Abstract：
OBJECTIVE:We hypothesized that diagnostic approaches to lower genital tract infections are inaccurate and proposed this study to evaluate typical approaches. STUDY DESIGN:Clinical diagnoses were made with symptoms, direct observation, wet mount, vaginal pH, and amines in 598 women with genital complaints. Laboratory testing for N gonorrhoeae, yeast, T vaginalis, C trachomatis, and bacterial vaginosis by Gram stain. RESULTS:The most frequent symptoms were vaginal discharge (64%), change in discharge (53%), malodor (48%), and pruritus (32%). The infection rates were 46% bacterial vaginosis, 29% yeast, 12% trichomoniasis, 11% chlamydia or gonorrhea; 21% of the patients had no infection. The symptoms did not predict laboratory diagnosis. Clinical signs and symptoms with office-based tests and microscopy improved the accuracy of diagnoses. Amsel's clinical diagnosis of bacterial vaginosis was the most sensitive at 92%. The sensitivity of wet mount diagnosis of trichomoniasis was 62%, of yeast by microscopy was 22%, and of mucopus for the prediction of gonorrhea and/or chlamydia was 30%. CONCLUSION:Symptoms alone should not be used to direct treatment in instances in which resources permit more complete evaluation with office-based testing that includes microscopy. Treatment failures or diagnostic uncertainty should prompt specific laboratory testing.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Landers DV,Wiesenfeld HC,Heine RP,Krohn MA,Hillier SLdoi
10.1016/j.ajog.2004.02.015subject
Has Abstractpub_date
2004-04-01 00:00:00pages
1004-10issue
4eissn
0002-9378issn
1097-6868pii
S0002937804001358journal_volume
190pub_type
杂志文章,多中心研究abstract：OBJECTIVE:Our purpose was to assess the effects of the adjunctive use of cardiovascular dynamics monitoring in the ambulatory management of 199 pregnant patients with severe hypertension. STUDY DESIGN:A prospective, observational study was performed. Determinants of mean arterial pressure were computed by using the Ho...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2002.123744
更新日期：2002-06-01 00:00:00
abstract：OBJECTIVE:Our purpose was to evaluate the role of fetal ultrasonography in prenatal detection of trisomy 21. STUDY DESIGN:A retrospective study was performed on all cases of trisomy 21 diagnosed prenatally or postnatally between January 1990 and December 1993 in the Jerusalem metropolitan area. Our program of prenatal...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(98)70623-4
更新日期：1998-01-01 00:00:00
abstract：:Sponsored by the nonprofit Berlex Foundation, this 6-day Faculty Development Course introduces small groups of new faculty to research design, critical appraisal of the literature, scientific writing, and evidence-based medicine. The course includes didactic presentations, small group discussions, and individual proto...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1067/mob.2000.107381
更新日期：2000-10-01 00:00:00
abstract：:Continuous follow-up of 224 patients treated for primary invasive squamous cell carcinoma of the vulva in a 20-year period (1955 to 1975) at the Mayo Clinic resulted in the detection of recurrent (or persistent) neoplasia in 59 (26%). Rates of treatment failure increased with advancing stage of disease-from 14% for St...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(82)90823-7
更新日期：1982-06-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to characterize the pelvic floor of the rhesus macaque as an experimental model for human pelvic organ prolapse and to initiate an evaluation of the effects of estradiol and progesterone on the rhesus paravaginal attachment. STUDY DESIGN:Histologic specimens were prepared from t...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2002.121723
更新日期：2002-03-01 00:00:00
abstract：OBJECTIVE:Our objective was to identify novel genes that are expressed in temporally and spatially restricted patterns during mouse embryonic development and organogenesis. STUDY DESIGN:Two genetic trapping reporter constructs that lack transcriptional regulatory sequences were introduced independently into transcript...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(93)90643-w
更新日期：1993-09-01 00:00:00
abstract：:A subset of women with a high rate of fetal wastage is identifiable among those with serologic but not necessarily clinical evidence of connective tissue disease. The presence of lupus anticoagulant in the plasma of a pregnant woman serves as a marker for a high rate of fetal wastage and risk of thrombosis. Lupus anti...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/s0002-9378(85)80124-1
更新日期：1985-10-01 00:00:00
