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 provide sperm in closer proximity to the egg has become popular, but intrauterine insemination also has a low success rate. We suggest that intrauterine insemination should be approached aggressively in cases of male factor infertility. The recipient should be stimulated to enhance egg production and closely monitored for ovulation. A semen specimen of not less than 1 X 10(6) motile sperm with antibiotics added should be placed in the uterus the day after ovulation. If no pregnancies occur within four cycles, alternate approaches should be considered. Therapeutic insemination by donor involves careful donor selection to avoid inheritance of malformations and familial diseases. Because of the possibilities of sexually transmitted diseases, careful and repeated screening should be conducted. A complete sexual history should be obtained, and donors should be excluded if they have had any homosexual contact since 1978, if they have been an intravenous drug user, if they come from a geographic area where the sex ratio of AIDS is close to 1:1, or if they have recently had multiple sexual partners. A permanent record preserving the confidentiality but allowing the tracing of genetic anomalies, even if not present at birth, should be kept.
journal_name
Obstet Gynecol Clin North Amjournal_title
Obstetrics and gynecology clinics of North Americaauthors
Alexander NJ,Ackerman Ssubject
Has Abstractpub_date
1987-12-01 00:00:00pages
905-29issue
4eissn
0889-8545issn
1558-0474journal_volume
14pub_type
杂志文章,评审abstract::Since its introduction more than 20 years ago, continuous electronic FHR monitoring has become the standard in most modern obstetric units. Practitioners well versed in FHR pattern interpretation do not question the value of fetal monitoring. Not only does this modality detect hypoxia early in its evolution, but also ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70073-5
更新日期:1999-06-01 00:00:00
abstract::The concept of Drug Treatment Court is relatively new and is an innovative response by local communities to deal with the escalation of criminal activity associated with substance abuse. The frequency of repeated offenses by drug users, the overcrowding of jail space, and a diminished sense of community well-being con...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章
doi:10.1016/s0889-8545(05)70368-5
更新日期:1998-03-01 00:00:00
abstract::Lichen planus is an inflammatory mucocutaneous condition with a myriad of clinical manifestations. There are 3 forms of lichen planus that effect the vulva: papulosquamous, hypertrophic, and erosive. Erosive lichen planus can progress to vulvar scaring, vaginal stenosis, and squamous cell carcinoma; these long-term se...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2017.04.004
更新日期:2017-09-01 00:00:00
abstract::Major advances in treatment for epithelial ovarian cancer have occurred over the last decade, giving hope to patients and families. Surgery remains a cornerstone of therapy. In early-stage epithelial ovarian cancer, a meticulous staging procedure should be performed to aid in determining patients who require appropria...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70234-5
更新日期:2001-12-01 00:00:00
abstract::The frequency of early term birth varies depending on patient, provider, and system characteristics. Early term deliveries are associated with suboptimal neonatal outcomes without evidence of maternal benefit. Some early term births are either unavoidable or absolutely indicated for maternal and/or fetal benefit in th...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2011.12.002
更新日期:2012-03-01 00:00:00
abstract::The discovery that insulin resistance has a key role in the pathophysiology of PCOS has led to a novel and promising form of therapy in the form of the insulin-sensitizing drugs. Although no extremely large trials using these drugs for this indication have been performed, more than 18 trials have specifically examined...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70191-1
更新日期:2001-03-01 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::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::This article summarizes and critically evaluates the scientific literature for the annual and lifetime medical care costs of obesity in women in the United States. Studies involving actual and projected costs are reviewed. Studies were favored that included large, nationally representative samples; accounted for the i...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2009.04.002
更新日期:2009-06-01 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::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::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::Contemporary management of HIV in pregnancy remains a moving target. With the development of newer antiretroviral agents with lower side-effect profiles and laboratory methods for detection and monitoring of HIV, considerable progress has been made. This review examines key concepts in the pathophysiology of HIV and p...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2014.08.003
更新日期:2014-12-01 00:00:00
