Abstract:
OBJECTIVE:Our goal was to improve the accuracy of estimating fetal weights among macrosomic fetuses with the traditional measurements of abdominal circumference, femur length, and head circumference. STUDY DESIGN:We used 4831 cases without anomalies from an ultrasonography laboratory database with an estimated fetal weight obtained a maximum of 14 days before delivery. Abdominal circumference, femur length, and head circumference were each regressed on birth weight to obtain estimated fetal weight by abdominal circumference, femur length, and head circumference, respectively. We compared the individual variation for estimated fetal weight by abdominal circumference, femur length, and head circumference by calculating a within-subject standard deviation to quantify the level of disparity. We adjusted the estimated fetal weight to the date of delivery and for dependencies on maternal diabetes mellitus, weight, and height. We then weighted cases with birth weight >4500 g and diabetic cases with birth weight >4000 g 20-fold (weighted estimated fetal weight) for the purpose of creating a favorable bias for classifying these cases. The equation of Hadlock et al, with abdominal circumference, femur length, and head circumference, was applied as a benchmark estimated fetal weight. RESULTS:Of the 4831 newborns, 308 (6.4%) had a birth weight >4000 g, and 56 (1.2%) had a birth weight >4500 g. There were 154 pregnancies complicated by diabetes mellitus; 26 (16.9%) of the resulting infants weighed >4000 g, and 5 (3.2%) weighed >4500 g. At 95% specificity, the weighted estimated fetal weight had a sensitivity of 85.7% at a cut point of 3912 g, compared with a sensitivity of 71.4% at 3604 g by use of the estimated fetal weight of Hadlock et al. CONCLUSIONS:We were able to improve the accuracy of identifying the macrosomic fetus compared to reliance on the equation by Hadlock et al. A fetus was found to be at significantly increased risk for birth weight >4000 g when the estimated fetal weight based on abdominal circumference is larger than that based on either head circumference or femur length or when there is a large within-subject variance in estimated fetal weight based on abdominal circumference, femur length, and head circumference. We also found that there were significantly different groups of patients whose estimated fetal weights require different equations for better estimates. Even given ultrasonographic measurements, taking into account maternal height, weight, and presence of diabetes mellitus can improve macrosomia detection. Although these findings remain to be optimized and validated, the approach used here appears to yield better predictions than the current "one function fits all" approach.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Sokol RJ,Chik L,Dombrowski MP,Zador IEdoi
10.1067/mob.2000.106853subject
Has Abstractpub_date
2000-06-01 00:00:00pages
1489-95issue
6eissn
0002-9378issn
1097-6868pii
S0002-9378(00)37928-5journal_volume
182pub_type
杂志文章,meta分析abstract:OBJECTIVES:Our purpose was to develop a method to induce premature delivery in rats and to use this method to identify biochemical changes that are critical to cervical dilatation by comparison to changes that occur during term delivery. STUDY DESIGN:Rats were treated with antiprogestational agents onapristone or lilo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1053/ob.1996.v175.a74254
更新日期:1996-09-01 00:00:00
abstract::The aerobic and anaerobic cervical microflora was determined before operation and on day 4 after operation in groups of women undergoing a clinical trial of prophylaxis with three doses of cefoxitin, cefazolin, or placebo for infectious complications of nonelective cesarean section. Floral shifts occurred post partum,...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(84)90109-1
更新日期:1984-08-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to determine whether an individualized growth standard (IS) improves the identification of preterm small-for-gestational-age (SGA) neonates at risk of developing moderate/severe cerebral palsy (CP) or death. STUDY DESIGN:This study was a secondary analysis of data from a random...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.06.007
更新日期:2013-10-01 00:00:00