abstract：BACKGROUND:Epithelial ovarian cancer prognosis is improved by the presence of intratumoral CD3 + T cells, which are known to produce interferon-gamma. We therefore speculated that interferon-gamma expression in ovarian cancer-infiltrating T-lymphocytes might cause better prognosis. PATIENTS AND METHODS:Reverse transcr...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2004.05.007
更新日期：2004-11-01 00:00:00
abstract：BACKGROUND:There is a robust association between altered angiogenic factor concentrations, which includes placental growth factor and clinically recognized preeclampsia. Alterations in concentrations of angiogenic factors precede the clinical onset of preeclampsia by several weeks. The temporal relationship between the...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,多中心研究
doi：10.1016/j.ajog.2019.09.003
更新日期：2020-03-01 00:00:00
abstract：OBJECTIVE:Our aim was to determine which factors influence the effectiveness of intrauterine insemination. STUDY DESIGN:This article is a retrospective statistical analysis of outcomes of 9963 consecutive intrauterine insemination cycles. RESULTS:Patient age was the main determinant of pregnancy outcome (analysis of ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(99)70048-7
更新日期：1999-06-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to estimate the usefulness of the fetal-pelvic index (FPI) in the prediction of cesarean delivery among nulliparous and women who undergo a trial of labor after cesarean delivery (TOLAC). STUDY DESIGN:This prospective cohort study included subjects at 2 hospitals from the Univer...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2013.06.026
更新日期：2013-11-01 00:00:00
abstract：:A total of 258 patients with candidal vulvovaginitis, all of whom also exhibited Candida organisms in the rectum, were treated for 1 week with vaginal tablets only (nystatin or clotrimazole) or with both vaginal and oral tablets (nystatin). Mycologic and symptomatic responses were superior for the group receiving comb...
journal_title：American journal of obstetrics and gynecology
pub_type： 临床试验,杂志文章
doi：10.1016/0002-9378(86)90297-8
更新日期：1986-09-01 00:00:00
abstract：OBJECTIVE:Our goal was to determine whether there are racial differences in the severity of illness on admission for premature newborn infants independent of gestational age. STUDY DESIGN:The study population consisted of all African American and Caucasian singleton infants with gestational ages <34 weeks who were adm...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2001.109941
更新日期：2001-03-01 00:00:00
abstract：OBJECTIVE:We sought to determine the fetal injury rate associated with shoulder dystocia and to determine whether there is a higher rate of brachial plexus injury or bone fracture when fetal manipulation techniques are required for delivery. STUDY DESIGN:A retrospective review of 285 cases of shoulder dystocia that oc...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(98)70312-6
更新日期：1998-06-01 00:00:00
abstract：:The role of the man in the etiology of recurrent vaginitis was examined in three women who reported an association between coitus and the initiation of clinical symptoms. The patients' disorders consisted of vaginal pruritus, burning, a white discharge, and painful coitus. Vaginal pH in each case was 4.5. Microscopic ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(88)90489-9
更新日期：1988-07-01 00:00:00
abstract：:A total of 1,996 direct fetal heart rate (FHR) tracings in labor were analyzed using the first and last 30 minutes of monitoring in order to evaluate individual FHR characteristics as to their ability to predict the fetal status. Comparisons were made between individual FHR characteristics occurring alone ("uncomplica...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(79)90113-3
更新日期：1979-04-01 00:00:00
abstract：:Steroid contraception was developed in the late 1950s and introduced into use in the early 1960s. It soon became apparent that estroprogestational agents had adverse systemic effects, mainly on the cardiovascular and blood coagulation system. During the 1970s, new contraceptive agents were developed that contained 3...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(16)32475-9
更新日期：1982-03-15 00:00:00
abstract：:Endometrial blood flow was measured through the menstrual cycle in nonpregnant women (28 studies of 17 women with normal menstrual cycles and 32 studies of 20 women with dysfunctional uterine bleeding) with use of a clearance technique in which 100 to 400 microCi of the gamma-emitting isotope, xenon 133 in saline solu...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(87)90229-8
更新日期：1987-01-01 00:00:00
abstract：:This article, from the To the Point series prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, is an overview of issues to consider regarding learner mistreatment and its effects on the undergraduate medical education learning environment in the United Stat...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2019.04.021