abstract::It is now widely accepted that cancer of the breast is a systemic disease and that some patients will not be cured even with the most extensive local treatment. This acceptance has resulted in a more conservative approach and participation of the patient in treatment planning. A number of factors influence the definit...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1994-12-01 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::Despite persisting controversy over shoulder dystocia prediction, prevention, and injury causation, the authors find considerable evidence in recent research in the field to recommend additional guidelines beyond the current American College of Obstetricians and Gynecologists and Royal College of Obstetricians and Gyn...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2011.02.015
更新日期:2011-06-01 00:00:00
abstract::Abnormal uterine bleeding in the reproductive age, that is, dysfunctional uterine bleeding, is a very common symptom encountered in office gynecology. The judicious use of hysteroscopy to manage this medical entity adds a new dimension in handling this often perplexing problem. This article focuses mainly on abnormal ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章
doi:
更新日期:1988-03-01 00:00:00
abstract::Urinary incontinence and voiding dysfunction are common forms of pelvic floor dysfunction affecting women. The complex interactions between the nervous system and lower urinary tract anatomy allow for the coordinated functions of urine storage and evacuation. A thorough understanding of these components and their inte...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章
doi:10.1016/j.ogc.2009.08.012
更新日期:2009-09-01 00:00:00
abstract::Amniotic fluid embolism remains one of the most devastating conditions in obstetric practice with an incidence of approximately 1 in 40,000 deliveries and a reported mortality rate ranging from 20% to 60%. The pathophysiology involves an abnormal maternal response to fetal tissue exposure associated with breaches of t...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2016.07.001
更新日期:2016-12-01 00:00:00
abstract::PID is a common infection in reproductive-age women that presents an enormous public health and economic burden. It is responsible for much short- and long-term morbidity that may necessitate interventions subsequent to the original infection. Mild PID seems to be much more common than severe or "classic" PID, and the...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(03)00088-3
更新日期:2003-12-01 00:00:00
abstract::This article provides a focused review of the evidence for several complementary health approaches (ie, omega-3 fatty acids, folate, vitamin D, selenium, zinc, magnesium, B vitamins, physical activity, yoga) in the treatment of perinatal depression. There is evidence that some of these treatments may be reasonable to ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2018.04.002
更新日期:2018-09-01 00:00:00
abstract::To ensure the integrity of gynecologic surgical practices and patient safety, changes need to be made in the training of gynecologic surgeons, both in residency and continuing surgical education. Although society demands competency in the training and continuing education of airline pilots, little is done in compariso...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2006.01.005
更新日期:2006-06-01 00:00:00
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-bas...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2007.06.009
更新日期:2007-09-01 00:00:00
abstract::Post-traumatic stress disorder (PTSD) accompanies miscarriage, intrauterine fetal demise, and preterm birth. Levels of PTSD may be higher for women who experience acute, life-threatening events during labor and delivery. Severe maternal morbidities or near misses for maternal death disproportionately impact African Am...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2020.04.004
更新日期:2020-09-01 00:00:00
abstract::AIDS is the leading cause of death among women aged 25 to 34 years in New York City. Gynecologic care should be directed toward early identification and aggressive treatment of infectious and neoplastic processes that may take a more fulminant course in immunosuppressed women. Dealing with women's contraceptive needs ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-09-01 00:00:00
abstract::Growing attention is being paid to obstetric quality of care as patients are pressing the health care system to measure and improve quality. There is also an increasing recognition of persistent racial and ethnic disparities prevalent in obstetric outcomes. Yet few studies have linked obstetric quality of care with ra...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2016.10.002
更新日期:2017-03-01 00:00:00
abstract::The appropriate use of screening mammography can significantly decrease deaths from breast cancer. Physicians and patients must become more vigilant in using available diagnostic modalities if we are to improve upon the survival of patients with breast cancer. ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1987-09-01 00:00:00
abstract::Women who use tobacco, alcohol and drugs during pregnancy are at increased risk of maternal and fetal morbidity. Universal screening using empirically validated approaches can improve identification of substance-using pregnant women and facilitate comprehensive assessment of treatment needs. There is strong evidence f...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2014.03.001
更新日期:2014-06-01 00:00:00
abstract::An understanding of cesarean delivery for nonreassuring fetal heart rate tracing is important for several reasons. This article describes the prevalence of cesarean for nonreassuring fetal heart rate tracing and risk factors, indicates what type of fetal heart rate tracing abnormalities prompts cesarean delivery, reit...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2005.01.003
更新日期:2005-06-01 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