Abstract:
OBJECTIVE:The purpose of this study was to determine the continuing effectiveness of active management of labor, a protocol that involves early detection and correction of dystocia with oxytocin in spontaneous cephalic nulliparous labor, by analysis of the contribution of this cohort to a doubled overall nulliparous cesarean delivery rate. STUDY DESIGN:This was a retrospective analysis of annually collated institutional data on cesarean delivery and perinatal outcome. RESULTS:From 1989 to 2000, 81,855 women were delivered at the National Maternity Hospital, of whom 34,201 women (42%) were nulliparous; the annual proportion of nulliparous women in spontaneous labor decreased progressively from 83% to 60%; the overall nulliparous cesarean rate increased from 8.1% to 16.6%. Cesarean birth rate among nulliparous women in spontaneous labor, although showing a significant upward trend between 1989 and 2000 (2.4%-4.8%; P = .001), was stable, averaging 5% for the last 8 years (P = .705); the peripartum death rate in this group fell significantly (P = .024). Comparing results for 1989 with results for 2000, nulliparous women in spontaneous labor accounted for 14% of the overall increase in cesarean deliveries (dystocia, 5%), compared with 51% for nulliparous women with induced labor. The perinatal mortality rate in term infants was unchanged. CONCLUSION:Active management of spontaneous first labors remains an effective protocol for the promotion of vaginal delivery with low peripartum mortality rates; factors other than dystocia in spontaneous labor account for the progressive increase in the nulliparous cesarean delivery rate.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Foley ME,Alarab M,Daly L,Keane D,Rath A,O'herlihy Cdoi
10.1016/j.ajog.2004.05.072subject
Has Abstractpub_date
2004-09-01 00:00:00pages
891-5issue
3eissn
0002-9378issn
1097-6868pii
S0002937804005575journal_volume
191pub_type
杂志文章abstract:OBJECTIVES:We determined which factors are associated with survival and good short-term neurologic outcome in newborns of 23 to 25 weeks' gestation. STUDY DESIGN:We retrospectively reviewed the charts of all (n = 82) infants born alive at our hospital at 23 to 25 weeks' gestation from 1988 through 1991. We used univar...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70139-3
更新日期:1994-05-01 00:00:00
abstract::A case of herpes gestationis recurring in each pregnancy, with a postpartum flare-up in the last pregnancy, is described. The diagnosis was confirmed by skin biopsy. The first pregnancy ended in a term stillbirth, but there were favorable outcomes in four subsequent pregnancies. Histopathologic examination of the plac...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90514-r
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:Disorders that lead to preterm delivery influence the fetal inflammatory response. STUDY DESIGN:We calculated odds ratios of elevated concentrations of 25 blood proteins on the first postnatal day in 798 infants born before the 28th week and classified by the pregnancy disorder that lead to preterm delivery....
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.12.010
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:To compare maternal and neonatal outcomes between planned cesarean delivery and induction of labor in women with class III obesity (body mass index ≥40 kg/m(2)). STUDY DESIGN:In this retrospective cohort study, we identified all women with a body mass index ≥40 kg/m(2) who delivered a singleton at our instit...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.06.045
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:Our purpose was to compare the effectiveness, women's views of the termination procedure, and success of umbilical cord culture for vaginal and oral misoprostol versus intra-amniotic prostaglandin PGF(2alpha) for second-trimester pregnancy termination (STPT). STUDY DESIGN:We randomized 217 women, 15 to 24 we...
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/j.ajog.2003.09.037
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:Our aim was to determine the effects of blocking prostaglandin synthesis, by infusion of indomethacin into the fetal circulation, on factors regulating amniotic fluid volume and on plasma composition in the mother and fetus. STUDY DESIGN:Indomethacin was administered to fetal sheep during 8 hours at 124.0 +/...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70406-6
更新日期:1994-01-01 00:00:00
abstract::A case of nonimmune hydrops fetalis associated with a supraventricular tachycardia was successfully treated with digoxin and verapamil. After resolution of the hydropic changes, however, the fetus unexplainedly died. Side effects from the drug therapy may have been responsible for the event. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90247-5
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND:The Twin Birth Study randomized women with uncomplicated pregnancies, between 32(0/7)-38(6/7) weeks' gestation where the first twin was in cephalic presentation, to a policy of either a planned cesarean or planned vaginal delivery. The primary analysis showed that planned cesarean delivery did not increase o...
