Abstract:
:Ethics in reproductive genetics comprise descriptive ethics and normative ethics. Ethical problems before prenatal diagnosis involve genetic counseling and informed consent for the choice patients must make. Prenatal diagnosis using amniocentesis is controversial. An international survey of geneticists showed that 25% would do prenatal diagnosis for sex selection, and 17% would refer the couple elsewhere. Hungary (60%), India (37%), the US (34%), Canada (30%), Greece (29%), and Sweden (28%) would do prenatal diagnosis. The statistical incidence of positive findings after prenatal diagnosis does not exceed 4% of all cases when most couples choose abortion. Respect for parental choice and for nondirective counseling was supported in responses to 3 cases in the international survey that also had disclosure dilemmas included with abortion choices. 84% of respondents would be nondirective for XYY and 88% for XO. In India, Hungary, Turkey, and Norway, 46%, 40%, 40%, and 33%, respectively, would advise aborting an XO (Turner) fetus. A survey of 737 genetics and obstetricians and ethicists and clergy showed acceptability of abortion in singleton pregnancies and in twins associated strongly with the trimester of pregnancy, indication for selective termination, and fetal number. Prior group review of risks and benefits of experimental fetal therapy, case selection for experimental fetal therapy, the optimal informed-consent process for fetal therapy, twin pregnancies, refusal of proven fetal therapy, the lack of federal support for research in fetal diagnosis (preimplantation embryo diagnosis) and therapy, and sources of a moral obligation are also addressed. The Belmont Report on the ethics of biomedical research in the US proposed ethical principles to guide research with human subjects including the fetus: respect for parsons, beneficence, and justice.
journal_name
Clin Obstet Gynecoljournal_title
Clinical obstetrics and gynecologyauthors
Fletcher JC,Evans MIdoi
10.1097/00003081-199212000-00009subject
Has Abstractpub_date
1992-12-01 00:00:00pages
763-82issue
4eissn
0009-9201issn
1532-5520journal_volume
35pub_type
杂志文章abstract::The ideal weight gain or energy intake for an individual woman cannot be determined from research studies. Current guidelines for maternal gain, however, combined with individualized assessment and follow-up, can provide the clinician and the pregnant women with a meaningful target and plan for achieving a healthy wei...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199409000-00005
更新日期:1994-09-01 00:00:00
abstract::Genitourinary syndrome of menopause (GSM) describes a collection of exam findings and bothersome symptoms associated with estrogen deficiency involving changes to the labia, introitus, clitoris, vagina, urethra, and bladder. Vulvovaginal atrophy is a component of GSM. GSM is a highly prevalent medical condition with a...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000380
更新日期:2018-09-01 00:00:00
abstract::Unlike urinary incontinence (UI) in younger women, UI in older women is usually multifactoral in etiology and involves factors beyond the more common types of lower urinary tract (LUT) pathophysiology associated with UI in younger women. The evaluation and management of UI in older women, therefore, must itself be mul...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e3180d0a4e7
更新日期:2007-09-01 00:00:00
abstract::The relationship between the clinical state of the cervix and spontaneous onset of labor has long been known. The cervix can be characterized by evaluating five parameters: effacement, dilatation, firmness, position, and level of the presenting part. The relative associations between successful labor induction and the...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199506000-00005
更新日期:1995-06-01 00:00:00
abstract::Although perinatal mortality rates have fallen considerably in the past several decades, the fetal component of this statistic has not decreased as rapidly as the neonatal portion. Syphilis, a significant cause of fetal death at the beginning of this century, has been eliminated and other conditions such as erythrobla...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-198706000-00010
更新日期:1987-06-01 00:00:00
abstract::Infection remains a major cause of maternal morbidity and mortality. Those entities that are most likely to threaten the life of the pregnant woman have been reviewed. Although intrapartum and postpartum pelvic infections consitute the majority such serious infections in pregnancy, attention has also been called to se...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00003081-197609000-00006
更新日期:1976-09-01 00:00:00
