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 assessment is becoming more widely available and provides increased sensitivity for Down syndrome detection with a detection rate of approximately 87% (95% confidence interval: 84.0% to 89.4%), at a fixed false-positive rate of 5%. With the advent of first trimester techniques, controversy has arisen as there are advocates for the different recently available approaches. In this chapter, we outline the various options in a manner that will provide practical information for physicians offering such testing. Clearly, implementation of first trimester risk assessment requires special training and meticulous quality control standards for nuchal translucency and laboratory measurements, access to chorionic villus sampling, and also appropriate counseling regarding risk assessment options.
journal_name
Clin Obstet Gynecoljournal_title
Clinical obstetrics and gynecologyauthors
Reddy UM,Wapner RJdoi
10.1097/GRF.0b013e31804c9b99subject
Has Abstractpub_date
2007-06-01 00:00:00pages
442-53issue
2eissn
0009-9201issn
1532-5520pii
00003081-200706000-00013journal_volume
50pub_type
杂志文章,评审abstract::The development of GnRH agonists has had a major impact on the practice of gynecology and reproductive endocrinology. The clinical usefulness of GnRH agonists will increase as modes of administration are improved and indications become better defined. GnRH agonists and, potentially, antagonists will provide a prompt, ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-198909000-00019
更新日期:1989-09-01 00:00:00
abstract::The process of genetic screening has evolved from a simple notation of maternal age to a complex algorithm incorporating age, maternal serum screening, and sonographic findings. The extent to which each of these variables should contribute to the overall screening result is much debated and deserves continued research...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3182488309
更新日期:2012-03-01 00:00:00
abstract::Influenza infection during pregnancy imparts disproportionate morbidity and mortality. This has been primarily noted during occasional influenza pandemics but also during seasonal epidemics. The majority of pregnant women who contract influenza appear to have a mild, self-limited course. However, influenza produces a ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e31827146bd
更新日期:2012-12-01 00:00:00
abstract::This article reviews the sonographic manifestations of fetal infection and the role of ultrasound in the evaluation of the fetus at risk for congenital infection. Several ultrasound findings have been associated with in utero fetal infections. For the patient with a known or suspected fetal infection, sonographic iden...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000342
更新日期:2018-03-01 00:00:00
abstract::OC (oral contraception) can cause hypertension in a small minority, about 5%, of users. There does not seem to be a relationship between estrogen dosage and hypertension, while a relationship between progesterone and hypertension seems more possible. Hypertensive reaction to OC has been primarily seen in patients ov...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-198109000-00016
更新日期:1981-09-01 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::Technologic advances and clinical research have been extending the scope of Doppler sonography and have resulted in the emergence of new diagnostic tools that show significant promise in clinical applications. This article aims to review some of these developments that are relevant for obstetrical practice. One of the...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3181fbad5e
更新日期:2010-12-01 00:00:00
abstract::Despite advances in estimating prognosis and predicting response to adjuvant systemic therapy, the status of the axillary lymph nodes remains a critical component in initial surgical planning and in determining therapeutic strategies for patients with breast cancer. Buoyed by evidence from multi-institutional randomiz...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000232
更新日期:2016-12-01 00:00:00
abstract::Maternal mortality is a complex problem requiring complex responses. Nevertheless, every intervention must operate through one of 3 pathways: preventing pregnancy, preventing complications, or preventing death when obstetric complications occur. We describe interventions following each pathway and assess their evidenc...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e3181a4bddb
更新日期:2009-06-01 00:00:00
abstract::There is compelling data and a rationale for embarking on screening to identify pregnant women with some of the multiple classes of subclinical thyroid dysfunction. However, the evidence to support such screening and treatment is lacking. Several important trials are underway or undergoing peer review that may provide...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e31822e27e3
更新日期:2011-09-01 00:00:00
abstract::One in 1000 pregnancies is complicated with cancer with the most common tumors being breast cancer, cervical cancer, thyroid, leukemia, lymphoma, and ovarian cancer. It is often assumed that cancer during pregnancy necessitates sacrificing the well-being of the fetus but in most cases appropriate treatment can be offe...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e318236e9f9
更新日期:2011-12-01 00:00:00
