Abstract:
OBJECTIVES:We aimed to analyze the predictive value of the fetal scalp blood lactate concentration and pH, especially in regard to outcome variables that are strong predictors of impaired long-term outcome. An additional aim was to establish cutoff lactate levels in fetal scalp blood. STUDY DESIGN:We conducted a retrospective study of all patients who had fetal scalp blood sampling performed because of an ominous fetal heart rate pattern at Huddinge University Hospital from October 1993 to October 1998. Fetal scalp blood sampling was performed in 1709 patients. The pH and the lactate concentration were determined in fetal scalp blood of 1221 and 814 of these patients, respectively. Outcome variables included pH <7.0 in umbilical artery blood; base deficit >16.0 mmol/L in umbilical artery blood; Apgar scores <7 at 1 minute, <7 at 5 minutes, and <4 at 5 minutes; and hypoxic-ischemic encephalopathy. RESULTS:Sensitivity and specificity were generally higher in the lactate group than in the pH group, particularly in relation to an Apgar score <4 at 5 minutes and moderate to severe hypoxic-ischemic encephalopathy. In 326 patients the scalp blood lactate concentration and pH value had been obtained at the same time, thus allowing a comparison between these methods. The areas under the receiver operating characteristic curves were significantly higher for the lactate concentration than for the pH value with 2 outcome variables: Apgar score <4 at 5 minutes (P =.033) and moderate to severe hypoxic-ischemic encephalopathy (P =.015). CONCLUSIONS:Our findings suggest that determination of the lactate concentration in fetal scalp blood is a more sensitive diagnostic tool than is determination of the pH value for predicting either an Apgar score <4 at 5 minutes or moderate to severe hypoxic-ischemic encephalopathy. In previous studies we also showed lactate measurements to be more often successful than pH analysis. Therefore we consider the measurement of lactate in fetal scalp blood to be an attractive alternative to pH analysis, and determination of the lactate concentration in fetal scalp blood seems to be a useful tool for monitoring the condition of the fetus. A suitable cutoff limit for fetal scalp blood lactate concentration as an indicator of fetal asphyxia could be 4.8 mmol/L.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Kruger K,Hallberg B,Blennow M,Kublickas M,Westgren Mdoi
10.1016/s0002-9378(99)70083-9subject
Has Abstractpub_date
1999-11-01 00:00:00pages
1072-8issue
5 Pt 1eissn
0002-9378issn
1097-6868pii
S0002-9378(99)70083-9journal_volume
181pub_type
杂志文章abstract:BACKGROUND:Accurate gestational dating is a critical component of obstetric and newborn care. In the absence of early ultrasound, many clinicians rely on less accurate measures, such as last menstrual period or symphysis-fundal height during pregnancy, or Dubowitz scoring or the Ballard (or New Ballard) method at birth...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2015.11.029
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to establish normal ranges for human epididymis protein 4 (HE4) serum levels in healthy women. STUDY DESIGN:HE4 levels were measured in healthy women and analyzed by age, menopausal status, and pregnancy status. Upper 95th percentiles were determined for normal ranges. RESULTS:...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ajog.2011.12.028
更新日期:2012-04-01 00:00:00
abstract::A total of 635 consecutive cesarean sections performed in private practices during the past 20 years are reviewed. In the course of this 20 year period, we have tried to alter gradually our surgical technique used for this procedure to conform to the principles of surgery developed by Halsted. The study is divided int...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80006-6
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to test the null hypothesis that the volume of exercise at different times during pregnancy has no effect on fetoplacental growth. STUDY DESIGN:Seventy-five women who exercised regularly were evaluated before pregnancy and randomly assigned at 8 weeks' gestation to one of 3 exer...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mob.2002.119109
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:The death of women from pregnancy-related causes remains a threat to national maternal and child health. Maternal deaths as persistent, albeit rare occurrences are overlooked if vital registration systems are relied on to report such deaths. STUDY DESIGN:Live birth records were matched with death records for...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91629-9
更新日期:1992-07-01 00:00:00
abstract::The serum concentration of ferritin in 11 patients with toxemia of pregnancy was compared to that of normal women in the early third trimester of pregnancy and in labor at term. The mean concentration of ferritin for toxemic patients was 91.8 ng/ml compared to 18.4 ng/ml and 19.4 ng/ml for the two control groups, resp...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(82)90247-2
