Abstract：
:There is approximately a 50% decrease in the fertility rate of unselected women attempting pregnancy at age 40 or older compared with younger women and a two to three fold increased rate of spontaneous abortion. Approximately 45% of older women achieve a term outcome, however. Proper counseling of the older patient should include a realistic view of the following risks: a 30% to 50% reduced pregnancy potential, effect of pregnancy on other maternal illnesses, an increased risk of pre-eclampsia, hypertension, and diabetes, and an increased risk of chromosomal abnormalities, abortion, and stillbirth. Knowing these risks, additional testing for ovarian reserve may help to identify women with favorable indices in whom IVF, other forms of assisted reproduction, or surgery to restore fertility are most appropriate. Women with decreased ovarian reserve could be offered oocyte donation as an alternative to surgical correction for infertility, because pregnancy rates are excellent when donor oocytes are transferred to the uteri of women older than the age of 40. In short, age alone should no longer be a deterrent in the treatment of infertility.
journal_name
Obstet Gynecol Clin North Amjournal_title
Obstetrics and gynecology clinics of North Americaauthors
Toner JP,Flood JTsubject
Has Abstractpub_date
1993-06-01 00:00:00pages
261-72issue
2eissn
0889-8545issn
1558-0474journal_volume
20pub_type
杂志文章,评审abstract：:The ultrasound assessment of the cervix has contributed to the understanding of the pathways to preterm birth. Transvaginal ultrasound measurement of the cervix provides an objective and noninvasive tool for the evaluation of cervical status. Despite widespread use of this procedure, standardization of measurement ind...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/S0889-8545(03)00120-7
更新日期：2004-03-01 00:00:00
abstract：:Reproductive health can be a reflection of overall health. It follows that abnormalities of reproductive milestones may be a manifestation of unhealthy aging. Since 1994, the Study of Women's Health Across the Nation (SWAN) has assessed how menopause and the process of that transition may affect future health. Themes ...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2011.05.001
更新日期：2011-09-01 00:00:00
abstract：:Addressing sexual health, screening, and counseling to prevent sequelae of risky sexual behavior are essential components of the adolescent visit to the gynecologist. Discussing sexuality and taking a sexual history may cause feelings of discomfort for the provider and adolescent patient alike. Taking the time to buil...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2009.01.001
更新日期：2009-03-01 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：:This article gives an overview of various clinical research designs such as randomization, cohort studies, and case-control studies. It also describes several biases that may occur in design studies and relevant statistics relating to surgeons using lasers. ...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章
doi：
更新日期：1991-09-01 00:00:00
abstract：:Congenital heart disease comprises most maternal cardiac diseases in pregnancy and is an important cause of maternal, fetal, and neonatal morbidity and mortality worldwide. Pregnancy is often considered a high-risk state for individuals with structural heart disease as a consequence of a limited ability to adapt to th...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2018.01.011
更新日期：2018-06-01 00:00:00
abstract：:The number of women diagnosed with breast cancer continues to increase, but mortality rates have substantially declined. Much of the credit for this decline has been attributed to early detection from mammographic screening. However, there are significant controversies about the effectiveness of all screening tools fo...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2013.05.001
更新日期：2013-09-01 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：:With the highest rates of unintended pregnancy and abortion in the developed world, the United States has plenty of room for improving the distribution of existing contraceptive options and an imperative for developing new methods. This article surveys new and future contraceptive methods. It does not contain a compre...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2007.01.006
更新日期：2007-03-01 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：: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：: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：:Abnormal uterine bleeding occurs secondary to a wide variety of functional and structural abnormalities. Although there is clearly a place for surgery, medical therapy has enormous potential for most women, especially those with dysfunctional uterine bleeding. To provide women with appropriate options for therapy, the...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8545(00)80021-2
更新日期：2000-06-01 00:00:00
abstract：:Since its initial approval by the US Food and Drug Administration (FDA) 20 years ago for the treatment of strabismus, hemifacial spasm, and blepharospasm in adults, botulinum toxin (BTX) has become one of the most frequently requested products in cosmetic rejuvenation around the world. After years of clinical success ...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ogc.2010.10.002
更新日期：2010-12-01 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 key to the differential diagnosis of these related conditions is knowledge of the natural history of each disease process; an awareness of how this usually translates in each instance into clinical and laboratory parameters; an appreciation for the wide spectrum of findings for each of these conditions, which are ...
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：: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：:Fecal incontinence (FI) has a significant social and economic impact on the patient and the community. In women, obstetric injury is commonly associated with the development of FI. Understanding FI is aided by a good knowledge of the pelvic floor anatomy and continence mechanisms. This same knowledge along with a good...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2008.03.005
更新日期：2008-06-01 00:00:00
abstract：:Recent guidelines from multiple organizations stress screening initiation no earlier than the age of 21 years and increased screening intervals for women aged 21 to 29 years. Primary prevention with human papillomavirus vaccination has the potential to significantly affect the development of high-grade cervical lesion...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ogc.2013.02.007
更新日期：2013-06-01 00:00:00
abstract：:Marihuana and tobacco smoking are two of the most commonly abused substances in pregnancy. Smoke from both agents contain a multitude of potentially active components, which make them difficult to study. Both have been associated with adverse effects in pregnancy in animal and human studies. Data on marihuana use duri...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8545(05)70358-2
更新日期：1998-03-01 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：: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 evid...
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：:Prevalence studies show that 1 in 5 women experience an episode of major depressive disorder during their lifetime. The peripartum period is a prime time for symptom exacerbation and relapse of depressive episodes. Health care providers, specifically those in obstetric care, should be aware of: (1) the frequency of de...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ogc.2009.10.006
更新日期：2009-12-01 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：:Advancements in cancer screening techniques have allowed for earlier detection of cancer at premalignant or early stages of disease. Several organizations have guidelines for screening strategies for breast, cervical, colon, and lung cancer. Ovarian cancer remains the deadliest cancer of the female reproductive tract;...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2019.04.007
更新日期：2019-09-01 00:00:00
abstract：:Inherited thrombophilias present an opportunity to review population-based screening paradigms. Inherited thrombophilias are a group of complex conditions, and women who carry mutations in implicated genes have an increased risk of adverse pregnancy outcomes as well as venous thromboembolism. That asymptomatic carrier...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ogc.2010.02.018
更新日期：2010-03-01 00:00:00
abstract：:The colposcope, basically binoculars on a stand, is used for the evaluation of the genital tract. Its optics, although complicated in theory, are easy to use in practice. Certain adjustments are necessary for stereoscopic viewing. Other adjustments adapt the optics for high viewing and either adapt the optics for high...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-03-01 00:00:00
abstract：:Access to the fetus as a true patient is a recent development in maternal-fetal medicine. We review the major invasive techniques currently available for establishing diagnoses and providing treatments to the fetus. These include fetoscopy, fetal blood sampling, fetal transfusions, and fetal shunts. Indications, techn...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-03-01 00:00:00
abstract：:Vaginal bleeding in early childhood, regardless of its duration and quantity, is always of clinical importance. This article discusses the examination of the child and adolescent and reviews the various causes of vaginal bleeding in these patient groups. ...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-06-01 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
