Abstract:
:Norgestimate (NGM) is one of a class of newer, more selective progestins. The authors describe its structure and biologic activity, contraceptive effectiveness, cycle control, metabolic effects, carbohydrate metabolism, coagulation factors, and clinical side effects. NGM-containing oral contraceptives (OC), either as a monophasic or triphasic formulation, perform as well as pills using older progestins. Androgenic side effects, however, are somewhat lower with NGM, but not enough to be of in clinical importance. Clinicians who believe in the potential for clinical consequences associated with changes in lipid and carbohydrate metabolism should make NGM their first choice OC progestin. Although no study has ever demonstrated a long-term superiority of one OC over another with respect to atherogenesis, there is some evidence that changes in HDL and LDL cholesterol, especially over a 20-year period secondary to pill use, may play a role in accelerating or retarding atherosclerosis. There are also multiple influences upon cardiovascular risk, including direct effects of estrogens upon the endothelium. The prudent healthcare professional should therefore choose, with the patient, the preparation which has the most favorable impact upon lipid metabolism.
journal_name
Clin Obstet Gynecoljournal_title
Clinical obstetrics and gynecologyauthors
Corson SLdoi
10.1097/00003081-199538040-00019keywords:
["Biology","Blood Coagulation Effects","Carbohydrate Metabolic Effects","Contraception","Contraceptive Agents","Contraceptive Agents, Female","Contraceptive Agents, Progestin","Contraceptive Effectiveness","Family Planning","Hematological Effects","Hemic System","Literature Review","Metabolic Effects","Norgestimate","Physiology"]subject
Has Abstractpub_date
1995-12-01 00:00:00pages
841-8issue
4eissn
0009-9201issn
1532-5520journal_volume
38pub_type
杂志文章,评审abstract::Patient safety is a significant concern for healthcare providers. Involving physicians in clinical quality activities in obstetrics and gynecology can be difficult for many reasons including time demands, lack of knowledge of process improvement activities, or change fatigue due to failure of adequate implementation o...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3181ec1b29
更新日期:2010-09-01 00:00:00
abstract::The role of Interventional radiologic procedures for the management of suspected placenta accreta spectrum (PAS) has evolved considerably over last 3 decades. In this article, the authors describe the various techniques of vascular occlusion for the management of PAS and provide a brief review of the literature examin...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000401
更新日期:2018-12-01 00:00:00
abstract::Preterm premature rupture of the membranes remains difficult to predict accurately. The majority of those suffering preterm premature rupture of the membrane lack risk factors that might lead to preventative treatments. Its management is centered on an evaluation of the risks and benefits of attempted pregnancy prolon...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e318217d4d3
更新日期:2011-06-01 00:00:00
abstract::Uterine leiomyomas pose a significant health issue to reproductive-age women. Many women desire uterine conservation, and previously safe and efficacious therapies have been limited. Magnetic resonance-guided focused ultrasound surgery is a new noninvasive therapy that has been proven to be both safe and efficacious i...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e318161e91f
更新日期:2008-03-01 00:00:00
abstract::The adnexal mass in a postmenopausal patient poses an important diagnostic and management dilemma for primary care providers and gynecologists. Postmenopausal women are at a significantly increased risk of gynecologic malignancy; yet even in this population the majority of adnexal masses are benign. Evaluation and man...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000085
更新日期:2015-03-01 00:00:00
abstract::In summary, ultrasound plays an important role in the evaluation of the postterm pregnancy, and its use should be considered in the following situations: 1) estimation of fetal weight in the potentially macrosomic infant before vaginal delivery is attempted; 2) frequent evaluation for oligohydramnios using the amnioti...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-198906000-00008
更新日期:1989-06-01 00:00:00
abstract::Uterine rupture is an important cause of obstetrical hemorrhage associated with morbidity for mother and fetus. Risk factors should be discussed in the counseling process. Intrapartum findings including maternal condition, fetal heart rate monitoring, and uterine activity may prove helpful in making the diagnosis of a...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3181cc4538
更新日期:2010-03-01 00:00:00
abstract::The use of mesh and graft in pelvic reconstructive surgery has increased over the last decade. As the use of these products increased, the frequency and complexity of mesh-related complications has also increased. Management of complications resulting from mesh placement requires a thoughtful, systematic approach. Alt...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3182856371
更新日期:2013-06-01 00:00:00
abstract::Technologic advances and clinical research have been extending the scope of Doppler sonography and have resulted in the emergence of new diagnostic tools that show significant promise in clinical applications. This article aims to review some of these developments that are relevant for obstetrical practice. One of the...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3181fbad5e
更新日期:2010-12-01 00:00:00
abstract::Chronic pelvic is a multifaceted condition that often has both peripheral and central generators of pain. Despite its high prevalence, the evaluation and management of a pelvic pain patient often present many challenges to the practicing gynecologist. As with many other chronic pain conditions, pain severity does not ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000486
更新日期:2019-12-01 00:00:00
abstract::Prospective studies that begin during pregnancy and follow the mothers and children into adolescence have shown that maternal mental illness during the antenatal and postpartum period can have long-lasting negative consequences on the developing child. The findings from these prospective studies and a discussion of th...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3181b52930
更新日期:2009-09-01 00:00:00
abstract::The recent published literature dealing with urinary tract calculi during pregnancy has been summarized. Our own experience with 17 patients, (0.08% of the deliveries) in a recent 12-year interval has been described. Emphasis must be placed on the safety and limitations of renal ultrasonography. Excretory urography sh...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-06-01 00:00:00
abstract::Genitourinary syndrome of menopause (GSM) describes a collection of exam findings and bothersome symptoms associated with estrogen deficiency involving changes to the labia, introitus, clitoris, vagina, urethra, and bladder. Vulvovaginal atrophy is a component of GSM. GSM is a highly prevalent medical condition with a...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000380
