Abstract:
PURPOSE OF THE REVIEW:The purpose of this review is to understand new modalities available to treat and manage type 1 and type 2 diabetes during pregnancy. RECENT FINDINGS:The use of new insulin analogs and oral agents, as well as new technologies to deliver insulin and monitor glucose during pregnancy remains controversial. This review will outline the advantages and disadvantages, as well as the safety profiles of these new medications and therapeutic options. SUMMARY:There are many effective treatments for diabetes during pregnancy. New insulin analogs seem to be safe to use in pregnancy and offer the potential for better glycemic control compared with older agents. Oral hypoglycemic medications also seem to be safe and may be an option for a select group of pregnant patients with type 2 diabetes. Insulin pumps and continuous glucose monitoring systems may be beneficial in certain patients, but adequate data are not yet available in terms of outcomes and cost-effectiveness to support widespread use. TARGET AUDIENCE:Obstetricians & Gynecologists, Family Physicians LEARNING OBJECTIVES:After participating in this CME activity, physicians should be better able to revise glycemic goals for pregnant patients with pregestational diabetes to be in line with our current understanding of glycemic profiles in normal pregnant women. Use new insulin analogs to treat pregnant women with abnormalities in glucose homeostasis and choose which patients will benefit from advanced technologies for diabetes management, such as insulin pumps and continuous glucose monitoring systems.
journal_name
Obstet Gynecol Survjournal_title
Obstetrical & gynecological surveyauthors
Lee-Parritz Adoi
10.1097/OGX.0b013e31824bb538subject
Has Abstractpub_date
2012-03-01 00:00:00pages
167-75issue
3eissn
0029-7828issn
1533-9866pii
0006254-201200300-00017journal_volume
67pub_type
杂志文章,评审abstract::Placental site trophoblastic tumor (PSTT) is an uncommon form of gestational trophoblastic disease (GTD) with variable spectrum of clinical behavior. PSTT can occur after a normal pregnancy, spontaneous abortion, termination of pregnancy, ectopic pregnancy or molar pregnancy. Surgery is the primary treatment. Chemothe...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/01.OGX.0000077466.40895.32
更新日期:2003-07-01 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: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::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:UNLABELLED:Among those facing infertility in the United States, underinsured and uninsured women are at the greatest disadvantage. Women who receive medical care under Medicaid are rarely covered for infertility testing; only 4 states will cover infertility treatment as an element of family planning and preconception c...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0b013e318286f780
更新日期:2013-04-01 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:UNLABELLED:Insulinomas are rare tumors with an incidence of approximately four cases per million person-years. Nineteen cases of insulinoma during pregnancy have been reported. Hypoglycemic symptoms usually appear during the first trimester. A 28-year-old primigravida was admitted at 6 weeks of gestation after referral...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-200204000-00022
更新日期:2002-04-01 00:00:00
abstract::The study was conducted to assess the effectiveness of interventions for the prevention or treatment of nutritional and infectious disorders during pregnancy on preterm birth rates. Cochrane systematic reviews or any other more up-to-date systematic review of antimicrobial and nutritional interventions were sought. El...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,meta分析
doi:10.1097/00006254-199809000-00025
更新日期:1998-09-01 00:00:00
abstract:Importance:We have performed a systematic search to summarize the role of statins for preventing and treating severe preeclampsia. Objective:The aim of this study was to examine whether pravastatin is a useful and safe alternative for treating preeclampsia during pregnancy. Evidence Acquisition:A systematic MEDLINE (...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0000000000000522
更新日期:2018-01-01 00:00:00
abstract:UNLABELLED:Urolithiasis complicates up to one in every 200 pregnancies; consequently, the practicing obstetrician should be aware of the symptoms of urolithiasis, the diagnostic procedures available for its diagnosis, and their associated risks. These include ultrasound, urography, and magnetic resonance imaging. Diagn...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/01.ogx.0000243773.05916.7a
更新日期:2006-11-01 00:00:00
abstract::The success of the Marshall-Marchetti-Krantz procedure is reviewed in 56 articles that were predominantly retrospective analyses. The overall success rate was 86.1 per cent in 2712 cases, with 92.1 per cent in primary and 84.5 per cent in repeat procedures. An overall complication rate of 21.1 per cent was calculated....
