Abstract：
OBJECTIVE:The risk of perinatal death associated with labor after previous cesarean section appears higher than with a repeated cesarean section. On the other hand, repeated cesarean sections are associated with increased maternal morbidity and mortality from placental pathologic conditions (previa or accreta) on subsequent pregnancies. The study was undertaken to analyze the decision for a trial of labor or a repeated cesarean section, after a prior cesarean section, with varying desire for an additional pregnancy. STUDY DESIGN:A model was formulated using a decision tree, based on the reported risks of the two approaches. Sensitivity analysis was performed over a variety of probabilities (eg, chance of uterine rupture or neonatal death, chance of rescue cesarean section, desire for an additional pregnancy) and utilities (eg, use of hysterectomy or neonatal death). RESULTS:The model favors a trial of labor if it has a chance of success of 50% or above and if the wish for additional pregnancies after a cesarean section is estimated at near 10% to 20% or above because the delayed risks from a repeated cesarean section are greater than its immediate benefit. The model was robust over a wide range of assumptions. CONCLUSION:An optimal decision for a trial of labor or a repeated cesarean section is substantially determined by the wish for future pregnancies. The default option of a repeated cesarean section is not directly applicable in populations in which family planning often extends over two children.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Mankuta DD,Leshno MM,Menasche MM,Brezis MMdoi
10.1067/s0002-9378(03)00833-0subject
Has Abstractpub_date
2003-09-01 00:00:00pages
714-9issue
3eissn
0002-9378issn
1097-6868pii
S0002937803008330journal_volume
189pub_type
杂志文章abstract：OBJECTIVE:The aims of this study were to assess the accuracy of uterine contraction palpation, determine whether the accuracy of palpation improves with experience, determine clinical factors that affect the accuracy of palpation, and evaluate the range of intrauterine pressure present when an observer notes the contra...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(96)70397-6
更新日期：1996-01-01 00:00:00
abstract：OBJECTIVE:We sought to evaluate inadequate gestational weight gain and fetal growth among overweight and obese women. STUDY DESIGN:We conducted an analysis of prospective singleton term pregnancies in which 1053 overweight and obese women gained >5 kg (14.4 ± 6.2 kg) or 188 who either lost or gained ≤5 kg (1.1 ± 4.4 k...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2014.02.004
更新日期：2014-08-01 00:00:00
abstract：:Biochemical studies to detect changes occurring in the composition of mother's milk from the initiation of proper lactation to weaning were done in a group of 36 postpartum women, volunteers who were either using the conventional contraceptives or taking a low-dose combination pill, a low-dose progestational compound,...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(77)90462-8
更新日期：1977-02-01 00:00:00
abstract：OBJECTIVE:The aim of this study was to test the hypothesis that standardization of cardiac output in pregnancy by correcting for body surface area, and thus obtaining cardiac index, is justified. STUDY DESIGN:Cardiac output was determined by thoracic electrical bioimpedance monitoring in 78 pregnant women; recordings ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(95)90367-4
更新日期：1995-09-01 00:00:00
abstract：:Five nonstress tests were interpreted by a national sample of obstetricians blinded to specific patient clinical data. The 169 questionnaires suitable for analysis showed that the reliability of the test interpretation, as measured by the kappa statistic, decreased with increasing number of categories of interpretatio...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(85)90459-4
更新日期：1985-11-01 00:00:00
abstract：:This study examined the effects of human chorionic gonadotropin, adrenocorticotropin, human luteinizing hormone, and mouse epidermal growth factor on growth (thymidine incorporation) and steroidogenesis (dehydroepiandrosterone sulfate production) of human fetal zone adrenal cells in monolayer culture. Two preparations...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(87)90077-9
更新日期：1987-03-01 00:00:00
abstract：OBJECTIVE:Our purpose was to investigate whether the sensitivity of myometrial cells to oxytocin is affected by prolonged exposure to oxytocin antagonists. STUDY DESIGN:Tissue slices or cultured myometrial cells were exposed to peptides in vitro. Myometrial activation was studied by measuring the formation of inositol...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(94)90414-6
更新日期：1994-12-01 00:00:00
abstract：:Repeated nutritional assessments were made on 118 low-income women who registered at an urban hospital clinic prior to the twenty-eighth week of pregnancy and then on 122 comparable women who were provided with protein-mineral supplementation. Demographic and background information were obtained. Medical assessments w...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(75)90487-1
更新日期：1975-12-01 00:00:00
abstract：:Nifedipine is a calcium channel blocker that reduces blood pressure and increases renal blood flow. This double-blind investigation evaluated the effect of nifedipine in postpartum patients with severe preeclampsia. Thirty-one patients were randomized to receive either nifedipine (10 mg) or placebo every 4 hours begin...
