract::This review concentrates on the structural and functional aspects of lesions of the female genital tract that cause infertility, including cervical changes after treatment for neoplasia, uterine malformations, leiomyoma, endometrial aberrations, infection-related tubal lesions, ovarian disorders (oocyte defects, prema...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1997-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Antenatal fetal surveillance is a field of increasing importance in modern obstetrics, especially as results in perinatal care have recently made dramatic progress. It is an evolving field, and it is no longer acceptable just to wait and see when problems arise in pregnancy. During the past few decade...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-200404000-00005
更新日期:2004-04-01 00:00:00
abstract::Magnetic resonance imaging represents a new method of imaging the pelvic viscera and pelvic floor musculature. Rapid sequences allow us to perform magnetic resonance imaging dynamically during straining or pelvic floor contraction, which can elegantly demonstrate the patterns of pelvic floor prolapse. The technique is...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-199808000-00003
更新日期:1998-08-01 00:00:00
abstract:PURPOSE OF REVIEW:This article provides an overview of types and trends in managed care, as well as insights into how obstetrician/gynecologists can work with managed care plans to improve process and outcomes for patients. RECENT FINDINGS:Although studies of managed care between 1990 and 2005 generally did not show c...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e328359efa9
更新日期:2012-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide clinicians with a review of recent research and clinically applicable tools regarding teen pregnancy. RECENT FINDINGS:Teen pregnancy rates have declined but still remain a significant problem in the USA. Teen pregnancy prevention was identified by Centers for Disease Control and Prevention...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000102
更新日期:2014-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The most appropriate surgical approach for uterine preservation still remains the subject of ongoing controversy. Uterine suspension procedures can be performed abdominally, vaginally, or laparoscopically. This article focuses on the three different laparoscopic approaches of uterine suspension for ut...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.gco.0000179664.83154.9c
更新日期:2005-10-01 00:00:00
abstract::Human embryo cryopreservation is now a fully established adjunct to assisted reproduction, with thawed embryos implanting at a rate approaching that of fresh embryos. As with fresh embryos, the quality of frozen-thawed embryos is affected by patient age at the time of oocyte retrieval, and by culture conditions. Ovari...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-199506000-00006
更新日期:1995-06-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review is to discuss the diagnosis, medical complications, and treatment of eating disorders as defined by the newly released Diagnostic and Statistical Manual, 5th edition. RECENT FINDINGS:With the introduction of the Diagnostic and Statistical Manual, 5th edition, the diagnostic...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000317
更新日期:2016-10-01 00:00:00
abstract:PURPOSE OF REVIEW:We present an update on amenorrhea in adolescent girls and young women. Amenorrhea may herald the onset of estrogen deficiency, which can adversely affect peak bone mass and ultimate risk of osteoporosis. RECENT FINDINGS:Adolescence is a critical period for bone accretion. Important modifiable factor...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-200310000-00005
更新日期:2003-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To review important considerations in the counseling and management of women over the age of 40 desiring a myomectomy for symptomatic fibroids. RECENT FINDINGS:Women in the late reproductive and perimenopausal years may choose a myomectomy over a hysterectomy for reasons of fertility preservation or ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000551
更新日期:2019-08-01 00:00:00
abstract::Approximately 2-3% of cervical smears will be reported as showing low-grade changes. Many of these smears are in fact associated with high-grade cervical intraepithelial neoplasia requiring treatment, but a significant number will be associated with an absence of cervical intraepithelial neoplasia, where surveillance ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1995-02-01 00:00:00
abstract::Pelvic floor dysfunction, specifically urinary and fecal incontinence, is thought to be widespread. Prevalence figures for these disorders vary greatly. This review highlights the accepted prevalence and incidence figures for pelvic floor dysfunction and their relative age distribution in women. Remission and natural ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1994-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Endometriosis is a frequent gynaecological disorder in young women. Colorectal endometriosis accounts for about 90% of all intestinal locations. The effectiveness of medical therapies is poor, and surgery, including colorectal resection, is therefore often required. Since the first description of lapa...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e328216f6bc
