European journal of obstetrics, gynecology, and reproductive biology
-
Eur. J. Obstet. Gynecol. Reprod. Biol. · Oct 2020
ReviewInternational Society for Gynecologic Endoscopy (ISGE) guidelines and recommendations on gynecological endoscopy during the evolutionary phases of the SARS-CoV-2 pandemic.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has raised some important interrogations on minimally invasive gynaecological surgery. The International Society for Gynecologic Endoscopy (ISGE) has taken upon itself the task of providing guidance and best practice policies for all practicing gynaecological endoscopists. Factors affecting decision making processes in minimal invasive surgery (MIS) vary depending on factors such as the phase of the pandemic, policies on control and prevention, expertise and existing infrastructure. ⋯ During the post-peak period of pandemic, debriefing and mental health screening for staff is recommended. Psychological support should be provided as needed. In conclusion, based on the existent evidence, ISGE largely supports the current international trends favoring laparoscopy over laparotomy on a case by case risk evaluation basis, recognizing the different levels of skill and access to minimally invasive procedures across various countries.
-
Eur. J. Obstet. Gynecol. Reprod. Biol. · Sep 2020
Meta AnalysisCOVID-19 in pregnant women: A systematic review and meta-analysis.
Coronavirus disease 2019 (COVID-19) is a novel infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several reports highlighted the risk of infection and disease in pregnant women and neonates. To assess the risk of clinical complications in pregnant women and neonates infected with SARS-CoV-2 carrying out a systematic review and meta-analysis of observational studies. ⋯ The present study suggests a high rate of maternal and neonatal complications in infected individuals. However, the current scientific evidence highlights a low risk of neonatal infection. Multicentre, cohort studies are needed to better elucidate the role of SARS-CoV-2 during pregnancy.
-
Eur. J. Obstet. Gynecol. Reprod. Biol. · Sep 2020
Meta AnalysisMaternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis.
Coronavirus disease 2019 (COVID-19) has become a global pandemic and may adversely affect pregnancy outcomes. We estimated the adverse maternal and neonatal characteristics and outcomes among COVID-19 infected women and determined heterogeneity in the estimates and associated factors. ⋯ Adverse pregnancy outcomes were prevalent in COVID-19 infected females and varied by location, type, and size of the studies. Regular screening and early detection of COVID-19 in pregnant women may provide more favorable outcomes.
-
Eur. J. Obstet. Gynecol. Reprod. Biol. · Sep 2019
ReviewNew blood pressure cut off for preeclampsia definition: 130/80 mmHg.
The classical diagnosis of preeclampsia is usually based on the fulfillment of 3 criteria: pregnancy > 20 weeks of gestation, proteinuria (2+ on dipstick or > 300 mg/24 h) and arterial hypertension ≥ 140/90 mm Hg. The current blood pressure cut off of 140/90 mm Hg was set by the American College of Obstetrics and Gynecology (ACOG)-issued practice bulletin of 2019, the 2013 Task Force and the guidelines prompted by the International Society for the Study of Hypertension in Pregnancy (ISSHP). The evidence on which the current cut-off is based is scarce and not updated. We propose the application of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines on pregnant women and defining preeclampsia with the new 130/80 blood pressure cut-off.
-
Eur. J. Obstet. Gynecol. Reprod. Biol. · May 2019
Clinical presentation and management of atypical polypoid adenomyomas: Systematic review of the literature.
The aim of this study is to investigate clinical behavior of Atypical Polypoid Adenomyomas (APAs) and to describe the rates of (i) recurrences, (ii) their association with endometrial hyperplasia and (iii) with endometrial cancer. All studies that reported the outcome of the clinical management of patients with histologically proven APAs were included. A review of the English literature since 1970 was systematically performed (PROSPERO No CRD42018080003). ⋯ In this review, the recurrence rate and the association of APAs with cancer appeared to be higher compared to the previously reported in the literature rates. APAs comprise an intriguing clinical entity that needs individualized treatment, considering the increased association to serious gynecological diseases. Hysterectomy is the appropriate treatment, however uterus-sparing surgery can be offered to selected patients.