更新日期:1982-10-15 00:00:00
abstract::Since 1955 standardized treatment applied uniformly to all cases of eclampsia at Parkland Memorial Hospital has consisted of (1) magnesium sulfate intravenously and intramuscularly to control convulsions, (2) intravenous hydralazine intermittently to lower diastolic blood pressure when it exceeded 110 mm. Hg, and (3) ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90042-3
更新日期:1975-11-01 00:00:00
abstract::Decisions in regard to the management of patients with premature rupture of the membranes depend on the relative risks of prematurity, infection, and hypoxia for the fetus or neonate and infection and cesarean section for the mother. These risks vary primarily with gestational age. Because of the many variables and ne...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90369-2
更新日期:1985-04-15 00:00:00
abstract::Amnion and human amnion-derived WISH cells release CA 125 antigen into culture medium. CA 125 output was higher in WISH cells than in amnion cells. In this study we showed that release of the antigen is regulated, with both amnion and WISH cells responding in a similar manner to the tested agents. Release of CA 125 de...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90713-2
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVE:We conducted, in a randomized, placebo-controlled manner, behavioral testing on mice offspring exposed antenatally to the herbal antidepressant Saint John's wort (Hypericum ). STUDY DESIGN:A daily dose of Saint John's wort (0.75 mg/g of food consumed), equivalent to that in human beings according to body sur...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.108889
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:To compare rectally administered misoprostol to intravenously administered oxytocin for the management of third-stage labor. STUDY DESIGN:Subjects were randomized to receive two, 200-microg misoprostol tablets rectally (study medication) plus 2 mL saline in Ringer's lactate intravenously or two lactose table...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mob.2001.117360
更新日期:2001-10-01 00:00:00
abstract::The deceleration delay index (DDI) is a statistical parameter computed by an on-line system which analyzes fetal monitor output for the temporal relationship between each uterine contraction and any associated deceleration of the fetal heart rate. A similar parameter describing this relationship is known to be quantit...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(77)90205-8
更新日期:1977-07-15 00:00:00
abstract::Sixty-one percent of refractory vulvodynia patients evaluated in a tertiary care vulvovaginal clinic had clinically relevant dermatoses based on dermatopathologist-analyzed vulvar biopsy including: lichen sclerosus, allergic/irritant dermatitis, lichen planus, and other inflammatory or neoplastic dermatoses. Given the...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.03.004
更新日期:2008-11-01 00:00:00
abstract::We describe 1 case of placenta increta and 1 of placenta percreta, both associated with elevated maternal serum creatine kinase concentration. In patients with placenta previa and ultrasonographic findings of an abnormally adherent placenta, an unexplained elevation in maternal serum creatine kinase level should alert...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70683-6
更新日期:1999-04-01 00:00:00
abstract::This study encompasses five years and includes 559 cancers, diagnosed at the Kaiser-Permanente Medical Center, Los Angeles, California. With current low-dose techniques, we have shown the efficacy of xeromammography, even in younger women. One third of the breast cancers, one third of the occult breast cancers, occurr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90821-3
更新日期:1977-09-01 00:00:00
abstract:BACKGROUND:Singleton infants conceived using assisted reproductive technology have lower average birthweights than naturally conceived infants and are more likely to be born low birthweight (<2500 gr). Lower birthweights are associated with increased infant and child mortality and poor adult health outcomes, including ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2017.12.223
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to test the hypothesis that fetuses destined to deliver preterm do not reach their individual growth potential. STUDY DESIGN:In a case control design, data on 44 preterm deliveries at < or =34 weeks were compared with data on a control group of next consecutive term deliveries...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.115865
更新日期:2001-08-01 00:00:00
abstract::Seventeen pregnant rabbits were studied under conscious, unstressed conditions after catheterization of the right ventricle (RV), a femoral artery (A), and a uterine vein (UV). Respiratory gas tensions, pH, and oxygen saturations and contents were determined serially throughout the latter half of gestation. The uterin...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(85)80054-5
更新日期:1985-07-15 00:00:00