更新日期:2018-09-01 00:00:00
abstract::This chapter will review the current modalities available to the clinician to screen for premalignant and malignant cervical lesions, which cast a broad net. The majority who test positive are not destined to suffer from or die from cervical cancer. Many who undergo screening and are triaged are young and subsequently...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000026
更新日期:2014-06-01 00:00:00
abstract::Fetal glucocorticoid overexposure is a key potential mechanism underlying the link between low birthweight and later life diseases. The fetus is protected from high maternal glucocorticoid levels by the placental enzyme 11β-hydroxysteroid dehydrogenase type 2. Antenatal glucocorticoid administration to women at threat...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e31829939f7
更新日期:2013-09-01 00:00:00
abstract::Higher-order multiple gestations have increased since the advent of advanced reproductive technologies. These pregnancies present unique risks to both mothers and fetuses. It is imperative that early diagnosis of chronicity be determined and that proper counseling is performed, so patients understand the risks, evalua...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000121
更新日期:2015-09-01 00:00:00
abstract::There has been a steady decline in breast cancer mortality that has led to a significant increase in the number of patients surviving breast cancer. We will review in this manuscript the evidence and guidelines for posttreatment surveillance of patients with breast cancer as well as the management options for patients...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000243
更新日期:2016-12-01 00:00:00
abstract::This article reviews the sonographic manifestations of fetal infection and the role of ultrasound in the evaluation of the fetus at risk for congenital infection. Several ultrasound findings have been associated with in utero fetal infections. For the patient with a known or suspected fetal infection, sonographic iden...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000342
更新日期:2018-03-01 00:00:00
abstract::This article will review the basic principles of risk management, the role of the risk manager, and the importance of risk management in the patient safety movement as it pertains to obstetrics and gynecology. Several tools that are used by risk managers including risk assessments and root cause analyses will be used ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000473
更新日期:2019-09-01 00:00:00
abstract::The drug abusing patient can provide a management dilemma for health care providers including nurses, obstetrician, anesthesiologist, and pediatrician. Certain illicit drugs may mimic other diseases of pregnancy and result in inappropriate treatment for the mother and child. Pain management may be challenging in such ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e318282738b
更新日期:2013-03-01 00:00:00
abstract::There are many problems in the diagnosis and treatment of vaginitis. Often, the patient is not examined (telephone treatment) or examined improperly with lack of attention to the wet prep. In patients with recurrent vaginitis, it should not be assumed that the current infection is the same as a previous infection with...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199906000-00004
更新日期:1999-06-01 00:00:00
abstract::The concept of early breast cancer as a palpable mass with limited secondary manifestations is rapidly changing. Thanks largely to mammography, a malignant breast neoplasm can be detected long before it forms a mass. Because cure rates in this stage are high, reliable means of early detection and diagnosis are of deep...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00003081-197506000-00012
更新日期:1975-06-01 00:00:00
abstract::Diagnosis of the cause of pruritus in a pregnant patient should be approached systematically, beginning with a detailed history (especially drug exposure) and physical examination. Systemic diseases must be excluded. Liver function tests and hepatitis screen are in order if symptoms suggest liver dysfunction. Stool ex...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199012000-00007
更新日期:1990-12-01 00:00:00
abstract::In recent years it has been recognized that in all phases of life, including pregnancy, physical activity promotes health benefits and precludes comorbidities, the scientific evidence is indisputable. Several organizations around the world have updated in recent years the guidelines and recommendations for exercise in...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000223
更新日期:2016-09-01 00:00:00
abstract::The application of real-time imaging to the study of fetal morphology and function is an exciting advance. Rapid accurate study of fetal dynamics is possible with this apparently safe, noninvasive technique. Animal studies have revealed the general physiology of fetal breathing movements, which are now under extensive...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00003081-197706000-00014
更新日期:1977-06-01 00:00:00
abstract::Minimally invasive surgery continues to transform the field of gynecologic oncology and has now become the standard of care for many early-stage malignancies. The proven benefits of minimally invasive surgery are driving the rapid introduction and dissemination of novel technologies and the increasing ability to perfo...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000286
更新日期:2017-06-01 00:00:00
abstract::Nothing improves the subsequent care of a woman with endometrial cancer more than the accurate determination of the extent of her disease. A significant number of women whose malignancy is apparently confined to the uterus will have extrauterine disease after careful, complete surgical staging. The failure to detect a...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199609000-00014
更新日期:1996-09-01 00:00:00
abstract::Hyperthyroidism is relatively uncommon during pregnancy. However, those caring for pregnant patients should be versed in the evaluation and management of hyperthyroidism, as there are potential maternal and fetal implications that are related to the disease and to treatment. The differential diagnosis of hyperthyroidi...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000435
更新日期:2019-06-01 00:00:00
abstract::Cardiac disease is a leading cause of morbidity and mortality in pregnant women. An increased prevalence of the cardiovascular disease has been found in women of childbearing age, in which the responsibility of the treating physician extends to the mother and to the unborn fetus. As a result, care of these high-risk p...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000579
更新日期:2020-12-01 00:00:00
abstract::The recent clinical trials indicate that EA is feasible. The use of ancillary tools, such as ultrasound, requires only a slight modification of the previously established techniques for MA. The amniotic fluid can be obtained and cultured. Combining the reported populations sampled, the procedural and cytogenetic failu...
journal_title:Clinical obstetrics and gynecology
pub_type: 临床试验,杂志文章,评审
doi:10.1097/00003081-198806000-00011
更新日期:1988-06-01 00:00:00