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.2015.12.051
更新日期:2016-03-01 00:00:00
abstract::In November, 1978, the fetal heart rate nonstress test (NST) was instituted as the primary screening procedure for the evaluation of fetal well-being at Vanderbilt University Hospital. The results of the first 1,000 patients tested are presented. The stillborn rate within 8 days of a reactive NST was 6.4 per 1,000, wi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32583-2
更新日期:1981-09-15 00:00:00
abstract:OBJECTIVE:This study was undertaken to determine whether the neonatal benefit of a single complete course of antenatal corticosteroids diminishes when delivery is remote from administration (> 14 days). STUDY DESIGN:This retrospective 2 center cohort trial included women who received a single complete course of antena...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2006.12.018
更新日期:2007-05-01 00:00:00
abstract::A retrospective analysis was made of Rh-sensitized patients delivered of their babies at Duke University Medical Center during a 24 year period. Records of 202 obstetric patients representing 280 sensitized pregnancies from a pool of 39,910 deliveries were analyzed for past obstetric history, blood group information, ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90083-1
更新日期:1981-08-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine risk factors for trocar implantation metastasis after diagnostic laparoscopy in patients with primary or recurrent advanced ovarian cancer. STUDY DESIGN:Eighty-three women with primary advanced ovarian cancer and 21 women with recurrent ovarian cancer undergoing a l...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70489-8
更新日期:1999-09-01 00:00:00
abstract::Performing a platelet count in fetal scalp blood was hitherto the only method to predict whether the infant of a mother with idiopathic thrombocytopenic purpura will be thrombocytopenic. Fifteen such cases are reported. Falsely low platelet counts were found in almost half of these fetal scalp samples. In two patients...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80074-1
更新日期:1987-10-01 00:00:00
abstract::Charts from 482 singleton pregnancies undergoing cerclage placement in patients over a 6-year period were reviewed. Cervical dilatation at time of surgery, number of previous spontaneous losses, and gestational age at placement were key determinants of outcome. The most frequent complication, premature rupture of the ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90283-w
更新日期:1991-09-01 00:00:00
abstract::The effects of intravenous cocaine on heart rate and blood pressure were studied in pregnant and oophorectomized nonpregnant ewes. In response to intravenous cocaine doses of 1.0 and 2.0 mg/kg, both pregnant and nonpregnant ewes demonstrated dose-dependent increases in systolic, diastolic, mean arterial, and pulse pre...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90424-6
更新日期:1990-02-01 00:00:00
abstract::Metformin is everywhere. Originally introduced in clinical practice as an antidiabetic agent, its role as a therapeutic agent is expanding to include treatment of prediabetes mellitus, gestational diabetes mellitus, and polycystic ovarian disease; more recently, experimental studies and observations in randomized clin...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2017.06.003
更新日期:2017-09-01 00:00:00
abstract::Neonatal condition was assessed in a group of 82 infants born at term after maternal treatment with ritodrine for an average of 28.5 days, and compared with that in a matched control group of infants. No statistically significant differences were found in umbilical pH, Apgar scores, head circumference, and neurologica...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)91106-7
更新日期:1983-10-01 00:00:00
abstract::Fecundity has been extended to the menopause by advances in assisted reproductive techniques. The incidence of ovarian cancer increases with age, and an increased risk of ovarian cancer has been associated with incessant ovulation and infertility. The increased risk of ovarian cancer in older infertility patients must...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90164-3
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:The purpose of the present systematic review is to evaluate the available medical treatments for vulvar lichen sclerosus, using an arm-based network meta-analysis protocol. DATA SOURCES:We searched Medline (1966-2019), Scopus (2004-2019), Cochrane Central Register of Controlled Trials CENTRAL (1999-2019), Cl...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2019.10.095
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:Our purpose was to analyze 3 obstetric outcomes according to the various forms of congenital uterine malformation after in vitro fertilization and embryo transfer. STUDY DESIGN:We conducted a retrospective analysis of data from 24 patients with the following types of congenital uterine malformation: 6 unicom...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70255-7
更新日期:1996-07-01 00:00:00
abstract::The use of reconstructive surgical techniques accelerates recovery from radical pelvic surgery. It also allows the surgeon greater latitude in the type of procedure and the selection of patients for extended pelvic surgery. The techniques involved in three such reconstructive procedures are described, and their applic...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90783-9
更新日期:1977-10-01 00:00:00
abstract::This is a retrospective study designed to compare the results of treatment of minimal and mild types of endometriosis with danazol alone, operative laparoscopy and danazol combined, and operative laparoscopy alone. The population consisted of 112 patients with minimal endometriosis and 126 patients with the mild type....
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(88)80173-x
更新日期:1988-10-01 00:00:00
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 t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2004.02.015
更新日期:2004-04-01 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:BACKGROUND:HIV-seropositive women face high risk for infection with oncogenic human papillomavirus (oncHPV) types, abnormal Pap test results, and precancer, but cervical cancer risk is only modestly increased. Human papillomavirus (HPV)16 is highly oncogenic but only weakly associated with HIV status and immunosuppress...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2015.09.086
更新日期:2016-03-01 00:00:00
abstract::Persistent bleeding is a common reason for the discontinuation of contraception. Standard terminology for describing bleeding patterns by reference period is presented. Observed bleeding patterns with oral contraceptives, depot medroxyprogesterone acetate, the levonorgestrel subdermal implant, and intrauterine devices...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0002-9378(94)05013-1
更新日期:1994-05-01 00:00:00
abstract::The gonadotropin-releasing hormone antagonist offers several advantages over the use of the agonist and allows several physiologic questions to be addressed. In this study, we evaluated the ability of Nal-Glu to acutely inhibit the luteinizing hormone surge and prevent ovulation. We also assessed whether recovery of t...
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(91)90037-r
更新日期:1991-12-01 00:00:00
abstract::Clinical research has shown that prostaglandins (PGs) play an important role in every phase of human reproduction. The logical consequence of early basic biological research into PGs is the current interest in clinical evaluation of PGs as agents to induce labor and abortion and to stimulate menstruation. This is a ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(72)90467-x
更新日期:1972-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine whether women with one elevated value of the 3-hour glucose tolerance test are at increased risk for adverse perinatal outcomes. STUDY DESIGN:This was a retrospective cohort study of singleton pregnancies that were screened for gestational diabetes mellitus with the u...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.01.028
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Previous studies have shown a decrease in cervical cancer associated with intrauterine device use. It has been hypothesized that intrauterine device use may alter the natural history of human papillomavirus infections, preempting development of precancerous lesions of the cervix and cervical cancer, but the ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.11.1053
更新日期:2017-04-01 00:00:00