更新日期：2019-11-01 00:00:00
abstract：OBJECTIVE:A recent increase in pertussis cases prompted the Advisory Committee on Immunization Practices to recommend administering the perinatal tetanus, diphtheria, and pertussis (Tdap) vaccine during each pregnancy. We sought to describe uptake of Tdap and identify predictors of vaccination in pregnancy. STUDY DESI...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2014.05.029
更新日期：2014-09-01 00:00:00
abstract：:Healthy pregnant women underwent a mild exercise study to evaluate the effects of this amount of work on their fetuses. The results indicated that there were no direct correlations between exercise and fetal body or breathing movements at this particular work intensity (2.33 m). We found a relationship between the mat...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(83)90003-0
更新日期：1983-11-01 00:00:00
abstract：OBJECTIVE:Our purpose was to determine differential effects of natural and synthetic glucocorticoids on cytochrome 17alpha-hydroxylase and cytochrome P-450 side-chain cleavage messenger ribonucleic acid in the sheep placenta and to determine whether feed-forward effects during labor are involved in further inducing pla...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(99)70619-8
更新日期：1999-05-01 00:00:00
abstract：:Fetal facial reactions and response decrement patterns to external noise stimulation were studied to characterize normal fetal neurobehavior in the third trimester. Response decrement, or habituation, is thought to reflect higher central nervous system function. Two hundred women with uncomplicated pregnancies, who we...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(88)90773-9
更新日期：1988-01-01 00:00:00
abstract：:It has recently been suggested that platelet-activating factor is involved in a number of processes associated with reproductive biology. We have demonstrated a critical role for this autacoid in the initiation and maintenance of parturition both in animals and man. In the present investigation, it has been demonstrat...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(11)90610-3
更新日期：1992-04-01 00:00:00
abstract：:Universal access to contraception benefits society: unintended pregnancies, maternal mortality, preterm birth, abortions, and obesity would be reduced by increasing access to affordable contraception. Women should be able to choose when and whether to use contraception, choose which method to use, and have ready acces...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2019.09.014
更新日期：2020-02-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to examine the association between preeclampsia and cancer incidence. STUDY DESIGN:The Jerusalem Perinatal Study is a population-based cohort of all births to 41,206 residents of Western Jerusalem from 1964-76. Cancer incidence to 2004 was assessed by linkage of the cohort with ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2008.06.057
更新日期：2009-01-01 00:00:00
abstract：:Surgical abortion in the first trimester comprises the majority of voluntary pregnancy interruptions performed in the United States. The majority of these procedures are done in outpatient settings with the patient under local anesthesia. Appropriate volume of and deep injection of local anesthetic can reduce pain ass...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1067/s0002-9378(03)00107-8
更新日期：2003-08-01 00:00:00
abstract：OBJECTIVE:This study was undertaken to evaluate the cost-effectiveness of Burch colposuspension compared with tension-free vaginal tape. STUDY DESIGN:A Markov decision model was developed to compare costs (2005 US dollars) and effectiveness (quality-adjusted life years) of Burch and tension-free vaginal tape for stres...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2007.02.039
更新日期：2007-07-01 00:00:00
abstract：:Severe pregnancy-induced hypertension and markedly elevated levels of serum alkaline phosphatase developed in a 29-year-old-woman in whom one pregnancy resulted in intrauterine death. Acute fatty liver of pregnancy developed with good fetal outcome in the next pregnancy. This case suggests that pregnancy-induced hyper...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(90)90677-y
更新日期：1990-10-01 00:00:00
abstract：:Plasma luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were measured in response to luteinizing hormone-releasing factor (LRF), given as a 100 microgram intravenous bolus and/or as a 4 hour infusion of 0.2 microgram per minute to 27 normal menstruating women and 15 women with the polycystic ovar...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(78)90318-6
更新日期：1978-03-15 00:00:00