abstract::The adnexal mass in a postmenopausal patient poses an important diagnostic and management dilemma for primary care providers and gynecologists. Postmenopausal women are at a significantly increased risk of gynecologic malignancy; yet even in this population the majority of adnexal masses are benign. Evaluation and man...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000085
更新日期:2015-03-01 00:00:00
abstract::Venous thromboembolism is a leading cause for maternal mortality. Because of the increase risk for thromboembolism in pregnancy and the postpartum period, the clinician must be on high alert for the signs and symptoms and use appropriate diagnostics in a timely manner so that prompt anticoagulation therapy can be init...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e3181deb27e
更新日期:2010-06-01 00:00:00
abstract::Polycystic ovarian syndrome (PCOS) presents as a constellation of clinical manifestations that can be varied among patients; however, the hormonal derangement associated with PCOS is uniformly characterized by excess androgens and abnormal insulin activity. The alteration in the normal hormonal milieu in these patient...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000598
更新日期:2021-03-01 00:00:00
abstract::The utility and effectiveness of screening mammography in diagnosing breast cancer at earlier stages and reducing disease-specific mortality remain controversial especially as to when to start and stop routine mammographic screening, and whether mammograms should be performed annually or biennially in average-risk wom...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000205
更新日期:2016-06-01 00:00:00
abstract::The application of real-time imaging to the study of fetal morphology and function is an exciting advance. Rapid accurate study of fetal dynamics is possible with this apparently safe, noninvasive technique. Animal studies have revealed the general physiology of fetal breathing movements, which are now under extensive...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00003081-197706000-00014
更新日期:1977-06-01 00:00:00
abstract::Cervical cerclage is a surgical procedure to prevent preterm birth. There are currently 3 main indications, based on either history, ultrasound, or physical exam changes. ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000185
更新日期:2016-06-01 00:00:00
abstract::Recent rise in rates of opiate replacement therapy among pregnant women have resulted in increasing number of infants requiring treatment for neonatal abstinence syndrome (NAS). Short-term and long-term developmental outcomes associated with prenatal opiate exposure are discussed, including symptoms and severity of NA...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e31827feea4
更新日期:2013-03-01 00:00:00
abstract::Increasingly, patients are expecting to be more involved than they traditionally have been in medical and surgical decision making. The unilateral process of informed consent is evolving into one of informed collaborative choice. Hysterectomy is a procedure that is frequently performed when reasonable surgical and non...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199712000-00022
更新日期:1997-12-01 00:00:00
abstract::Today, reproductive surgery has a limited place. In selected cases such as young women with a history of pelvic inflammatory disease, pelvic adhesions, and endometriosis, surgery could be considered. Most operations can be performed by laparoscopy; these include tubal anastomosis that yields a high pregnancy rate. On ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3181b08b5f
更新日期:2009-09-01 00:00:00
abstract::Chronic pelvic is a multifaceted condition that often has both peripheral and central generators of pain. Despite its high prevalence, the evaluation and management of a pelvic pain patient often present many challenges to the practicing gynecologist. As with many other chronic pain conditions, pain severity does not ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000486
更新日期:2019-12-01 00:00:00
abstract::Urinary tract infection in women has its origin, predominantly, via ascending bacteria from the periurethral microflora. Asymptomatic bacteriuria, except for the pregnant patient, need not be treated. E. coli is the most common bacterium to cause UTIs, and is usually susceptible to oral antibiotics. Patients who are h...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199809000-00030
更新日期:1998-09-01 00:00:00
abstract::1. The use of ultrasound may improve perinatal outcome in twin pregnancy. 2. Singleton growth curves for FL, BPD, and AC may be used to assess fetal growth prior to 28 weeks gestation. 3. After 28 weeks gestation, specific twin growth curves should be used. However, increased morbidity may be seen when fetal weight fa...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199003000-00008
更新日期:1990-03-01 00:00:00