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：10.1016/0002-9378(90)91011-z
更新日期：1990-03-01 00:00:00
abstract：:In the roundtable that follows, clinicians discuss a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed: Warren JE, Nelson LM, Stoddard GJ, et al. Polymorphisms in the promoter region of the interleukin-10 (IL-10) gen...
journal_title：American journal of obstetrics and gynecology
pub_type： 评论,杂志文章
doi：10.1016/j.ajog.2009.07.019
更新日期：2009-10-01 00:00:00
abstract：:One hundred twenty preterm newborns less than 34 weeks' gestational age have been studied prospectively to determine the frequency of fetal and newborn metabolic acidosis and to examine the relationship of metabolic acidosis to periventricular leukomalacia as demonstrated by serial newborn ultrasonographic examination...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(90)91299-r
更新日期：1990-04-01 00:00:00
abstract：OBJECTIVE:Our purpose was to compare the estimated maternal cerebral perfusion pressure and an index of vascular resistance, the resistance area product, in nonpregnant women with hypertensive pregnant women. STUDY DESIGN:The maternal middle cerebral artery was evaluated by transcranial Doppler ultrasonography in 17 n...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(98)70131-0
更新日期：1998-11-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to determine the prevalence of burnout in chairs of academic departments of obstetrics and gynecology, identify important stressors, and develop strategies to treat and prevent burnout. STUDY DESIGN:We performed a cross-sectional study of 131 chairs in the United States and Puer...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2002.122391
更新日期：2002-04-01 00:00:00
abstract：:The maturation of the glomerular filtration rate (GFR) and the interrelationship between the GFR and the renal transport of sodium and chloride have been evaluated during the last trimester of gestation with the use of long-term experiments in fetal lambs. An increase in GFR (milliliters per minute) parallel to the in...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(77)90712-8
更新日期：1977-08-01 00:00:00
abstract：OBJECTIVE:We sought to evaluate whether serial amnioinfusions for persistent oligohydramnios can affect the perinatal and long-term outcomes in extreme cases of preterm premature rupture of membranes. STUDY DESIGN:All singleton pregnancies with preterm premature rupture of membranes at <26 weeks' gestation and lasting...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2000.108873
更新日期：2000-10-01 00:00:00
abstract：:The Supreme Court decision in Webster v Reproductive Health Services permits states to regulate abortion in fashions that may be medically unsound and may significantly restrict access. This decision challenges the contemporary practice of obstetrics and threatens to curtail access to needed services, particularly for...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(90)91174-b
更新日期：1990-08-01 00:00:00
abstract：OBJECTIVE:We hypothesize that genetic variations (single nucleotide polymorphisms-SNPs) in the tumor necrosis factor-alpha (TNF-alpha), TNF receptors (TNFRI and TNFRII), interleukin-6 (IL-6) and IL-6 receptor (IL-6R) genes predict high-risk status for spontaneous preterm birth (sPTB) in European-American women. In this...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2006.03.059
更新日期：2006-06-01 00:00:00
abstract：:Thirty-two patients with uncomplicated twin pregnancies had ultrasonographic examinations for genetic amniocentesis, confirmation of twinning, or assessment of fetal growth. The dividing membranes between the fetuses were visualized, and the thickness of the membranes was measured. With a thickness of 2 mm used as a c...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(89)90921-6
更新日期：1989-12-01 00:00:00
abstract：OBJECTIVE:This study was undertaken to characterize variations in the management for women with preterm premature rupture of membranes (PPROM) among maternal-fetal medicine (MFM) specialists in the context of current recommendations for clinical practice and evidenced-based practice. STUDY DESIGN:We performed a Web-ba...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2004.08.005
