Abstract:
OBJECTIVE:The recommendation to perform a perimortem cesarean delivery within 4 minutes of maternal cardiac arrest was introduced in 1986. This recommendation was based on the assumptions that cardiopulmonary resuscitation is ineffective in the third trimester because of aortocaval compression, and that fetal and perhaps maternal outcomes would be optimized by timely delivery. Our objective was to review the outcomes of perimortem cesarean deliveries to attempt to validate those assumptions. STUDY DESIGN:Ovid MEDLINE searches using maternal mortality, cardiopulmonary resuscitation, perimortem cesarean delivery, heart attack, and cardiac arrest from 1985 until 2004. Citations from bibliographies of identified publications were perused and cross-referenced for other potential articles. Case reports were included for analysis when mothers had complete cardiopulmonary arrest, and cardiopulmonary resuscitation had been initiated before cesarean delivery. RESULTS:There were 38 cases of perimortem cesarean delivery identified; 34 infants survived (3 sets of twins, 1 set of triplets); 4 other infants survived initially, but died several days after the deliveries from complications of prematurity and anoxia. Of the 34 infants (25-42 weeks' gestation), time of delivery after maternal cardiac arrest was available for 25. Eleven infants were delivered within 5 minutes, 4 were delivered from 6 to 10 minutes, 2 were delivered from 11 to 15 minutes, and 7 were delivered more than 15 minutes. Of 20 perimortem cesarean deliveries with potentially resuscitatable causes, 13 mothers were resuscitated and discharged from the hospital in good condition. One other mother was successfully resuscitated after the delivery, but died within 24 hours from complications related to her amniotic fluid embolism. In 12 of 18 reports that documented hemodynamic status, cesarean delivery preceded return of maternal pulse and blood pressure, often in a dramatic fashion. Eight other cases noted improvement in maternal status. Importantly, in no case was there deterioration of the maternal condition with the cesarean delivery. We wish to emphasize the large selection bias in this data. CONCLUSION:Published reports from 20 years support, but fall far from proving, that perimortem cesarean delivery within 4 minutes of maternal cardiac arrest improves maternal and neonatal outcomes.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Katz V,Balderston K,DeFreest Mdoi
10.1016/j.ajog.2005.02.038subject
Has Abstractpub_date
2005-06-01 00:00:00pages
1916-20; discussion 1920-1issue
6eissn
0002-9378issn
1097-6868pii
S0002937805002346journal_volume
192pub_type
杂志文章,评审abstract::Two techniques were used to study the neuromuscular control of rabbit ovarian contractions. First, the ovary was denervated by stripping its artery. Spontaneous contractions were noted, as was a normal response to exogenously administered adrenergic agents. Second, the ovarian nerves were electrically stimulated in an...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90679-2
更新日期:1977-05-15 00:00:00
abstract::In a patient with polycystic ovarian disease, low-dose intravenous pulsatile gonadotropin-releasing hormone (5 mcg every hour) and no exogenous human chorionic gonadotropin induced multiple follicular development and elevated estrogen levels and resulted in a triplet pregnancy. Patients with polycystic ovarian disease...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(86)80017-5
更新日期:1986-10-01 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:OBJECTIVE:We sought to compare our 5-year program of fragile X screening of high-risk gravid women with our program of fragile X testing of affected individuals (probands). STUDY DESIGN:All women referred to the prenatal genetics clinic from 1994 to 1998 who had a family history of unspecified mental retardation or le...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70302-9
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:Our purpose was to test the hypothesis that lipopolysaccharide potentiates the transcription of human placental prostaglandin H synthase-2 gene, a rate-limiting enzyme in prostaglandin synthesis. STUDY DESIGN:We transfected normal term cytotrophoblasts with a reporter vector containing either prostaglandin H...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70422-3
更新日期:1998-03-01 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::Environmental origins of disease risk and harm to health have been increasingly acknowledged for numerous outcomes, in both adult and pediatric populations. Adverse reproductive and developmental effects have also been linked to environmental exposures. In addition to the current queries about a patient's alcohol and ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.10.044
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:In 2017, the Dutch cervical cancer screening program had replaced the primary cytology-based screening with primary high-risk human papillomavirus-based screening, including the opportunity to participate through self-sampling. Evaluation and balancing benefit (detection of high-grade cervical intraepithelia...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2020.08.026
更新日期:2020-08-13 00:00:00
abstract:OBJECTIVE:The objective of the study was to determine the degree of benefit of a transobturator midurethral polypropylene sling in patients with stress urinary incontinence through a quality-of-life instrument and outcome analysis. STUDY DESIGN:Forty-seven patients completed the validated Individual Incontinence Impac...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.07.036
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVE:We tested the hypothesis that the proliferative estrogen effect on the endometrium is enhanced in obese vs lean animals. STUDY DESIGN:Using Zucker fa/fa obese rats and lean control, we examined endometrial cell proliferation and the expression patterns of certain estrogen-regulated proproliferative and antip...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.08.064
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the effect of plasma volume expansion on the pulsatility indices of the fetal umbilical and middle cerebral arteries. STUDY DESIGN:Two hundred sixteen patients with severe preeclampsia, HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome, ec...
