Abstract:
OBJECTIVE:The purpose of this study was to assess the validity of vaginal fetal fibronectin as a screening test for spontaneous preterm birth in patients with cervical cerclage. STUDY DESIGN:A historic cohort of 117 patients who underwent cervical cerclage placement between 1996 and 2002 were identified. All patients were followed up in a maternal-fetal medicine faculty practice in a university setting. Serial fetal fibronectin samples of vaginal secretions were collected every 2 to 3 weeks, starting at 22 weeks of gestation and continuing until 32 weeks or delivery, whichever came first. RESULTS:There were 81 singleton, 23 twin, 12 triplet, and 1 quadruplet pregnancies. There were 61 ultrasound-indicated, 47 prophylactic, and 9 emergency cerclages that were placed. Most cerclages were of the modified Shirodkar type (95%) with a median gestational age at cerclage placement of 16.6 weeks. Overall, 33.3% of gestations were delivered spontaneously before 37 weeks of gestation; 17.1% of gestations were delivered spontaneously before 34 weeks. For deliveries within 2 weeks and 3 weeks of a single fetal fibronectin assessment, the test had a sensitivity of 50% and 48.3%, a specificity of 90% and 91.1%, a positive predictive value of 16.3% and 28.6%, and a negative predictive value of 97.9% and 96%, respectively. Subgroup analysis by number of fetuses (singleton, twin, and higher order multiple gestations) revealed similar values. For delivery before 34 weeks of gestation, fetal fibronectin had a sensitivity of 50%, a specificity of 78.4%, a positive predictive value of 33.3%, and a negative predictive value of 88%. CONCLUSION:This study is the first to evaluate the use of vaginal fetal fibronectin assessments to screen for preterm birth in patients who had undergone cervical cerclage procedures. We conclude that this test has similar validity to predict spontaneous preterm delivery in these high-risk pregnancies, as in previously published cohorts.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Roman AS,Rebarber A,Sfakianaki AK,Mulholland J,Saltzman D,Paidas MJ,Minior V,Lockwood CJdoi
10.1067/s0002-9378(03)00656-2subject
Has Abstractpub_date
2003-11-01 00:00:00pages
1368-73issue
5eissn
0002-9378issn
1097-6868pii
S0002937803006562journal_volume
189pub_type
杂志文章abstract::Sixty-six patients with fibrocystic mastopathy were enrolled in the trial after being selected according to clinical, radioultrasonographic, and histologic criteria. No characteristic hormonal profile was noted in most patients (52%). Estrogen receptors or progesterone receptors, or both, were found in 57% of patients...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90680-p
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVE:Photodynamic therapy is a technique in which tissue is irradiated with light after the use of a photosensitizing drug that produces singlet oxygen, which has a cytotoxic effect. The feasibility of using photodynamic therapy with photofrin II for endometrial ablation was studied. STUDY DESIGN:Fifty-eight rabb...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91787-b
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVE:Patients with preeclampsia (PE) have endothelial dysfunction and an increased future risk of cardiovascular (CV) mortality. The number of circulating endothelial cells (CECs) is markedly increased in conditions associated with a high degree of endothelial cell activation/injury including PE. We hypothesized t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2015.06.043
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:Our purpose was to investigate the levels of very-low-density lipoprotein and low-density lipoprotein receptor messenger ribonucleic acid expression in placentas obtained from normal pregnant women at various gestational stages and from patients with preeclampsia. STUDY DESIGN:The relative level of expressio...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70105-9
更新日期:1996-12-01 00:00:00
abstract::The serum ferritin level was used to diagnose iron depletion in 137 pregnant patients who came to an inner-city hospital outpatient clinic. Seventy-three patients (53.3%) had ferritin levels less than 20 micrograms/L, indicating iron depletion. The prevalence of iron depletion was 29% in the first trimester, 64% in th...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90429-2
更新日期:1988-11-01 00:00:00
abstract:OBJECTIVE:Heritable thrombophilias have been implicated as a potential cause of abruption by vascular disruption at the uteroplacental interface. Polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene have been linked to vascular complications outside of pregnancy, which includes stroke. Given the underl...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2007.06.046
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:Human trophoblast proteolytic activity is believed to have implications for early implantation events and maintenance of chorionic structural integrity later in gestation. Abnormal release of chorion-derived extracellular matrix proteins such as fibronectin may identify patients at risk for preterm labor and ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)80012-9
更新日期:1997-01-01 00:00:00
abstract::One of the largest nationally reported cases of carcinoma in situ in the teenage population of the United States is based on 1 year's computerized data from Cancer Screening Services. In 1981, 796,337 women were screened with an average age of 25.9. Of these, 18,589 (2.33%) had abnormal cytology. In 194,069 (24.3%) of...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90555-6
更新日期:1984-03-15 00:00:00
abstract::A total of 1,755 fetal heart rate (FHR) tracings of the second stage of labor was analyzed. The FHR patterns were classified according to the behavior of the baseline FHR and are listed in decreasing order of benignity: normocardia, transitory bradycardia, tachycardia, persistent bradycardia, and progressive bradycard...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90041-7
更新日期:1981-06-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare clinical manifestations, treatment, and pregnancy outcome of adnexal torsion in pregnant and nonpregnant women. STUDY DESIGN:We conducted a retrospective case-control study in the Departments of Gynecology at 2 tertiary centers between 1999-2008. Forty-one pregnant an...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.11.028
更新日期:2010-06-01 00:00:00
abstract::Partial colpocleisis, in comparison with complete colpocleisis, offers several advantages. The most obvious advantage is the avoidance of recurrent prolapse in sexually nonactive, older patients. Historically, colpocleisis has been reported to produce stress incontinence, which may be avoided by partial colpocleisis. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90699-x
更新日期:1986-06-01 00:00:00