abstract::Plasma lipoproteins constitute a complex lipid transport system. Very low-density lipoproteins transport triglycerides to peripheral tissues, whereas low-density lipoproteins are the main carriers of cholesterol. Cholesterol transport in low-density lipoprotein enters body cells by way of "low-density lipoprotein rece...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(90)90571-n
更新日期:1990-07-01 00:00:00
abstract:BACKGROUND:Although preterm birth <37 weeks' gestation is the leading cause of neonatal morbidity and mortality in the United States, the majority of data regarding preterm neonatal outcomes come from older studies, and many reports have been limited to only very preterm neonates. Delineation of neonatal outcomes by de...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.01.004
更新日期:2016-07-01 00:00:00
abstract::This article presents a review of 902 tubal sterilizations performed in an 18 1/2-year period at a predominantly private teaching service. 803 (89%) of the sterilizations were puerperal, generally performed within 48 hours of delivery or with cesarean section. The Pomeroy technique (often modified) was used in 97.2%...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1967-02-15 00:00:00
abstract:OBJECTIVE:The primary aim of this study was to examine whether 1 week of continuous auricular acupuncture could reduce low back and posterior pelvic pain associated with pregnancy. STUDY DESIGN:A randomized controlled trial was conducted on pregnant women who have lower back and posterior pelvic pain. These women were...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ajog.2009.04.028
更新日期:2009-09-01 00:00:00
abstract::Amniotic fluid samples from 12 pregnant baboons at 173 to 176 days of gestation were studied. Five fetuses were growth retarded and seven were normally developed. Mean amniotic fluid volumes and composition (osmolality, protein concentration, delta optical density at 450 nm, and amniotic fluid/maternal plasma creatini...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90114-6
更新日期:1986-07-01 00:00:00
abstract::The daily symptom records of 150 untreated women with a convincing history of the premenstrual syndrome were investigated qualitatively and quantitatively by means of time series analysis in the form of Trigg's technique for trends. Symptoms were monitored with use of a modified menstrual distress questionnaire. Analy...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90808-2
更新日期:1986-08-01 00:00:00
abstract:OBJECTIVE:Pregnancies complicated by diabetes are frequently characterized by an increased volume of amniotic fluid, and the pathophysiologic mechanism of this increase is not known. Our goal was to evaluate the relationship between amniotic fluid glucose concentration and the amniotic fluid index in pregnancies compli...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(00)70343-7
更新日期:2000-04-01 00:00:00
abstract::We performed a case-control study of the effect of exposure to Chlamydia trachomatis on the risk for tubal pregnancy. Sixty women with tubal pregnancies and 60 matched control women with normal second-trimester intrauterine pregnancies were studied. Cases were more likely than controls to have detectable antichlamydia...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(88)80177-7
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVE:Knowledge about the causes of placental dysfunction disorders is limited. We performed an intergenerational study, focusing on the risks of placental dysfunction disorders in mothers and fathers who had been born small for gestational age (SGA). STUDY DESIGN:Using linked generational data from the Swedish Me...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.05.009
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:Our purpose was to learn whether cytokines such as interleukin-1 beta and related (or antagonistic) cytokines, hormones, and growth factors could regulate secretion of the vasorelaxant parathyroid hormone-related protein in human umbilical vein endothelial cells in culture. STUDY DESIGN:Secondary cultures of...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90265-1
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:We sought to investigate CpG-island methylation profiling of apoptotic genes apoptotic protease activating factor 1, caspase 8, death-associated protein kinase (DAPK), tumor necrosis factor receptor superfamily member 6 (FAS), Survivin, and tumor necrosis factor-related apoptosis-inducing ligand receptor-1 an...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.11.037
更新日期:2010-03-01 00:00:00
abstract::During a 12-year period, 254 cases of eclampsia were managed at this center. Eighty patients (32%) did not have edema, 58 (23%) had "relative hypertension," and 49 (19%) did not have proteinuria at the time of convulsions. Eclampsia developed at less than or equal to 20 weeks in 6 patients and beyond 48 hours post par...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)91123-t
更新日期:1990-09-01 00:00:00