Abstract:
:Sepsis is a leading cause of death in pregnancy and results in significant perinatal mortality. These deaths occur despite the younger age of pregnant patients, the low rate of comorbid conditions and the potential for effective interventions that should result in rapid resolution of illness. To date, no "evidence-based" recommendations are specific to the pregnant patient who is critically ill or septic. Optimal care for the septic patient requires a multidisciplinary team with expertise in obstetrics, maternal-fetal medicine, critical care, infectious disease, anesthesia, and pharmacy. Coordination of care and good communication amongst team members is essential. Incorporation of early goal directed therapy for suspected sepsis into obstetric practice is needed to optimize maternal and neonatal outcomes.
journal_name
Obstet Gynecol Clin North Amjournal_title
Obstetrics and gynecology clinics of North Americaauthors
Guinn DA,Abel DE,Tomlinson MWdoi
10.1016/j.ogc.2007.06.009subject
Has Abstractpub_date
2007-09-01 00:00:00pages
459-79, xiissue
3eissn
0889-8545issn
1558-0474pii
S0889-8545(07)00060-5journal_volume
34pub_type
杂志文章,评审abstract::The incidence of malignant melanoma is rising, and this may be the most frequently encountered malignancy during pregnancy. Because effective treatment of advanced or metastatic disease remains elusive, the key to adequate therapy is surveillance for early disease with prompt diagnostic work-up and treatment. Review o...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70014-0
更新日期:1998-06-01 00:00:00
abstract::Advancements in cancer screening techniques have allowed for earlier detection of cancer at premalignant or early stages of disease. Several organizations have guidelines for screening strategies for breast, cervical, colon, and lung cancer. Ovarian cancer remains the deadliest cancer of the female reproductive tract;...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2019.04.007
更新日期:2019-09-01 00:00:00
abstract::Women with unexplained recurrent pregnancy loss (RPL) represent a highly heterogeneous group of patients. Past studies have investigated systemic endocrine and immunologic mechanisms as potential causes for pregnancy loss in unexplained RPL, while exciting new work has focused on spermatozoal, embryonic, and endometri...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2013.10.008
更新日期:2014-03-01 00:00:00
abstract::Chorionic villus sampling (CVS) has been used a successful and safe first-trimester prenatal diagnostic technique for over 12 years. Developed to avoid the medical and psychological complications of later prenatal diagnosis by amniocentesis, CVS rapidly has become a primary tool for the diagnosis of fetal cytogenetic,...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70291-6
更新日期:1997-03-01 00:00:00
abstract::The role of cytology in cervical cancer screening is rapidly evolving. Widespread implementation of The Bethesda System with its accompanying atlas has provided uniform terminology and criteria for reporting cervical pathology. The development of new methods for preparing cytologic specimens as well as many other scre...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1996-09-01 00:00:00
abstract::Congenital heart disease comprises most maternal cardiac diseases in pregnancy and is an important cause of maternal, fetal, and neonatal morbidity and mortality worldwide. Pregnancy is often considered a high-risk state for individuals with structural heart disease as a consequence of a limited ability to adapt to th...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2018.01.011
更新日期:2018-06-01 00:00:00
abstract::Proper use of postmenopausal hormone replacement has been the subject of debate for decades. Prevailing medical opinion has swung between enthusiastic endorsement and extreme caution. The wave of optimism over estrogen's beneficial effects on menopausal symptoms and skeletal health was temporarily set back by the evid...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-12-01 00:00:00
abstract::Vaginal bleeding in early childhood, regardless of its duration and quantity, is always of clinical importance. This article discusses the examination of the child and adolescent and reviews the various causes of vaginal bleeding in these patient groups. ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-06-01 00:00:00
abstract::Fecal incontinence (FI) has a significant social and economic impact on the patient and the community. In women, obstetric injury is commonly associated with the development of FI. Understanding FI is aided by a good knowledge of the pelvic floor anatomy and continence mechanisms. This same knowledge along with a good...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2008.03.005
更新日期:2008-06-01 00:00:00
abstract::The use of laparoscopic ultrasound probes has been shown to improve outcomes and facilitate surgery for hepatobiliary and pancreatic cancers. It is a useful, inexpensive, and safe imaging technique that should also supplement operative laparoscopy for gynecologic indications. These techniques are new, and their use in...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70058-9
更新日期:1999-03-01 00:00:00
abstract::This article gives an overview of various clinical research designs such as randomization, cohort studies, and case-control studies. It also describes several biases that may occur in design studies and relevant statistics relating to surgeons using lasers. ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章
doi:
更新日期:1991-09-01 00:00:00
abstract::Reproductive health can be a reflection of overall health. It follows that abnormalities of reproductive milestones may be a manifestation of unhealthy aging. Since 1994, the Study of Women's Health Across the Nation (SWAN) has assessed how menopause and the process of that transition may affect future health. Themes ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2011.05.001
更新日期:2011-09-01 00:00:00
abstract::The number of women diagnosed with breast cancer continues to increase, but mortality rates have substantially declined. Much of the credit for this decline has been attributed to early detection from mammographic screening. However, there are significant controversies about the effectiveness of all screening tools fo...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2013.05.001
更新日期:2013-09-01 00:00:00
abstract::The hypothalamic-pituitary-adrenal axis is central to mammalian reproductive function, including conception, pregnancy maintenance, parturition, and breastfeeding. Pregnancy is associated with substantial physiologic changes within this endocrine axis to meet the demands of pregnancy, which include support of the fetu...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2004.08.003
