Abstract:
:Hypothyroidism during pregnancy occurs in 1/1600-2000 deliveries, according to the most recent publications. The most common causes are chronic autoimmune thyroid disease, radiodine-131 treatment, or surgical removal. The diagnosis is difficult to make on clinical grounds alone, even in advanced cases, and a high index of suspicion is needed. Some women are at high risk of developing hypothyroidism, and they should be screened. These women may have had previous treatment for hyperthyroidism; high-dose neck irradiation, evidence of thyroid autoimmunity, amiodarone therapy, suspected hypopituitarism, and type I diabetics. The best laboratory test is the serum TSH, followed, if elevated, by a free T4 index and a TPO-ab titer. Thyroid antibodies have been associated with an increased (double) risk of miscarriage and postpartum thyroiditis. Frequent (22-44%) pregnancy-induced hypertension leading to preterm delivery, and prematurity is the main complication observed in those still hypothyroid near term. Proper therapy eliminates or reduces the risk. No congenital anomalies have been reported in the most recent studies, and the data available shows that both physical and mental development have been normal until children are 10 years old. However, one study reported lower IQs in children of euthyroid women with positive TPO-ab than in children of TPO-ab negative mothers. Levothyroxine is the treatment of choice. Euthyroidism must be reached and maintained in a timely fashion. Many women need more thyroxine during pregnancy, and surveillance of thyroid function is needed throughout gestation to make dose adjustments when needed. During the postpartum periods the thyroxine requirements decrease to preconception levels.
journal_name
Clin Obstet Gynecoljournal_title
Clinical obstetrics and gynecologyauthors
Montoro MNdoi
10.1097/00003081-199703000-00008subject
Has Abstractpub_date
1997-03-01 00:00:00pages
65-80issue
1eissn
0009-9201issn
1532-5520journal_volume
40pub_type
杂志文章,评审abstract::The relationship between the clinical state of the cervix and spontaneous onset of labor has long been known. The cervix can be characterized by evaluating five parameters: effacement, dilatation, firmness, position, and level of the presenting part. The relative associations between successful labor induction and the...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199506000-00005
更新日期:1995-06-01 00:00:00
abstract::The software known as Clinical Decision Support Services (CDSS) has emerged as a buzzword from the explosion of information systems within health care. CDSS is installed within a practice to provide resources and tools to support the utilization of patient data in the provider decision-making process. Additional appli...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e31829cb0bf
更新日期:2013-09-01 00:00:00
abstract::The advent of ultrasound fetal imaging and the evolution of dynamic imaging (real-time) methods have opened great new vistas in which fetal responses can be monitored with remarkable precision and clarity. Contained within this new wealth of information may lie the key to direct determination of the fetus at risk for ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199503000-00006
更新日期:1995-03-01 00:00:00
abstract::In this review I have briefly outlined some of the cellular and molecular reasons for dystocia. I have described the myogenic, that may control the normal progression of labor and explain inadequate uterine contractility associated with dystocia. I have placed particular emphasis on our studies of gap junctions and th...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-198703000-00004
更新日期:1987-03-01 00:00:00
abstract::Osteoporosis is frequently called the silent disease because it lacks symptoms or signs until a fracture has occurred. Osteoporosis is common in aging women because of progressive postmenopausal bone loss. Fractures related to bone loss can result in reduced quality of life, lengthy hospital stays, long-term instituti...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e31825caa50
更新日期:2012-09-01 00:00:00
abstract::Several advantages are apparent in the use of self-monitored or automatic ambulatory blood pressure monitoring by pregnant patients who appear to have borderline or mild hypertension. Home recordings, combined with conventional office measurements, can give a more accurate picture of the patient's dynamic blood pressu...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract::Urinary tract infection in women has its origin, predominantly, via ascending bacteria from the periurethral microflora. Asymptomatic bacteriuria, except for the pregnant patient, need not be treated. E. coli is the most common bacterium to cause UTIs, and is usually susceptible to oral antibiotics. Patients who are h...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199809000-00030
更新日期:1998-09-01 00:00:00
abstract::The provision of hormone therapy, both estrogens and antiandrogens, to adult transgender females is well within the scope of practice of the obstetrician gynecologist. The goal is to induce feminizing changes and suppress previously developed masculinization. Estrogens in sufficient doses will usually achieve both goa...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000396
更新日期:2018-12-01 00:00:00
abstract::Abdominal myomectomy and hysterectomy remain the traditional treatment of large symptomatic uterine myomas. The preoperative indications for abdominal myomectomy or hysterectomy must be clearly evaluated and delineated avoid unnecessary intervention. There appears to be an increasing trend toward expectant management ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-200106000-00024
更新日期:2001-06-01 00:00:00
abstract::Because it is known that antibiotics given to the mother may reach and affect the fetus, when prescribing antibiotics during pregnancy, one must take into consideration both maternal and fetal well-being. Therapy should be directed toward the maternal disease but also be safe for the fetus. The volume of distribution ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00003081-199312000-00012
更新日期:1993-12-01 00:00:00
abstract::Women with gestational diabetes mellitus require a continuum of care before, during, and after pregnancy for optimal management of hyperglycemia. Postpartum education and lifestyle modification should begin during pregnancy, and should continue during the postpartum period. Women should receive education on the long-t...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3182a8e0bb
更新日期:2013-12-01 00:00:00