abstract::In recent years it has been recognized that in all phases of life, including pregnancy, physical activity promotes health benefits and precludes comorbidities, the scientific evidence is indisputable. Several organizations around the world have updated in recent years the guidelines and recommendations for exercise in...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000223
更新日期:2016-09-01 00:00:00
abstract::Placental lesions identified in cases of stillbirth are of clinical interest and are frequently invoked as having a causal role. However, most of the placental changes found in stillbirth are also seen in liveborn pregnancies, and are of uncertain pathogenetic significance. Much of the literature addressing placental ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3181eb68fe
更新日期:2010-09-01 00:00:00
abstract::The relevance of extraneous factors on fetal and neonatal respiratory gas exchange and acid-base balance must be considered when interpreting umbilical cord blood values. However, although many of these factors can alter these values to a minor degree, the clinical impact is negligible in the unstressed fetus. The mor...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199303000-00009
更新日期:1993-03-01 00:00:00
abstract::The majority of ectopic pregnancies can be diagnosed on transvaginal scan before treatment. Diagnosis should be based on positive visualization of an ectopic pregnancy rather the inability to visualize an intrauterine pregnancy. The majority of ectopic pregnancies will be visible on the initial transvaginal scan perfo...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e31824e35fe
更新日期:2012-06-01 00:00:00
abstract::Counseling regarding the options for aneuploidy risk assessment is complicated and requires thorough counseling with the patient. Second trimester serum risk assessment has been the gold standard because of widespread availability, low cost, and vast experience with counseling and performance. First trimester risk ass...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e31804c9b99
更新日期:2007-06-01 00:00:00
abstract::Several advantages are apparent in the use of self-monitored or automatic ambulatory blood pressure monitoring by pregnant patients who appear to have borderline or mild hypertension. Home recordings, combined with conventional office measurements, can give a more accurate picture of the patient's dynamic blood pressu...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract::Ovulation induction is the principal infertility treatment for women with polycystic ovarian syndrome (PCOS). Among PCOS patients who are overweight or obese, weight loss is the most physiologic method of inducing ovulation. For women in whom weight loss is not possible, or for lean women with PCOS, clomiphene citrate...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e31802f361e
更新日期:2007-03-01 00:00:00
abstract::Shoulder dystocia complicates ∼1% of vaginal births. Although fetal macrosomia and maternal diabetes are risk factors for shoulder dystocia, for the most part its occurrence remains largely unpredictable and unpreventable. ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000227
更新日期:2016-12-01 00:00:00
abstract::The responsibility of the obstetrician is to identify during the first trimester women who are carriers for thalassemia. When she has been identified, the father of the baby should be screened and if he is also a carrier, the couple should be offered prenatal diagnosis. In the majority of cases, prenatal diagnosis can...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199509000-00008
更新日期:1995-09-01 00:00:00
abstract::A recent review of the literature on thrombophilia and adverse pregnancy outcome (APO) reveals contradictory findings. We have limited our review of literature mostly to the most recent decade. On the basis of our review, screening for thrombophilias with a history of APO (preeclampsia, abruptio placenta, intrauterine...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.grf.0000211954.66959.e1
更新日期:2006-12-01 00:00:00
abstract::Endometriomas are common in reproductive-aged women, but controversy exists regarding their management. PubMed was searched to identify pertinent studies on outcomes of medical and surgical management of endometrioma, with focus on randomized controlled trials and meta-analyses. Surgical excision is more effective tha...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000151
更新日期:2015-12-01 00:00:00
abstract::The foregoing discussion is consistent with the following conclusions: First structural differentiation of the gonads, consonant with chromosomal sex of human fetuses, requires complex interactions of primordial germ cells with coelomic and mesonephric epithelial cells and mesenchymal cells in the genital ridge. The m...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-09-01 00:00:00