Abstract:
Importance:Polycystic ovary syndrome (PCOS) is the most common endocrinopathy of reproductive-aged women. Women with PCOS are at increased risk of developing several metabolic and reproductive abnormalities, including metabolic syndrome. Underlying the combined metabolic and reproductive dysfunction is lipotoxicity, defined as the ectopic deposition of lipid in nonadipose tissue where it induces oxidative stress linked with insulin resistance and inflammation. Objective:To examine what metabolic components underlie insulin resistance in PCOS, how lipotoxicity through insulin resistance impairs metabolism and reproduction in these women, and why evidence-based, individualized management is essential for their care. Evidence Acquisition:PubMed search was performed using relevant terms to identify journal articles related to the subject. Relevant textbook chapters were also used. Results:Polycystic ovary syndrome by Rotterdam criteria represents a complex syndrome of heterogeneous expression with variable adverse metabolic and reproductive implications. Women with classic PCOS are often insulin resistant and at greatest risk of developing metabolic syndrome with preferential fat accumulation and weight gain. Moreover, PCOS women may also have an altered capacity to properly store fat, causing ectopic lipid accumulation in nonadipose tissue, including the ovaries, where it can perpetuate insulin resistance and inflammation and harm the oocyte. Conclusions and Relevance:A personalized approach to managing PCOS is essential to improve the health of all PCOS women through cost-effective prevention and/or treatment, to minimize the risk of pregnancy complications in those individuals wishing to conceive, and to optimize the long-term health of PCOS women and their offspring.
journal_name
Obstet Gynecol Survjournal_title
Obstetrical & gynecological surveyauthors
Brennan KM,Kroener LL,Chazenbalk GD,Dumesic DAdoi
10.1097/OGX.0000000000000661subject
Has Abstractpub_date
2019-04-01 00:00:00pages
223-231issue
4eissn
0029-7828issn
1533-9866journal_volume
74pub_type
杂志文章abstract::Endometriosis is a common gynecological disorder with varied symptomatology including chronic pelvic pain, dysmenorrhea, and infertility. The association of endometriosis and infertility has been recognized for years, although definite evidence of causality still eludes us. In this review, we will explore three genera...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-199706000-00021
更新日期:1997-06-01 00:00:00
abstract::Viral venereal infection caused by human Papillomavirus has reached epidemic state. The proper management of this infection in men is of great benefit, because it may possibly decrease the reservoir of disease in both sexes from which genital condylomata and associated lesions may arise. We report a selection of curre...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:
更新日期:1994-11-01 00:00:00
abstract::The last three decades have witnessed a dramatic increase in the use of assisted reproductive technology (ART) so that now, in developed countries, 1.7% to 4.0% of all children are born after ART. Although absolute risks appear small, data from prospective and retrospective studies indicate increased risks of adverse ...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0b013e31826a5d4a
更新日期:2012-09-01 00:00:00
abstract:UNLABELLED:Whether practice differences exist between the sexes is a question of clinical and educational significance. The obstetrician-gynecologist (ob-gyn) workforce has been shifting to majority women. An examination of sex differences in ob-gyn practice contributes to the discussion about how the changing workforc...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0b013e318286f0aa
更新日期:2013-03-01 00:00:00
abstract::Oxytocin, elevated estrogen-progesterone ratio, fetal corticosteroids, prostaglandins, catecholamines, and changes in uterine blood flow have all been implicated as triggers of labor. In approximately one-third of cases of threatened premature labor contractions stop spontaneously. Thus placebo-controlled randomized t...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章
doi:10.1097/00006254-197808000-00001
更新日期:1978-08-01 00:00:00
abstract::Obstetrician/gynecologists are taking on more primary care responsibilities and thus are expected to have a wider base of medical knowledge on a variety of women's health issues. The Collaborative Ambulatory Research Network (CARN) was created in 1990 to investigate issues pertinent to women's health and to the practi...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章
doi:10.1097/01.ogx.0000143775.07827.bb
更新日期:2004-11-01 00:00:00
abstract::Rapid progress has been made in the last 10 years regarding minimally invasive access to the human fallopian tube. Coaxial catheter systems are being used with hysteroscopy, fluoroscopy, ultrasonography, and tactile sensation to cannulate the fallopian tube transcervically with consistent success. Uterotubal obstructi...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-199311000-00026
