Current opinion in obstetrics & gynecology
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Curr. Opin. Obstet. Gynecol. · Oct 2015
ReviewMidurethral slings: which should I choose and what is the evidence for use?
Midurethral slings are currently the most commonly performed surgeries for stress urinary incontinence (SUI). This review examines the pros and cons of the main types of midurethral slings that are available for the surgical treatment of SUI - full-length retropubic, full-length transobturator, and single-incision slings - to assist patients and physicians in choosing between them. ⋯ Both full-length midurethral slings - retropubic and transobturator - are reasonable for the surgical treatment of SUI. The decision to choose one or the other should be individualized based on patient preference after counseling about the risks of each. More recent data suggest that the currently available single-incision slings may be comparable.
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Curr. Opin. Obstet. Gynecol. · Oct 2015
ReviewConscientious objection to abortion and reproductive healthcare: a review of recent literature and implications for adolescents.
Conscientious objection to reproductive healthcare (refusal to perform abortion, assisted reproductive technologies, prenatal diagnosis, contraception, including emergency contraception and sterilization, etc.) has become a widespread global phenomenon and constitutes a barrier to these services for many women. Adolescents are a particularly vulnerable group because some providers object to specific aspects of their reproductive healthcare because of their status as minors. ⋯ Conscientious objection is understudied, complicated, and appears to constitute a barrier to care, especially for certain subgroups, although the degree to which conscientious objection has compromised sexual and reproductive healthcare for adolescents is unknown. Physicians are well positioned to support individual conscience while honoring their obligations to patients and to medical evidence.
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Curr. Opin. Obstet. Gynecol. · Apr 2015
ReviewReducing maternal anxiety and stress in pregnancy: what is the best approach?
To briefly review results of the latest research on approaching antenatal maternal anxiety and stress as distinct constructs within a broad spectrum of maternal antenatal distress and the preventive strategic role of the maternal healthcare practitioner. ⋯ A shift in perception and attitude towards a broad theoretical and practical approach of antenatal maternal mental health and well-being is required. Case finding with subsequent selective and indicated preventive strategies during pregnancy would conform to this approach and are evidence based.
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Curr. Opin. Obstet. Gynecol. · Apr 2015
Review Observational StudyElective cesarean delivery at 38 and 39 weeks: neonatal and maternal risks.
The purpose of this article is to critically review the existing literature with regard to neonatal and maternal outcomes after elective cesarean delivery at 38 completed weeks versus 39 completed weeks of gestation. ⋯ http://links.lww.com/COOG/A18.
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Curr. Opin. Obstet. Gynecol. · Feb 2015
ReviewNew clinical research strategies for rare gynecologic malignancies.
More than 50% of all gynecologic cancers can be classified as rare tumors (defined as an incidence of <6 per 100 000) and as such represent a major challenge for clinicians. ⋯ This requires international partnerships, harmonization of treatment recommendations, and international collaborations to overcome existing regulatory barriers in international trials. Whereas randomized trials may be possible in some rare tumor types, there are others for which conducting even single arm studies may be challenging. For these very rare tumors, robust collection of data through national registries could lead to improvements in treatment.