Abstract:
IMPORTANCE:Uterine leiomyomata or fibroids are the most common pelvic tumor experienced in women. A minimally invasive approach to hysterectomy has proven benefits of cosmesis, lower blood loss, less pain, decreased hospital stay, and faster recovery. The incidence of uterine morcellation, the process of making a uterine specimen smaller for purposes of removal via a minimally invasive approach, has increased for this reason. OBJECTIVE:We review the history, techniques, and direct and indirect risks described in the literature, recommendations for appropriate use, and how to counsel patients regarding this procedure. EVIDENCE ACQUISITION:A thorough search of PubMed for all current literature was performed. Techniques for morcellation were reviewed. We included studies that addressed the type and incidence of morcellator-associated risks including those addressing the incidence of leiomyosarcoma in patients with presumed uterine fibroids. RESULTS:We have summarized several techniques to aid the practitioner in performing morcellation procedures and the risks involved. We have summarized all of the current consensus statements regarding the recommendations for use of morcellation and the approach to proper counseling. CONCLUSIONS AND RELEVANCE:Morcellation is an effective method of specimen removal that can decrease the need for laparotomy in both benign and malignant conditions. Upon analysis of current data and consensus statements, when possible, morcellation should be performed within a contained environment to minimize any potential tumor spread in the event of an undiagnosed malignancy. Patients should be adequately counseled to make an informed decision regarding undergoing a morcellation procedure. Future methods for enclosed specimen extraction will hopefully change the future of morcellation.
journal_name
Obstet Gynecol Survjournal_title
Obstetrical & gynecological surveyauthors
Stine JE,Clarke-Pearson DL,Gehrig PAdoi
10.1097/OGX.0000000000000088subject
Has Abstractpub_date
2014-07-01 00:00:00pages
415-25issue
7eissn
0029-7828issn
1533-9866journal_volume
69pub_type
杂志文章abstract::The purpose of this review is to provide the obstetrician/gynecologist with a comprehensive review of the open Burch procedure including operative technique and modifications, complications, and success rates. A computerized search of English-language articles was performed on the MEDLINE database. Additional sources ...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-199901000-00024
更新日期:1999-01-01 00:00:00
abstract::In the past 25 years, human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) have become leading causes of illness and death in the United States. Over 1 million people are living with HIV/AIDS in this country, yet there continue to be many individuals who are unaware of their HIV status. Eff...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章
doi:10.1097/OGX.0b013e318181a4a7
更新日期:2008-09-01 00:00:00
abstract:IMPORTANCE:A range of energy sources are used in gynecologic laparoscopy. These energy sources include monopolar electrosurgery, bipolar electrosurgery (including "advanced bipolar" devices that incorporate tissue feedback monitoring), and various types of laser and ultrasonic technologies. Gynecologists using these to...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0000000000000130
更新日期:2014-12-01 00:00:00
abstract::Anesthesia and surgery interfere with normal thermoregulation, and nearly all patients will become hypothermic unless compensatory measures are used. Preoperative patient warming and intraoperative methods using forced air and warmed intravenous fluids are important methods for maintaining patient's core temperature d...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0b013e3182605ccd
更新日期:2012-07-01 00:00:00
abstract::Eclampsia, defined as the occurrence of seizures in pregnant women, usually in the setting of preeclampsia and in the absence of other neurologic disorders, occurs mainly before, during , or within 48 hours after delivery. When convulsions occur later postpartum, diagnosis is difficult and treatment disputed. We revie...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/01.ogx.0000219564.65999.0d
更新日期:2006-07-01 00:00:00
abstract::Fibromatosis is a benign, infiltrating, nonmetastasizing neoplasm which is rarely completely resected. Therefore, the incidence of recurrence is high. Fibromatosis is more common in females and is frequently diagnosed during pregnancy. Inasmuch as fibromatosis of the female pelvis appears to be a discrete entity, mana...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-198905000-00012
更新日期:1989-05-01 00:00:00
abstract::In the late 1980s and early 1990s, researchers hypothesized that aspirin could be used to prevent or delay the onset of preeclampsia. This hypothesis was tested in numerous trials which showed limited, but positive results. Subsequently, aspirin has been used in an attempt to improve pregnancy outcomes in women who ha...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0b013e31815e8731
更新日期:2008-01-01 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:Importance:Vaginal birth after previous cesarean birth (VBAC) is a reasonable option for many women with previous cesarean delivery. Objective:The aim of this study was to summarize evidence and compare recommendations from national guidelines regarding VBAC. Evidence Acquisition:A descriptive review of 3 national gu...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章
doi:10.1097/OGX.0000000000000596