更新日期:1993-11-01 00:00:00
abstract::The alleged association between induced abortion and breast cancer is one of the most controversial and important questions in women's health today. To help clinicians provide appropriate counseling, we reviewed both the primary data and review articles on this topic. We identified the studies and reviews by using Med...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-199811000-00024
更新日期:1998-11-01 00:00:00
abstract::This review first makes some general comments about prophylactic antibiotics: animal models for antimicrobial prophylaxis, bacterial flora of the female genital tract, timing and duration of prophylactic antibiotic administration, and drug of choice for prophylaxis. Subsequent sections cover the following: prophyla...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-198409000-00001
更新日期:1984-09-01 00:00:00
abstract:UNLABELLED:Vaginal discharge is highly variable in quality and quantity among different individuals, and even in the same individual during different periods of life. Vaginal discharge is most commonly caused by infection with sexually transmitted organisms or increased colonization by different facultative pathogenic ...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0b013e31822bdf31
更新日期:2011-06-01 00:00:00
abstract::Rectus sheath hematoma (RSH) is a rare, but important potential cause of acute upper abdominal pain in pregnancy. We report a patient with history of hemolysis, elevated liver enzymes, low platelets syndrome who presented with upper abdominal pain, hypotension, elevated hepatic transaminase levels, and a visibly enlar...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0b013e3181f87eaf
更新日期:2010-08-01 00:00:00
abstract::The physiology of oocyte development, maturation, and selection forms the basis for understanding ovarian follicle dynamics, reproductive function and ovulation induction. The number of ovarian follicles with which women are invested from birth and the rate of decline determine their reproductive lifespan. The process...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-200007000-00024
更新日期:2000-07-01 00:00:00
abstract::A patient with a hydatidiform mole complicated by eclampsia is presented. The findings from 57 other cases discovered in a review of the literature since 1866 are summarized to define the clinical characteristics of women experiencing eclampsia as a manifestation of their hydatidiform mole. Eclampsia complicating a mo...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:
更新日期:1988-04-01 00:00:00
abstract::About 45% of all pregnant women and 25% of all women postpartum suffer from pelvic girdle pain and/or low back pain (PLPP). It has been suggested that increased motion of the three joints in the pelvic ring is one of the causes of PLPP. However, in spite of the availability of high technology the relation between enla...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0b013e3181950f1b
更新日期:2009-03-01 00:00:00
abstract:Importance:Postpartum hemorrhage (PPH) remains a major cause of maternal mortality worldwide, occurring in both vaginal and cesarean deliveries. We have witnessed improvements in both prevention and treatment of PPH. Tranexamic acid (TXA) has been investigated as a potential adjunct therapy to uterotonics within this s...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0000000000000597
更新日期:2018-10-01 00:00:00
abstract:Importance:Real-time electrohysterography (EHG)-based technologies have recently become available for uterine monitoring during term labor. Therefore, obstetricians need to be familiar with the diagnostic value, advantages, and limitations of using EHG. Objective:The aims of this study were to determine the diagnostic...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0000000000000560
更新日期:2018-05-01 00:00:00
abstract::Puberty is a defining time of many adolescents' lives. It is a series of events that includes thelarche, pubarche, and menarche. Primary amenorrhea is the absence of menarche. There are numerous etiologies including outflow tract obstructions, gonadal dysgenesis, and anomalies of the hypothalamic axis. This review's a...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0000000000000111
更新日期:2014-10-01 00:00:00
abstract::This article reviews the literature that evaluates pruritic urticarial papules and plaques of pregnancy, herpes gestationis, and intrahepatic cholestasis of pregnancy and their impact on the fetus. Using MEDLINE years 1966 to 1999, a literature search was performed using the terms pregnancy, dermatology, pruritic urti...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-200107000-00022
更新日期:2001-07-01 00:00:00
