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 evidence that linked estrogen to endometrial cancer. Once studies showed that progestogen cotherapy could protect against this adverse effect, physicians were again encouraged to prescribe hormone replacement. Since 1980, increasing epidemiologic and experimental evidence has suggested a hitherto unappreciated and immense CHD health benefit from use of postmenopausal estrogen therapy. Although addition of progestogen may offset the cardiovascular benefits of estrogen slightly, its use is reasonable and practical. No woman need be subjected to unopposed estrogen's carcinogenic effects on her endometrium. Based on available evidence, hormone replacement therapy, appropriately administered, is both safe and beneficial. Unfortunately, there is no single way to prescribe it. The treating physician must make a series of best judgments. Practically speaking, this entails, in each case, finding the form of therapy that is acceptable to the patient and that provides the greatest health benefits with the least likelihood of adverse affects. Our prescribing habits have evolved in the last 15 to 20 years. We have better discrimination of the woman most likely to benefit; improved therapy through use of newer formulations, dosages, routes, and schedules; and more appropriate implementation of monitoring procedures. Although questions remain, we should not let our imperfect knowledge dissuade us from more widespread prescribing of hormone replacement therapy.
journal_name
Obstet Gynecol Clin North Amjournal_title
Obstetrics and gynecology clinics of North Americaauthors
Ettinger Bsubject
Has Abstractpub_date
1990-12-01 00:00:00pages
741-57issue
4eissn
0889-8545issn
1558-0474journal_volume
17pub_type
杂志文章,评审abstract：:Despite the problems associated with coitus-dependent methods of contraception, barrier methods have an important role. The fact that they work as contraceptives without systemic effects makes them particularly appropriate for women with medical conditions that prevent the use of hormonal contraception. In addition, c...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8545(05)70174-1
更新日期：2000-12-01 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 clinical integration of prenatal genetic technologies raises a series of important medical and ethical considerations for patients, families, health care providers, health care systems, and society. It is critical to recognize, understand, and address these issues in conjunction with the continued development of n...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2017.10.006
更新日期：2018-03-01 00:00:00
abstract：:Voiding dysfunction in women results from either a failure of the bladder to contract appropriately or a failure of the urethra or bladder neck to relax during attempts at micturition. Complaints of urinary frequency and urgency most often accompany voiding dysfunction. Associated symptoms, which are not always presen...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-12-01 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：:As the health care system transforms to accommodate an increased need for primary care services and more patients, new models of health care delivery are needed that can provide quality health care services efficiently. An integrated collaborative practice of certified nurse-midwives, obstetrician-gynecologists, and p...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2012.05.009
更新日期：2012-09-01 00:00:00
abstract：:Obesity is increasing at epidemic rates in all women, but especially in minority women and children. Factors that contribute to this include changes in caloric intake and expenditure (calories), cost and ease of acquiring food along with pressures from the marketplace and media (commerce) and the community response to...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2009.04.003
更新日期：2009-06-01 00:00:00
abstract：:Tubal factor infertility accounts for a large portion of female factor infertility. The most prevalent cause of tubal factor infertility is pelvic inflammatory disease and acute salpingitis. The diagnosis of tubal occlusion can be established by a combination of clinical suspicion based on patient history and diagnost...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2012.09.006
更新日期：2012-12-01 00:00:00
abstract：:The use of fetal blood sampling has been advocated widely to improve the specificity of fetal heart rate monitoring, but it remains a clinically unpopular procedure. This article considers its physiologic rationale and evidence base. It includes descriptions of the technique with suggestions for improved clinical inte...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8545(05)70104-2
更新日期：1999-12-01 00:00:00
abstract：:It is an unfortunate fact that all pregnancies do not end with healthy babies and healthy mothers. Families who have experienced an adverse pregnancy outcome require accurate information about the risk of recurrence to plan future childbearing. This article examines the recurrence risk of four complications of pregnan...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2008.04.003
更新日期：2008-09-01 00:00:00
abstract：:All the existing data show that combination estrogen/progestogen therapy is mandatory if any replacement therapy is to be given to the woman over age 40. Sufficient evidence has indicated that estrogen alone is inadequate; progestogen must be given to prevent endometrial hyperplasia, lower the risk of breast cancer, a...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-03-01 00:00:00
abstract：:Canavan disease is a severe leukodystrophy more common among Ashkenazi Jews. The enzyme defect, apartoacylase, has been identified, and the gene cloned. Only two mutations account for over 98% of all Jewish alleles with Canavan disease. The carrier frequency among healthy Jews is 1:37-58. Carrier detection and prenata...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8545(01)00003-1
更新日期：2002-06-01 00:00:00