abstract::Swan-Ganz catheterization was performed in 15 postpartum women who presented with severe pregnancy-induced hypertension at a mean gestational age of 31.5 weeks. The mean arterial pressure on presentation was 137.6 torr (range, 116 to 167 torr), and it remained at approximately 115 torr for the next 72 hours. Serial pu...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90750-6
更新日期:1984-03-01 00:00:00
abstract::Right and left ventricular outputs were measured continuously in fetal lambs in utero for 2 to 21 days after implantation of electromagnetic flow tranducers around the main pulmonary trunk and ascending aorta. Surface pacing electrodes were implanted on the left and right atria. The intact cervical vagus nerve was sti...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)33296-3
更新日期:1976-01-15 00:00:00
abstract:OBJECTIVE:The study was performed to examine the satisfaction of a specific population of oncology patients with their physicians and to quantify its association with characteristics of their disease. STUDY DESIGN:A descriptive design was used in which patients attending a weekend cancer support retreat completed the ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.281
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:We studied ovarian cancers for the expression of membrane markers of hematopoietic origin. STUDY DESIGN:We used flow cytometry to systematically characterize the expression of more than 30 hematologic antigens on ovarian carcinoma cell lines and to assess their stability under estrogen exposure. The expressi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.05.013
更新日期:2009-08-01 00:00:00
abstract::Sixty patients with chronic pelvic pain were monitored after diagnostic laparoscopy had excluded obvious pelvic pathology. Six months after the procedure only two patients described their symptoms as unchanged or worse. Treatment should be limited to the minority of patients whose symptoms remain 6 months after laparo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91343-9
更新日期:1992-03-01 00:00:00
abstract:OBJECTIVE:Intrapartum fetal heart rate (FHR) recordings in twins were compared for fetal signal loss during both stages of labor to assess the quality of these recordings by the method that had been used: external ultrasound or directly via a scalp electrode. STUDY DESIGN:Analysis of recordings collected between Janua...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.04.037
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to determine whether adrenomedullin, a hypotensive peptide, decreases vasomotor tone in fetoplacental vasculature that has been constricted with the thromboxane sympathomimetic U46619. STUDY DESIGN:The fetoplacental vascular beds of 20 perfused human placental cotyledons were vasoco...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.108071
更新日期:2000-12-01 00:00:00
abstract::Clearance indices (clearance of experimental material: clearance of antipyrine, CI) across the perfused human placenta were determined for urea, sodium, and chloride. The selected materials are of relatively small molecular weight and are water soluble. Clearance of urea was determined under conditions of net transfer...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(15)33310-x
更新日期:1981-11-15 00:00:00
abstract::Samples of cord blood from 46 deliveries were collected between 2 and 8 mo after an epidemic of influenza caused by A/Port Chalmers/73 (H3H2) virus. Of 10 samples with HAI antibody titers against A/Port Chalmers of 1:16 or greater, one had 2-mercaptoethanol-sensitive IgM class antibodies against the virus. Lymphocyte ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90609-8
更新日期:1981-10-15 00:00:00
abstract::Rabbit fetuses were injected intramuscularly with 0.5 mg. of isoxsuprine on the twenty-eighth day of gestation. They were killed in utero four hours after the injection, and fetal pulmonary fluid (FPF) was collected through a tracheal catheter. The quantity of FPF and the lung weight/body weight ratio were both signif...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90744-x
更新日期:1977-09-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the effect of early oral bowel stimulation with osmotic laxatives on gastrointestinal function, postoperative nausea and vomiting (PONV) and pain in patients who undergo fast-track abdominal hysterectomy. STUDY DESIGN:This was a double-blind, placebo-controlled stud...
