ABSTRACT
Pelvic organ prolapse is a common condition that negatively affects womens' quality of life. Sacrocolpopexy is an abdominal procedure designed to treat apical compartment prolapse including uterine or vaginal vault prolapse and multiple-compartment prolapse. Although traditionally performed as an open abdominal procedure, minimally invasive sacrocolpopexy, whether laparoscopic or robotic, has been successfully adopted in the practice of many pelvic reconstructive surgeons. There are many variations to this procedure, with different levels of evidence to support each of them. Herein we review the current literature on sacrocolpopexy, with emphasis on the minimally invasive approach. Procedural steps and controversies are examined in light of the existing literature, and recommendations are made on the basis of the level of existing evidence.
Subject(s)
Gynecologic Surgical Procedures/methods , Robotic Surgical Procedures/methods , Sacrum/surgery , Uterine Prolapse/surgery , Vagina/surgery , Female , Humans , Laparoscopy/methods , Pelvic Organ Prolapse/surgery , Quality of Life , Treatment OutcomeABSTRACT
Thyroid physiology is altered during pregnancy as a result of an increase in thyroid-binding globulin, the stimulatory effect of hCG on TSH receptors, and increased peripheral thyroid hormone requirements. In addition, hyper and hypothyroid disorders are prevalent among women of reproductive age, and most of them have a significant impact on the gravida, fetus and neonate. Aberrant thyroid function can be readily recognized and treated during pregnancy, avoiding such complications. Here, we will review the thyroid function changes occurring during pregnancy, the different disorders, their maternal and fetal implications, and the ways to screen, prevent and treat these conditions.