abstract：:Hormone replacement therapy should be discussed with every postmenopausal woman and should be the first therapy offered to treat hot flashes owing to its high efficacy and other beneficial properties. Women who are ineligible for or uncomfortable with estrogen replacement therapy and who suffer from hot flashes that i...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-06-01 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：:This article focuses on the clinical evaluation and management of women who have thrombophilia-related placental vascular complications, including fetal loss, pre-eclampsia, intrauterine fetal growth restriction, and placental abruption. All are major causes of maternal and fetal adverse outcomes. ...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2006.05.010
更新日期：2006-09-01 00:00:00
abstract：:The influence of physiologic, psychologic, and cultural influences on human sexuality is reviewed. These factors are considered in the exploration of how adolescents express their sexuality and the consequences of that expression. ...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-03-01 00:00:00
abstract：:Hepatitis B virus is an important sexually transmitted organism that causes not only disease in sexual partners but important perinatal illness as well. The obstetrician-gynecologist must be aware of the epidemiology and the pathophysiology of HBV infections, as well as strategies for treatment and prevention. Physici...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-09-01 00:00:00
abstract：:Obesity has increased dramatically in the United States over the last several decades, with approximately 40% of pregnant women now considered overweight or obese. Obesity has been shown to be associated with numerous poor pregnancy outcomes, including increased rates of preeclampsia, gestational diabetes, fetal macro...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2015.01.008
更新日期：2015-06-01 00:00:00
abstract：:Hysteroscopy and hysterography approach the uterine cavity in different ways and each has advantages and limitations. Hysteroscopy is more accurate for the diagnosis of abnormalities that project into the uterine cavity such as polyps, submucous myomas, endometrial hyperplasia, and endometrial adenocarcinoma. Contrast...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-09-01 00:00:00
abstract：:This report summarizes the current literature on abdominal, laparoscopic, and transvaginal mesh for the treatment of pelvic organ prolapse. This article reviews objective and subjective cure rates as well as complications associated with synthetic mesh use for pelvic organ prolapse repair. The focus is on the latest l...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2015.10.004
更新日期：2016-03-01 00:00:00
abstract：:Female pelvic medicine and reconstructive surgery (FPMRS) is a rapidly expanding surgical specialty that focuses on the evaluation and treatment of pelvic floor disorders in women. Evaluation and treatment of several pelvic floor disorders can be accomplished with office-based procedures, yielding significant advantag...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2013.09.003
更新日期：2013-12-01 00:00:00
abstract：:Management strategies for overweight and obese women with polycystic ovarian syndrome (PCOS) who desire fertility should include weight loss. Even a small reduction in body weight can improve ovulatory function and pregnancy rate and reduce adverse obstetric outcomes. New data suggest that letrozole should be consider...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2014.09.003
更新日期：2015-03-01 00:00:00
abstract：:The fluorinated quinolones are synthetic derivatives of nalidixic acid. They are well absorbed when administered orally and have an extended duration of action. They are of primary value in treating gonorrhea and complicated urinary tract infections in nonpregnant women. ...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
abstract：:Sleep and metabolism are essential components of health. Metabolic health depends largely on individual's lifestyle. Disturbances in sleep health, such as changes in sleep patterns that are associated with menopause/reproductive aging and chronologic aging, may have metabolic health consequences. Sleep restriction and...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2018.07.008
更新日期：2018-12-01 00:00:00
abstract：:If the contraindications to hysteroscopy are observed, complications should be small. The risks of fluid overload, especially in operative cases, is the most common critical problem, so that accurate recording of fluid use and collection are essential. The inexperienced, unsupervised surgeon is most likely to encounte...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-09-01 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：:An update on the current epidemiology and a review of the risk factors of cervical and endometrial cancers are discussed. Cervical cancer prevention with a focus on human papillomavirus vaccination and cervical cancer screening is reviewed, emphasizing the new focus of less frequent intervention in an effort to mainta...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2017.02.009
更新日期：2017-06-01 00:00:00
abstract：:Puerperal inversion of the uterus is an unusual and potentially life-threatening event occurring in the third stage of labor, but when managed promptly and aggressively inversion can result in minimal maternal morbidity and mortality. Once the diagnosis of inversion is made, measures should be undertaken to manage and...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 历史文章,杂志文章,评审
doi：
更新日期：1995-06-01 00:00:00
abstract：:Seizures and intracranial hemorrhage are possible medical diseases that any obstetrician may encounter. This article reviews the cause, treatment, and medical management in pregnancy for seizures and intracranial hemorrhage, and how the two can overlap into preeclampsia or eclampsia. This article also highlights some ...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2012.11.009
更新日期：2013-03-01 00:00:00