abstract::Brain abscess is a potentially life-threatening complication that is only rarely associated with pregnancy. Although predispositions such as a preexisting infection, foreign body, or immunosuppression are often present, up to 30% of individuals could have no risk factors. Presenting symptoms are often nonspecific but ...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/01.ogx.0000115861.54002.8b
更新日期:2004-03-01 00:00:00
abstract:UNLABELLED:Thromboembolism in pregnancy is a major contributor to pregnancy morbidity and mortality with potentially serious adverse effects for both mother and fetus. The purposes of this article are to explore the impact of heritable and acquired thrombophilias on pregnancy and to determine the appropriateness of scr...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/01.ogx.0000165116.96026.4e
更新日期:2005-06-01 00:00:00
abstract:Importance:Uterine torsion is an uncommon but life-threatening clinical situation that requires a high index of suspicion for diagnosis. Objective:The aim of this study was to review literature and determine the etiology, presentation, diagnosis, and management of uterine torsion in the gravid and nongravid patients. ...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0000000000000767
更新日期:2020-04-01 00:00:00
abstract:UNLABELLED:Pregnancy is a hypercoagulable state that increases the risk of thromboembolic events. These risks may be further increased in the presence of an acquired or inherited thrombophilia. Thrombophilias have been associated with both maternal and fetal complications. The use of anticoagulants during pregnancy may...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/01.ogx.0000193878.57208.ad
更新日期:2006-01-01 00:00:00
abstract::All available English, French, and German literature published prior to January 1978 in which post-sterilization tubal pregnancy was reported was surveyed. From 1957 on, the Index Medicus or Current List of Medical Literature was surveyed for reported sterilization failures. Additional references cited in the litera...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-197907010-00029
更新日期:1979-07-01 00:00:00
abstract::This paper discusses the various methods used to diagnose uterine perforation caused by an IUD. Radiography, or plain film, has a limited use in the diagnosis of uterine perforation since its usefulness depends on the radiopacity of the particular IUD; if the IUD appears on film, plain film does not allow one to conc...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-198108000-00001
更新日期:1981-08-01 00:00:00
abstract::Arthropod-borne bacterial diseases affect more than 25,000 Americans every year and thousands more around the world. These infections present a diagnostic dilemma for clinicians because they mimic many other pathologic conditions and are often low on or absent from the differential diagnosis list. Diagnosis is particu...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0b013e3182a5ed46
更新日期:2013-09-01 00:00:00
abstract::Porencephaly may result from either a developmental anomaly or an antepartum intraparenchymal insult. Pre- and postnatal ultrasonography can demonstrate characteristic images of porencephaly. There is minimal literature on diagnosis and outcome of antenatally diagnosed porencephaly. There are two types of porencephaly...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-199509000-00023
更新日期:1995-09-01 00:00:00
abstract:Importance:Preconception care (PCC) has the potential to optimize pregnancy outcomes. However, awareness of PCC among the target population is generally limited, and the use of PCC remains low. Importance:The objective of this study was to review the literature on women's perceptions regarding barriers and facilitator...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0000000000000360
更新日期:2016-10-01 00:00:00
abstract::Quinolones and fluoroquinolones are highly efficient antibiotics. However, concerns regarding possible harmful effects have limited their use during pregnancy. Nevertheless, accumulating clinical data suggest that they may be safe during pregnancy. This review aimed to explore the mechanisms of action of the quinolone...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0000000000000122
更新日期:2014-11-01 00:00:00
abstract::Mature cystic teratomas (MCT), commonly called dermoid cysts, are the most common benign germ cell tumors of the ovary in women of reproductive age. Future fertility is of major concern among these women; therefore, the surgical management must focus on preserving ovarian tissue and minimizing adhesion formation. Pati...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-200012000-00004
更新日期:2000-12-01 00:00:00
abstract:Importance:Hereditary angioedema (HAE) is a rare but severe disease, with high risk of death, and attacks have been associated to high estrogen levels. Polycystic ovary syndrome (PCOS) is a common hyperandrogenic condition, which is frequently treated with combined oral contraceptives. Objective:The aim of this study ...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0000000000000457
更新日期:2017-07-01 00:00:00