abstract::The prostaglandin synthetase inhibitor ibuprofen was evaluated for relief of severe primary dysmenorrhea in a controlled, double-blind, cross-over study in seven patients for a total of 23 menstrual cycles. In eight untreated cycles, the amount of prostaglandin (PG) in the menstrual fluid was higher than in nondysmeno...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare longitudinally sampled maternal angiogenic proteins between singleton and twin pregnancies. STUDY DESIGN:Placental growth factor (PlGF), soluble feline McDonough sarcoma (fms)-like tyrosine kinase (sFlt)-1, and soluble endoglin from healthy pregnant women were quantif...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.11.035
更新日期:2015-05-01 00:00:00
abstract::The ability to predict clinical outcomes is of great importance to physicians and patients alike. Accordingly, multiple different methods have been used in an effort to accurately predict these outcomes. These methods include the development of scoring systems based on univariable and multivariable analysis, as well a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2005.09.002
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:Our purpose was to document noninvasively the effect of sickle cell disease on left ventricular systolic and diastolic function during the third trimester of pregnancy. STUDY DESIGN:Fifteen patients with sickle cell disease underwent a two-dimensional M-mode echocardiography obtained using the long axis with...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70393-0
更新日期:1994-01-01 00:00:00
abstract::Of 468 diagnosis-related groups identified by the federal government for Medicaid reimbursement, 15 are related to obstetric hospital care. Each diagnosis-related group is considered a distinct group in which cases are homogeneous with respect to resource consumption. Because the diagnosis-related group system is base...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(87)90052-4
更新日期:1987-03-01 00:00:00
abstract::This study was undertaken to determine the significance of the changes in nonsuppressible insulin-like activity as measured by the fat pad assay and by the levels of immunoreactive somatomedin C, growth hormone, and human placental lactogen in sera of term normal pregnant women, mothers who delivered prematurely, and ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90087-0
更新日期:1985-10-15 00:00:00
abstract::Grand multiparity has been considered to be a factor in maternal and neonatal morbidity. In addition, families with seven or more children have been associated with low socioeconomic status. To minimize the confounding effect of the socioeconomic status, the outcome of grand multiparity has been investigated in a most...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90213-x
更新日期:1988-05-01 00:00:00
abstract::Placental-related fetal growth restriction arises primarily due to deficient remodeling of the uterine spiral arteries supplying the placenta during early pregnancy. The resultant malperfusion induces cell stress within the placental tissues, leading to selective suppression of protein synthesis and reduced cell proli...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2017.11.577
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Surgical abortion is a generally safe procedure. Obesity is a known risk factor for complications in other surgical procedures, but insufficient information exists to determine the effects of increasing body mass index on the risk of surgical abortions. OBJECTIVE:The purpose of this study was to determine w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2017.10.018
更新日期:2018-02-01 00:00:00
abstract::Original histologic slides were reviewed from 87 patients with advanced ovarian carcinoma, all of whom had been treated with cisplatin, alone or in combination. The degree of lymphocyte infiltration in the tumor was not related to histologic or cytologic tumor differentiation. However, the degree of lymphocyte infiltr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(82)90178-8
更新日期:1982-12-15 00:00:00
abstract::We analyzed interview and record review data from 9,823 deliveries to evaluate the relationship between prior history of induced abortion and subsequent late pregnancy outcomes. Complications such as bleeding in the first and third trimesters, abnormal presentations and premature rupture of the membranes, abruptio pla...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)91041-4
更新日期:1983-05-15 00:00:00
abstract:OBJECTIVE:To summarize what is known about satisfaction with childbirth, with particular attention to the roles of pain and pain relief. STUDY DESIGN:A systematic review of 137 reports of factors influencing women's evaluations of their childbirth experiences. The reports included descriptive studies, randomized contr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1067/mob.2002.121141
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:We sought to review the risks of placenta accreta, increta, and percreta, and provide guidance regarding interventions to improve maternal outcomes when abnormal placental implantation occurs. METHODS:Relevant documents were identified through a search of the English-language literature for publications incl...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2010.09.013
更新日期:2010-11-01 00:00:00
abstract::FloSeal hemostatic matrix has been reported to be effective for the control of intraoperative bleeding in various surgeries. We report 3 patients who experienced a possible allergic response to FloSeal with the formation of excessive granulation tissue and fibrosis that were associated with early postoperative pelvic ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.10.052
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:We sought to determine the impact of geographic location on advanced-stage ovarian cancer mortality in relation to adherence to National Comprehensive Cancer Network (NCCN) treatment guidelines and hospital case volume. STUDY DESIGN:This was a retrospective observational cohort study of patients diagnosed wi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2015.01.045
更新日期:2015-07-01 00:00:00
abstract::We report 2 cases of 47,XXX that were diagnosed prenatally and were screened positive for trisomy 21 by biochemical and ultrasound markers. These cases underline the importance of discussing the sex chromosome abnormalities during the genetic counseling after an abnormal triple screen test or ultrasound examination. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.12.037
更新日期:2005-05-01 00:00:00
abstract::A reusable plastic Papanicolaou smear training model was developed to teach the techniques of the Papanicolaou smear. The model design allows immediate feedback and opportunity for skills practice, yet it is efficient and cost effective. Its use is recommended for instruction in the techniques of the Papanicolaou smea...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80147-3
更新日期:1987-08-01 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:OBJECTIVE:The purpose of this study was to evaluate the effect of elevated levels of circulating estradiol on the clotting and fibrinolytic system in patients undergoing controlled ovarian hyperstimulation. STUDY DESIGN:Fifty-two patients undergoing controlled ovarian hyperstimulation with human menopausal gonadotropi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90434-k
更新日期:1993-12-01 00:00:00