更新日期:2004-12-01 00:00:00
abstract::The introduction of transabdominal fiberoptic thin-gauge visualization of the embryo or fetus in the first trimester allows an earlier diagnosis of congenital anomalies currently beyond the resolution of ultrasound. In addition, it has the true potential of providing access to the fetal circulation at an early age, an...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1993-09-01 00:00:00
abstract::Urinary tract abnormalities are fairly common in the perinatal period. Ultrasonography is an effective diagnostic tool for identifying fetal urinary tract anomalies and can be helpful in establishing prognosis and guiding treatment decisions. The sonographer is encouraged to characterize and localize the fetal urinary...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70026-7
更新日期:1998-09-01 00:00:00
abstract::The placenta can serve as a valuable source of information about maternal and fetal conditions during the pregnancy; however, the abilities to perform a preliminary gross examination and interpret a placental pathology report are variable among obstetricians. This article discusses the indications for placental submis...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2019.10.007
更新日期:2020-03-01 00:00:00
abstract::There is approximately a 50% decrease in the fertility rate of unselected women attempting pregnancy at age 40 or older compared with younger women and a two to three fold increased rate of spontaneous abortion. Approximately 45% of older women achieve a term outcome, however. Proper counseling of the older patient sh...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1993-06-01 00:00:00
abstract::A specific technique of advanced operative laparoscopy, known as videolaseroscopy, using the CO2 laser and videomonitor, is described. Operating room setup, anesthesia considerations, and specific applications to pelvic disease are elaborated. ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-09-01 00:00:00
abstract::The frequency and variety of solid organ transplantation in reproductive-age women increases each year. Pregnancy is no longer contraindicated in transplant recipients provided that their graft is functioning well and they are in good general health. Physicians who care for pregnant transplant recipients should be awa...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2004.03.005
更新日期:2004-06-01 00:00:00
abstract::Hematologic disorders in pregnancy are relatively common and encompass a wide spectrum of clinical conditions. The treatment and obstetric management of the majority of these diseases are well established, although controversy exists in areas such as sickle cell disease and ITP. Once the diagnosis of a specific disord...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1992-12-01 00:00:00
abstract::The ever-increasing value of diagnostic and operative hysteroscopy for patients with AUB serves as an appropriate, although belated, tribute to Pantaleoni who in 1869 dared to look inside a woman's uterus. Future generations of women and their physicians will be indebted to this physician-pioneer. Contemporary instrum...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70068-1
更新日期:1999-03-01 00:00:00
abstract::Breast symptoms are appropriately evaluated by a breast-oriented history and by the diagnostic triad of clinical breast examination, FNA, and mammography. In the case of a palpable dominant mass, concordance of the diagnostic triad yields a reliable clinical diagnosis. If there is not concordance, or if there is any d...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1994-09-01 00:00:00
abstract::Recognizing the enormous impact that quality breast screening mammography can have on reducing breast cancer deaths, we need to determine when women's and physician's perceived restrictions for mammography examination impede the progress of its use for early cancer detection. A uniform system should emphasize valid co...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-12-01 00:00:00
abstract::Breast enhancement through augmentation improves not only the woman's physical appearance but also contributes to her psychologic well-being. With the current emphasis placed on women's breasts in the media, it is not surprising that small-breasted women feel inadequate. Recent US Federal Drug Administration approval ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(03)00055-x
更新日期:2002-03-01 00:00:00
abstract::Vaginal bleeding is the most common cause of emergency care in the first trimester of pregnancy and accounts for the majority of premenopausal bleeding cases. Ultrasound evaluation combined with a quantitative beta human chorionic gonadotropin test is an established diagnostic tool to assess these patients. Spontaneou...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2011.02.006
更新日期:2011-03-01 00:00:00
abstract::Electrosurgery is used on a daily basis in the operating room, but it remains poorly understood by those using it. In addition, the physics of electrosurgery are far more complicated than those of laser. Common belief notwithstanding, electrosurgery has an enormous capacity for patient injury if used incorrectly, even...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2010.05.007
更新日期:2010-09-01 00:00:00
abstract::As many as 50% of spontaneous preterm births are infection-associated. Intrauterine infection leads to a maternal and fetal inflammatory cascade, which produces uterine contractions and may also result in long-term adverse outcomes, such as cerebral palsy. This article addresses the prevalence, microbiology, and manag...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2005.03.001
更新日期:2005-09-01 00:00:00
abstract::Early diagnosis, treatment, and appropriate prophylaxis may prevent serious maternal sequelae of thromboembolism. Objective techniques for diagnosis should be used aggressively, using noninvasive methods such as Doppler or IPG when possible for DVT. 125I-fibrinogen should be avoided. The possible consequences of failu...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-06-01 00:00:00
abstract::Except in special circumstances, therapeutic insemination with a husband's sample has a low success rate. Couples in whom oligozoospermia has been identified as the principal cause of infertility do not benefit from therapeutic insemination by husband. Because of this low success rate, intrauterine insemination to pro...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1987-12-01 00:00:00