abstract::Ovarian neoplasms are common in women of all ages. As many as 10% of women in the United States will undergo surgical removal of an adnexal mass sometime in their lifetime. Gynecologic surgeons have pioneered laparoscopic surgery, developing what was originally a diagnostic tool into a safe and effective approach to m...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-200609000-00013
更新日期:2006-09-01 00:00:00
abstract::This chapter will review the current modalities available to the clinician to screen for premalignant and malignant cervical lesions, which cast a broad net. The majority who test positive are not destined to suffer from or die from cervical cancer. Many who undergo screening and are triaged are young and subsequently...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000026
更新日期:2014-06-01 00:00:00
abstract::Bacterial vaginitis is responsible for approximately 10 million office visits per year. This condition may disrupt marriages and cause psychologic stress that may be reflected in the individual's work and social life. Bacterial vaginitis also has been thought to lead to postpartum endometritis, pelvic cellulitis, pelv...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1991-09-01 00:00:00
abstract::Because it is known that antibiotics given to the mother may reach and affect the fetus, when prescribing antibiotics during pregnancy, one must take into consideration both maternal and fetal well-being. Therapy should be directed toward the maternal disease but also be safe for the fetus. The volume of distribution ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00003081-199312000-00012
更新日期:1993-12-01 00:00:00
abstract::The final decision to perform a certain method of hysterectomy customarily mirrors experience and level of comfort with a particular surgical approach in the context of the patient's condition and indication for surgery. Given the morbidity and recovery associated with a laparotomic incision, every effort should be ma...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.grf.0000211946.51712.42
更新日期:2006-12-01 00:00:00
abstract::Endometriosis is a chronic medical condition that affects around 6% to 10% of reproductive age women. Pelvic pain, dysmenorrhea, and infertility are the most common presenting symptoms. The disease is characterized by estrogen-dependent growth of the endometrial glands and stroma outside the endometrial cavity. The di...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000292
更新日期:2017-09-01 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::Rectovaginal fistulas and chronic anal sphincter lacerations are uncommon complications that are most often secondary to vaginal delivery, gynecologic surgery, and inflammatory bowel disease. In this chapter, we will review the pertinent anatomy, focusing on the 6 structures that should be considered during the repair...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3181cf7488
更新日期:2010-03-01 00:00:00
abstract::The avoidance of neonatal medical and neurologic sequelae resulting from a compromised pregnancy, labor, or delivery is the goal of all members of the health care team. Correct identification of those patients at risk for fetal distress prior to as well as during labor is most important as a major step in achieving th...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00003081-198528040-00010
更新日期:1985-12-01 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::During pregnancy, women have a 4- to 5-fold increased risk of thromboembolism. Candidates for anticoagulation in pregnancy include women with current thrombosis, a history of thrombosis, risk factors for postpartum thrombosis, and some women with thrombophilia and a history of poor pregnancy outcome. Although, there a...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e31825cfe7b
更新日期:2012-09-01 00:00:00
abstract::Prospective studies that begin during pregnancy and follow the mothers and children into adolescence have shown that maternal mental illness during the antenatal and postpartum period can have long-lasting negative consequences on the developing child. The findings from these prospective studies and a discussion of th...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3181b52930
更新日期:2009-09-01 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::Causative factors in cerebral palsy (CP) vary to some degree according to gestational age group and clinical CP subtype. Such catastrophes of birth as placental abruption, cord prolapse, and uterine rupture sharply heighten risk of CP. These conditions are fortunately uncommon, and are sometimes not survived; individu...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e318187087c
更新日期:2008-12-01 00:00:00
abstract::The American College of Obstetricians and Gynecologists and the American Association of Gynecologic Laparoscopists confirm advantages of conventional minimally invasive surgery over laparotomy for benign gynecological procedures; however, adoption remains low for the general gynecologist. A systematic search for gynec...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e31822b4998
更新日期:2011-09-01 00:00:00
abstract::The simple mnemonic ABCDE summarizes the five key principles of neonatal resuscitation: 1. Airway 2. Breathing 3. Circulation 4. Drugs 5. Evaluation of concurrent and causative problems and maintenance of a neutral thermal Environment. ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-198709000-00015
更新日期:1987-09-01 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::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::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