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.2004.06.061
更新日期:2005-01-01 00:00:00
abstract::Over a 10-year period 12,643 gynecologic surgical procedures were performed with the patients under general anesthesia. Succinylcholine was the muscle relaxant used in the majority of cases. Four of these patients developed prolonged postoperative apnea; the longest period of apnea was 6 hours. In one patient atypical...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(82)90680-9
更新日期:1982-05-01 00:00:00
abstract::The application of the Home Ovarian Hormone Monitor to the avoidance of pregnancy by periodic abstinence has been explored. No woman had difficulty with the daily urine testing, and their results consistently identified the distinctive hormone pattern of the ovulatory cycle and the day of ovulation and correlated clos...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)90568-7
更新日期:1991-12-01 00:00:00
abstract::Percutaneous nephrostomy is a useful method of supravesical diversion when ureteral obstruction occurs at initial diagnosis of gynecologic cancer or recurrence of disease. Although survival is prolonged, the attendant quality of life would indicate that percutaneous nephrostomy should be performed only in those cases ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90120-0
更新日期:1984-08-01 00:00:00
abstract:OBJECTIVE:We determined developmental and labor-related changes in 11beta-hydroxysteroid (HSD) 1 and 2 expression in baboon placentas during the final third of gestation and labor. We examined whether maternal glucocorticoid administration alters placental 11beta-HSD 2 expression. STUDY DESIGN:Maternal and fetal plasm...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.62
更新日期:2003-01-01 00:00:00
abstract::A 31-year-old nulligravid patient presented with irregular menses, severe hirsutism, and infertility. Evaluation revealed marked increases of serum androstenedione and testosterone levels and a possible ovarian mass. At operation a cystic teratoma was removed from the left ovary and bilateral wedge resection revealed ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90706-4
更新日期:1986-06-01 00:00:00
abstract::The intellectual, visual-motor, and social development of 15 children, 3 to 10 years of age, who received IUT for eythroblastosis fetalis was compared with that of 15 children of similar age who had required only exchange transfusions for the treatment of the same disorder. No over-all differences were found between t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90304-1
更新日期:1979-04-15 00:00:00
abstract::The ultrafast echo-planar magnetic resonance imaging technology, developed and built in Nottingham, has been used to produce the first snapshot images of the human fetus in utero. The imager, operating at a proton resonance frequency of 22 MHz, produces transaxial views in 64 or 128 milliseconds. These images comprise...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)91209-u
更新日期:1990-08-01 00:00:00
abstract::An attempt is made to define the quality of life in terms of the patient with gynecologic cancer. The effect of the diagnosis of cancer and its recurrence or its terminal state on the quality of life is considered. Possible methods of assessing the patient's individual feelings about the quality of her life are review...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90857-3
更新日期:1979-08-15 00:00:00
abstract::In the field of genetics, a rapid and accurate test for the prenatal determination of fetal sex, especially in cases of sex-linked disorders, is desirable. Amniotic fluid testosterone was measured by the radioimmunoassay technique in 37 samples obtained at saline abortion between 16 and 19 weeks' gestation. Final conf...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90089-8
更新日期:1977-11-01 00:00:00
abstract::The HAIR-AN syndrome that consists of hyperandrogenism (HA), insulin resistance (IR), and acanthosis nigricans (AN) is an underdiagnosed endocrinopathy, because hyperandrogenic women are not commonly screened for insulin resistance or acanthosis nigricans. The distinct pathophysiologic features of the HAIR-AN syndrome...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(83)90091-1
更新日期:1983-09-01 00:00:00
abstract:OBJECTIVE:The pathogenesis of the HELLP (hemolysis, enzyme liver, low platelets) syndrome is unknown. Recently soluble endoglin (sEng) was identified as a cause of the appearance of schistocytes and liver pathology in an animal model of preeclampsia (PE). STUDY DESIGN:We explored the value of sEng in 82 women who deli...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.03.006
更新日期:2010-06-01 00:00:00
abstract::It has been suggested that continued diffusion gradients from mother to fetus would exist and that both meperidine and normeperidine would accumulate in the fetus following multiple doses of meperidine to the mother during labor. However, no pharmacokinetic data are available. Therefore, the purpose of this study was ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90314-x
更新日期:1985-02-01 00:00:00
abstract::The amniotic fluid index and the nonstress test are commonly used in the expectant management of preterm premature rupture of membranes. This study was designed to investigate the interrelationship of the nonstress test and the amniotic fluid index during the preterm rupture of membranes latency period. Fifty patients...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90477-9
更新日期:1991-10-01 00:00:00
abstract::Denaturing gradient gel electrophoresis was used to identify single-base differences in the cytochrome P-450 21-hydroxylase (CYP21) genes of 132 unrelated control individuals and family members of three unrelated patients with 21-hydroxylase deficiency. The salt-wasting variety was caused by gene deletion and gene con...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91857-7
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to determine whether adolescent pregnancy is associated with increased risks of adverse pregnancy outcomes. STUDY DESIGN:We studied 854,377 Latin American women who were younger than 25 years during 1985 through 2003 using information recorded in the Perinatal Information System dat...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.10.593
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:Our aim was to assess the association between loop electrosurgical excision procedure (LEEP) and the subsequent risk for spontaneous preterm delivery, with the use of population-based data from various nationwide registries. STUDY DESIGN:The study population consisted of all singleton deliveries in Denmark d...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.02.004
更新日期:2009-07-01 00:00:00
abstract::A case of ovarian and systemic sarcoidosis with mucinous cystadenoma coexisting in the same ovary is described. This association has not been previously reported. The differentiation of systemic sarcoidosis from metastatic spread of ovarian cancer and from sarcoid-like reactions in regional lymph nodes of tumors is di...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90038-9
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVE:Our aim was to understand how vaginal eversion after hysterectomy differs from other forms of prolapse. STUDY DESIGN:The role of individual structures involved in vaginal support was studied by pelvic dissection of 61 cadavers. Serial cross sections from 13 additional cadavers were examined. RESULTS:The upp...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91562-o
更新日期:1992-06-01 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