更新日期:2018-09-01 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:UNLABELLED:Although stem cells have held the fascination of scientists for years, the attention of the general public has recently been captured by the derivation of human embryonic stem cells. In this review we describe the historical experiments leading up to the isolation of human embryonic stem cells and discuss re...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/01.OGX.0000055204.35328.F3
更新日期:2003-03-01 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::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::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::The various phenomena of toxemia of pregnancy both in primiparous and multiparous women may be explained by postulating a defect in the calcium transport mechanism, both in the smooth muscle of the uterus and vascular smooth muscle as well as a similar defect in platelets. The involvement of prostaglandin E has not be...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章
doi:10.1097/00006254-198005000-00028
更新日期:1980-05-01 00:00:00
abstract::Essential thrombocythemia is a myeloproliferative disorder characterized by a persistent increase in the platelet count. The disease occurs more often in late middle age, but reports confirm the possibility of earlier occurrence. When the disease affects women during pregnancy, an adverse pregnancy outcome is possible...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-199704000-00021
更新日期:1997-04-01 00:00:00
abstract::Understanding molecular biology can improve the clinical acumen of the practicing obstetrician/gynecologist. An area of basic research now becoming clinically relevant involves the G proteins and G protein-coupled receptors. Clinicians already manipulate G protein-coupled receptors in their daily practice. Examples in...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-199701000-00025
更新日期:1997-01-01 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::HIV infection has been associated with progressive deterioration of the immune system and the development of opportunistic infections and various malignancies. As more experience has been accumulated on the nature and complications of AIDS, the gynecological implications of neoplasia developing in the HIV-positive pat...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-199611000-00022
更新日期:1996-11-01 00:00:00
abstract::Fetal tumors lead to serious illness or even death in the fetal or neonatal period. Problems vary from severe hydrops to underdevelopment of fetal organs. In some instances a tumor may cause mechanical obstruction during the birth process. Polyhydramnios frequently develops. Adequate prenatal diagnosis is of utmost im...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-199010000-00001
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the risk factors, clinical and radiologic criteria for diagnosis, and management of this unusual complication of pregnancy. METHODS:A PubMed and Web of Science search was undertaken with no limitations on the number of years searched. RESULTS:There were 36 publications...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0000000000000247
更新日期:2015-11-01 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::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::For a majority of women, nausea and vomiting of pregnancy (NVP) is an unpleasant but normal feature of pregnancy. NVP has a largely unknown etiology, but it is widely agreed that physiological, psychological, genetic, and cultural components are contributing factors. The occurrence of NVP may be of benefit in pregnanc...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-200112000-00004
更新日期:2001-12-01 00:00:00
abstract::Our objective was to discuss the role of erythropoietin in fetal erythropoiesis and to review its clinical uses in perinatal medicine. All relevant articles compiled through a MEDLINE search (years 1986-1997) were reviewed. Erythropoietin is essential for fetal erythropoiesis and is produced in response to hypoxia and...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-199808000-00023
更新日期:1998-08-01 00:00:00
abstract::Hypertensive disorders of pregnancy remain a major cause of maternal and perinatal morbidity and mortality. Diagnosis and management of these disorders has relied on conventional blood pressure measurement, a technique fraught with error and uncertainty. Ambulatory blood pressure measurement is a promising new techniq...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-199810000-00022
更新日期:1998-10-01 00:00:00
abstract::Cesarean rates have been rising in the United States. Recently, there has been an upsurge of interest in "cesarean on maternal request" in the absence of any medical indication, a phenomenon that will further increase the cesarean rate. This trend may not be benign on a population basis, and reliable data are lacking....
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章
doi:10.1097/01.ogx.0000248826.44123.73
更新日期:2006-12-01 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::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::Human chorionic gonadotropin is a highly sensitive and specific tumor marker for gestational trophoblastic neoplasia that accurately reflects tumor volume and the clinical course of disease. In women with endodermal sinus tumors and embryonal carcinomas, alpha-fetoprotein usually is a reliable marker, and it accuratel...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-199009000-00002
更新日期:1990-09-01 00:00:00