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.2006.10.902
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVES:We analyzed the safety and patient acceptance of amniotic fluid insulin measurements by third-trimester amniocentesis in women with gestational diabetes mellitus. STUDY DESIGN:We studied the rate of early uterine contractions, need for tocolysis, premature rupture of membranes, mode of delivery, length of g...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70221-2
更新日期:1998-10-01 00:00:00
abstract::Reductions in publicly funded prenatal care programs in 1981 to 1984 resulted in an increase in unregistered patient deliveries from 7.8% to 14.9% of births at University of California San Diego Medical Center. To assess the economic and perinatal impact of the increasing number of deliveries of women without prenatal...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90387-x
更新日期:1986-01-01 00:00:00
abstract::Urinary tract infections are the most common outpatient infections, but predicting the probability of urinary tract infections through symptoms and test results can be complex. The most diagnostic symptoms of urinary tract infections include change in frequency, dysuria, urgency, and presence or absence of vaginal dis...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2017.12.231
更新日期:2018-07-01 00:00:00
abstract::Nicardipine, a calcium antagonist, suspended the spontaneous activity of the excised rabbit uterus at a concentration of 1 microgram/ml and abolished the electrical excitability at a concentration of 10 microgram/ml. In situ, single doses of 100 and 500 microgram reversibly suspended the spontaneous activity of the po...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(82)90749-9
更新日期:1982-03-01 00:00:00
abstract::We report a case of persistent gestational trophoblastic disease (GTD) in which a selective uterine artery embolization instead of invasive surgery achieved both the control of pelvic hemorrhage and of disease. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.02.029
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:Postpartum infections are polymicrobial and typically include Ureaplasma, an intracellular microbe that is treated by macrolides such as azithromycin. The aim of this study was to evaluate the perinatal pharmacokinetics of azithromycin after a single preincision dose before cesarean delivery. STUDY DESIGN:Th...
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.2015.01.015
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to determine whether the Toyota production system process improves Papanicolaou test quality and patient safety. STUDY DESIGN:An 8-month nonconcurrent cohort study that included 464 case and 639 control women who had a Papanicolaou test was performed. Office workflow was redesi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.06.069
更新日期:2006-01-01 00:00:00
abstract::Placental pathology can be useful in a variety of ways including immediate diagnosis of important conditions affecting the mother or infant, identifying conditions that are likely to recur in subsequent pregnancies, separating clinical syndromes into distinct pathological phenotypes for further investigation, and unco...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2015.05.056
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:Recent developments permit the use of pulse oximetry to evaluate fetal oxygenation in labor. We tested the hypothesis that the addition of fetal pulse oximetry in the evaluation of abnormal fetal heart rate patterns in labor improves the accuracy of fetal assessment and allows safe reduction of cesarean deliv...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mob.2000.110632
更新日期:2000-11-01 00:00:00
abstract::Survival data on 36 patients with clear-cell adenocarcinomas are reported: seven with vaginal lesions and 29 with cervical lesions. Although the tumor responds to present treatment modalities, it tends to be associated with early lymph node involvement, thus making early diagnosis essential. Radiation as a primary the...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90158-7
更新日期:1976-02-01 00:00:00
abstract:BACKGROUND:Premenstrual syndrome is characterized by the cyclic occurrence of physical, behavioral and psychological symptoms during the luteal phase of the menstrual cycle disappearing within a few days of the onset of menstruation. Generally symptoms are mild, but 5-8% of women suffer from severe PMS. Apart from conv...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ajog.2017.02.028
更新日期:2017-08-01 00:00:00
abstract::A 13-year-old patient with an ovarian abscess caused by Salmonella paratyphi C1-7 had positive stool cultures for the same organism. She recovered after surgical removal of the abscess and intravenous antibiotics. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90118-3
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Fetal growth restriction is defined using ultrasound parameters during pregnancy or as a low birthweight for gestational age after birth, but these definitions are not always concordant. OBJECTIVE:The purpose of this study was to investigate fetal and neonatal outcomes based on antenatal vs postnatal assess...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2017.02.001
更新日期:2017-05-01 00:00:00
abstract::Physicians who deliver babies in Alabama were surveyed to determine their level of knowledge about the survival of low--birth weight/early gestational age infants. These estimates of neonatal survival were compared to the actual neonatal survival rates at local hospitals and at the regional perinatal centers in Alabam...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(82)90114-4
更新日期:1982-07-15 00:00:00
abstract::Factors that will affect both contraceptive use and choice of method during the next 20 years are reviewed. Two factors are predictable: the changing age distribution of women and the revised upper-age limits for oral contraceptive use, with the effect of the latter as yet unknown. Less predictable factors include the...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(12)90405-6
更新日期:1992-10-01 00:00:00
abstract::The obstetric events leading to the birth of infants who developed respiratory distress syndrome (RDS) were evaluated. In a retrospective study of 100 consecutive cases it was determined that untimely or unwarranted physician intervention in the pregnancy was responsible for 15 per cent of cases and possibly responsib...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1975-11-15 00:00:00