更新日期:2007-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Spontaneous preterm birth complicates 3-11% of pregnancies and is a major cause of neonatal mortality and morbidity worldwide. If accurate tests can be identified, a potentially effective screening strategy with an adjunct preventive therapy may be trialled to reduce the rate of spontaneous preterm bi...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章
doi:10.1097/GCO.0b013e328359823a
更新日期:2012-12-01 00:00:00
abstract::Urinary incontinence remains a common problem that adversely affects the quality of life of millions of women. In detrusor instability, treatment measures often lack efficacy or are accompanied by unacceptable side effects. In this review, standard treatments are discussed, together with recent pharmacologic advances ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1991-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Therapeutics targeting the ErbB protein family receptors have not always yielded favorable or successful results in present cancer therapy. This review discusses the possibility of the clinical adaptation of targeting against heparin-binding epidermal growth factor-like growth factor (HB-EGF), one of ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e3283409c91
更新日期:2011-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Intestinal endometriosis is commonly diagnosed in the setting of deeply infiltrating endometriosis. A multidisciplinary team that includes gynaecologists and general surgeons traditionally performs laparoscopic bowel resections for symptomatic patients. Recently, Pereira et al. has published the resul...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e32833beae0
更新日期:2010-08-01 00:00:00
abstract:PURPOSE OF REVIEW:To evaluate the impact of early pregnancy complications involving placentation and early placental development on adverse obstetric outcome in ongoing and subsequent pregnancies. RECENT FINDINGS:We found an increased risk of adverse outcome (odds ratio >2.0) in ongoing pregnancies of preterm delivery...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e3283404e44
更新日期:2010-12-01 00:00:00
abstract::In the past decade, neoadjuvant and concomitant multimodality therapies have been studied in patients with cervical cancer. The past year has witnessed more pilot studies confirming the feasibility of multimodality therapy. It is now time to move to prospective randomized clinical trials to determine the effects on di...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1993-02-01 00:00:00
abstract::This review explores some of the implications for a balanced approach to the ethics of maternal participation in clinical research, from the perspective of the fetus as a patient, which is a central concept in obstetric ethics. The review therefore begins with an account of this topic, followed by an examination of so...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-199912000-00002
更新日期:1999-12-01 00:00:00
abstract::The failure to store urine resulting from bladder outflow incompetence requires a method to increase outflow resistance. Peri- and intraurethral injection is one form of treatment capable of accomplishing this need. The best results are obtained in those women who do not have detrusor abnormalities, who have adequate ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The increased risk of infertility in men with varicocele is well established. Varicocelectomy has been shown to improve semen parameters and increase pregnancy rates. Yet varicocele pathophysiology is poorly understood and potential implications for testosterone production are less clear. Evidence sug...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e328348a3e2
更新日期:2011-08-01 00:00:00
abstract::During the period under review (December 1990 through January 1992), the revised World Health Organization Histological Classification of Ovarian Neoplasms and Tumor-like Lesions was completed, and it is presented herein. This system of classification incorporates recent advances and includes newly recognized entities...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1992-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Monochorionic compared with dichorionic twins have disproportionately high fetal loss rates, perinatal mortality and morbidity. This is because of the unpredictable vascular anastomoses and the often asymmetrical distribution of the single placenta between both twins. RECENT FINDINGS:The pathophysiol...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-200304000-00013
更新日期:2003-04-01 00:00:00
abstract::The most important papers address controversial aspects of fetal cardiology, for example, screening for congenital heart disease (CHD), the diagnosis and the accuracy of diagnosis, and the management of fetal tachycardias. There are some interesting additions to the literature although some conclusions require further...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Recently some studies have reinforced the arguments supporting the laparoscopic management of early ovarian cancer. These studies and reports questioning the use of laparoscopy in patients with early ovarian cancer will be reviewed. RECENT FINDINGS:Advances in laparoscopic techniques have enabled the...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.gco.0000175352.95436.fc
更新日期:2005-08-01 00:00:00