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-198812000-00003
更新日期:1988-12-01 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
abstract::Published reports, case studies, and articles from the English language regarding ultrasonographic detection of fetal anemia in red blood cell alloimmunization were obtained from a MEDLINE search from 1966 to November 1999 using the keywords Rh disease, hemolytic disease of the newborn, ultrasound, and Doppler flow st...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-200004000-00024
更新日期:2000-04-01 00:00:00
abstract:UNLABELLED:Intracytoplasmic sperm injection, a relatively new technique used at the time of in vitro fertilization to fertilize human oocytes, has provided couples with very severe male factor infertility the ability to conceive their own biologic children. Many men with severe oligospermia or azoospermia can now pass ...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章
doi:10.1097/00006254-200001000-00024
更新日期:2000-01-01 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:UNLABELLED:The endometrium is one of the most fascinating tissues in the human body. Its sole purpose is to enable implantation of an embryo during a very short window of opportunity in the menstrual cycle. When implantation does not take place, the endometrial cells are shed, enabling growth of a new endometrial layer...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0b013e318195136f
更新日期:2009-04-01 00:00:00
abstract::The goal of this manuscript is to review the contemporary evidence on issues pertinent to improving the safety profile of vaginal birth after cesarean (VBAC) attempts. Patients attempting VBAC have success rates of 60%-80%, and no reliable method of predicting VBAC failure for individual patients exists. The rate of u...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章
doi:10.1097/OGX.0b013e31817f1505
更新日期:2008-08-01 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::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:UNLABELLED:Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and is responsible for one third of all preterm births. PPROM will affect 120,000 women in the United States each year. It is associated with significant maternal, fetal, and neonatal morbidity and mortality resulting from infection, ...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/01.ogx.0000137610.33201.a4
更新日期:2004-09-01 00:00:00
abstract::Trichomonas vaginalis (TV) is the most common curable sexually transmitted infection worldwide. Annually, 7.4 million new infections are estimated in the United States, which is greater than combined new cases of Chlamydia, gonorrhea, and syphilis. Serious adverse reproductive health outcomes including pregnancy compl...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0b013e318279fb7d
更新日期:2013-01-01 00:00:00
abstract::The pregnant woman is susceptible to a variety of respiratory complications. When a pregnant patient presents with an abnormal chest x-ray or a pulmonary complaint, an understanding of the pathophysiology of pregnancy will guide the clinician in establishing a diagnosis. Pregnancy brings about many changes to a woman'...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-200201000-00022
更新日期:2002-01-01 00:00:00
abstract:UNLABELLED:Human reproduction provides unique opportunities for the transmission of infectious agents. Furthermore, the mother and her offspring have distinct susceptibilities to infection at each stage of reproduction, from conception and gestation to parturition and the neonatal period. The impact of pathogens on rep...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0b013e3181c9e7a1
更新日期:2010-01-01 00:00:00
abstract::Preterm delivery presents the main cause of neonatal morbidity and mortality worldwide. The rate of preterm delivery is 12% to 13% in the United States, of which 29% concerns preterm deliveries before 34 weeks of gestation. Basic parameter of prevention strategy is implementation of tocolytic therapy in cases of threa...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/OGX.0000000000000302
更新日期:2016-04-01 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::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:UNLABELLED:Our objective was to assess current knowledge regarding PAPNET (Neuromedical Systems, Inc.) automated cervical cytology screening methods and to assess the performance of this automated system in comparison with manual screening. To this goal, studies published in the English language regarding the PAPNET sy...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,meta分析
doi:10.1097/00006254-199904000-00022
更新日期:1999-04-01 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::The use of blood products has come under closer scrutiny over the past decade because of the autoimmune deficiency syndrome. Newer technology has led to the use of component therapy in most situations. The use of fresh-frozen plasma has been overstated in the older literature, and fresh-frozen plasma should be used in...
journal_title:Obstetrical & gynecological survey
pub_type: 杂志文章,评审
doi:10.1097/00006254-199105000-00015
更新日期:1991-05-01 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