更新日期：2004-10-01 00:00:00
abstract：:A total of 1,996 fetal heart rate (FHR) tracings were analyzed to assess the prognostic significance of variable decelerations. Nineteen percent (186 cases) of 988 tracings with variable decelerations in the last 30 minutes of monitored labor exhibited signs of atypia listed in order of frequency: (1) loss of initial ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1983-02-01 00:00:00
abstract：:To determine if the activity of the adrenocorticotropic hormonal-adrenal axis is modulated in part by estrogens and progestins, we have compared pituitary and adrenal responses to corticotrophin-releasing hormone in normal women during the early follicular, late follicular, and midluteal phases of the menstrual cycle ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(87)80229-6
更新日期：1987-12-01 00:00:00
abstract：:Unrecognized assay drift that may occur during low-volume (fewer than 500 specimens per week) maternal serum alpha-fetoprotein testing could result in either underestimation or overestimation of the number of pregnant women who are at increased risk of fetal malformations and genetic anomalies. Quality control softwar...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(91)90502-i
更新日期：1991-03-01 00:00:00
abstract：OBJECTIVES:Because dehydroepiandrosterone may protect against neoplasia, osteoporosis, and cardiac disease, we investigated the bioavailability of oral micronized dehydroepiandrosterone, anticipating its adjunctive use in postmenopausal steroid replacement. STUDY DESIGN:Eight postmenopausal women randomly received eit...
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：
更新日期：1992-04-01 00:00:00
abstract：:Advances in perinatal care have resulted in a decline in mortality of very-low-birth-weight infants (< 1.5 kilograms) and also in an extension of the mortality period. To determine the current relevance of neonatal mortality results as indicators of outcome, all deaths among 427 very-low-birth-weight infants admitted ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(80)90888-1
更新日期：1980-08-01 00:00:00
abstract：BACKGROUND:Preeclampsia (PE) affects 2-3% of all pregnancies and is a major cause of maternal and perinatal morbidity and mortality. The traditional approach to screening for PE is to use a risk-scoring system based on maternal demographic characteristics and medical history (maternal factors), but the performance of s...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2015.11.016
更新日期：2016-05-01 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：:From 1977 to 1981, 39 cases of primary cervical carcinoma were assayed for the presence or absence of cytoplasmic estrogen (ERc) and progesterone (PRc) receptors by a saturation point dextran-coated charcoal assay. The levels of ERc and PRc were compared with clinical stage, histologic type, histologic grade, menstrua...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(83)90752-4
更新日期：1983-06-01 00:00:00
abstract：OBJECTIVE:The bleeding time is one of the most commonly used diagnostic tests to evaluate platelet-related hemorrhagic disorders. Magnesium has been shown in vitro to be a platelet antiaggregant. This study was conducted to evaluate the hypothesis that magnesium sulfate has no effect on the template bleeding time. STU...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(95)91363-7
更新日期：1995-10-01 00:00:00
abstract：:Gonadotropins are released in a pulsatile fashion at a frequency of between 1 and 2 hours in the follicular phase of the menstrual cycle. Human menopausal gonadotropins are usually administered intramuscularly. We evaluated the gonadal response to intravenous human menopausal gonadotropins administered in a pulsatile ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(84)90736-1
更新日期：1984-03-01 00:00:00
abstract：:Pelvic floor disorders are common, with 1 in 4 US women reporting moderate to severe symptoms of urinary incontinence, pelvic organ prolapse, or fecal incontinence. Given the high societal burden of these disorders, identifying potentially modifiable risk factors is crucial. Physical activity is one such potentially m...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2015.08.067
更新日期：2016-02-01 00:00:00