abstract::Although there are fairly wide variations AFV normally undergoes characteristic changes across gestation in which it increases from 10-20 ml at 10 weeks gestation to average 800 ml at 24 weeks. Little change occurs from then until near term when AFV begins to decrease, and large decreases can occur in postterm pregnan...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199706000-00005
更新日期:1997-06-01 00:00:00
abstract::The UK Confidential Enquiry into Maternal Deaths has been in operation for more than 60 years, during which time maternal mortality rates have fallen 10-fold. The program includes two aspects, surveillance and confidential case review, providing different information to aid quality improvement in maternity care. The e...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000352
更新日期:2018-06-01 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::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::State Perinatal Quality Collaboratives (PQCs) represent a major advance for scaling up quality improvement efforts for reducing maternal mortality and severe maternal morbidity. The critical roles of partners, rapid-cycle low-burden data systems, and linkage to maternal mortality review committees are reviewed. The ch...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000361
更新日期:2018-06-01 00:00:00
abstract::Significant advances have been made in the last 20 years in our knowledge about the subcellular events occurring during myometrial contractions and cervical ripening and in the mechanism of action of oxytocin and prostaglandins. These advances have been instrumental in furthering our understanding of the mechanism of ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-200009000-00006
更新日期:2000-09-01 00:00:00
abstract::More than 1 million abortions are performed annually in the United States. Women presenting for abortion care are often motivated by the pregnancy to use effective contraception; they are also at high risk for repeat unintended pregnancy. For these reasons, abortion represents an optimal time to initiate effective con...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000057
更新日期:2014-12-01 00:00:00
abstract::Perinatal transmission and reproductive decisions of HIV-infected women can be categorized in statistical and epidemiological terms. These reports and figures, however, do little to fully explain the complexities of human relationships, life experiences, personal and cultural influences, and situational and environmen...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199606000-00008
更新日期:1996-06-01 00:00:00
abstract::A comprehensive knowledge of the boundaries, contents, and interactions between surgical spaces is essential to safely and effectively perform mesh-augmented prolapse repairs and anti-incontinence procedures. This knowledge is also critical when managing intraoperative and postoperative complications such as bleeding,...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e31828e629c
更新日期:2013-06-01 00:00:00
abstract::The relevance of extraneous factors on fetal and neonatal respiratory gas exchange and acid-base balance must be considered when interpreting umbilical cord blood values. However, although many of these factors can alter these values to a minor degree, the clinical impact is negligible in the unstressed fetus. The mor...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199303000-00009
更新日期:1993-03-01 00:00:00
abstract::The addition of the human papillomavirus vaccination and the 2006 national guidelines for the management of abnormal cervical cytology have led to significant changes in the management of cervical disease among adolescents. This article reviews recommendations for prevention, screening, diagnosis, and management of ce...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e318172d0dc
更新日期:2008-06-01 00:00:00
abstract::During the past decade, prophylactic doses of low-molecular-weight heparin (LMWH) have been suggested to decrease the risk of placental-mediated complications. Herein, we review the prospective randomized trials that addressed the usefulness of LMWH in preventing placental-mediated complications in high-risk women. In...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000252
更新日期:2017-03-01 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::About 85% of all births in the US occur to women under 35 years of age. According to the US National Survey of Family Growth, women aged 35-39 years expect to have an additional 0.3 births while those 40-44 years anticipate only 0.1 additional births. Thus, there is a need to protect women age 35 years and over from...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199812000-00021
更新日期:1998-12-01 00:00:00
abstract::Using oral agents for induction of labor would reduce the need for repeated vaginal examinations; this is more acceptable to women and could reduce infection rates. A systematic review was conducted of 41 randomized trials comparing oral misoprostol to other induction agents. Oral misoprostol is effective at achieving...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-200609000-00023
更新日期:2006-09-01 00:00:00
abstract::The development of GnRH agonists has had a major impact on the practice of gynecology and reproductive endocrinology. The clinical usefulness of GnRH agonists will increase as modes of administration are improved and indications become better defined. GnRH agonists and, potentially, antagonists will provide a prompt, ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-198909000-00019
更新日期:1989-09-01 00:00:00
abstract::This review provides an evidence-based approach to the management of fetal growth restriction (FGR). The management consists of the following components: appropriate fetal surveillance, timely intervention, and selective etiological management. Umbilical arterial (UA) Doppler sonography is the primary test. Supplement...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-200606000-00013
更新日期:2006-06-01 00:00:00
abstract::Endometriosis is an enigmatic disease affecting up to 10% of reproductive-aged women causing pain and infertility. Up to 50% of women with endometriosis are infertile, and agreement about treatment options has been difficult to establish. The association between endometriosis and infertility is derived from comparison...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e3181db7d71
更新日期:2010-06-01 00:00:00
abstract::Endometriomas are common in reproductive-aged women, but controversy exists regarding their management. PubMed was searched to identify pertinent studies on outcomes of medical and surgical management of endometrioma, with focus on randomized controlled trials and meta-analyses. Surgical excision is more effective tha...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000151
更新日期:2015-12-01 00:00:00