Abstract:
:Reanalysis of data on the ovulation method of natural family planning collected by the World Health Organization yields the following conclusions. The method is effective during perfect (correct and consistent) use, with a first-year probability of failure of 3.4%. However, it is extremely unforgiving of imperfect use, with a first-year probability of failure of 84.2% if the method is not used correctly. During the initial year, 87% of the cycles were characterized by perfect use. Nevertheless, the 13% of cycles characterized by imperfect use had a tremendous impact on the overall failure rate. During the first year of typical use 22.5% of the women in the clinical trial became accidentally pregnant. :Re-analysis of data collected from clinical trials of the ovulation method (OM) of natural family planning (NFP) delineated failure rates for both perfect and imperfect use during the teaching phase, the effectiveness phase, and the actual 1st year of use, and offered computed failure rates for various types of use errors. The data, originally published in 1981, covered 765 women in the teaching phase (2701 cycles), and 725 in the effectiveness phase (7514 cycles), from New Zealand, India, Ireland, Philippines and El Salvador. In this study rules for the teaching phase differed significantly from the effectiveness phase, with total abstinence required for the 1st cycle, and more restrictions in the teaching phase generally. The data suggested that errors were underreported, and that failure rates were higher than those typically reported in other studies. Except for the 1st cycle, cycles with no intercourse were eliminated from analysis. 2.0% conceived in the 1st cycle, as 46% had coitus. Life table probabilities of pregnancy were 22.0% in the 1st year, 3.2% in perfect use and 84.1% in imperfect use. Failure rates per cycle in the teaching phase (cycles 2-6), 0.22% failure with perfect use, and 9.9% with imperfect use, were similar to those in the effectiveness phase, 0.24% for perfect use and 14.4% with imperfect use. The most risky behaviors were having intercourse on wet/mucus days, within 3 days after the peak, during stress, on the peak day or around a 2nd peak (90% failure rate). Moderately risky behaviors were intercourse during mischarted cycles, spotting/bleeding days, having genital contact on wet days (50%). Intercourse on consecutive early days was least risky (16.6%). By plotting the percent failing in the 1st year as a function of per cycle failure rates for perfect and imperfect use, it was concluded that the OM is fairly effective if used perfectly, extremely unforgiving of imperfect use, and moderately difficult to use perfectly. If underreporting is taken into account, the conclusion would be that OM is moderately effective if used perfectly, and very difficult to use perfectly.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Trussell J,Grummer-Strawn Ldoi
10.1016/s0002-9378(11)90581-xsubject
Has Abstractpub_date
1991-12-01 00:00:00pages
2054-9issue
6 Pt 2eissn
0002-9378issn
1097-6868pii
S0002-9378(11)90581-Xjournal_volume
165pub_type
杂志文章abstract::Physicians who deliver babies in Alabama were surveyed to determine their level of knowledge about the survival of low--birth weight/early gestational age infants. These estimates of neonatal survival were compared to the actual neonatal survival rates at local hospitals and at the regional perinatal centers in Alabam...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(82)90114-4
更新日期:1982-07-15 00:00:00
abstract::To determine whether anesthesia lowers fetal oxygen consumption, sodium pentobarbital (10 mg/kg) was given intravenously to seven chronically instrumented pregnant ewes (123 to 144 days' gestation). Oxygen consumption fell by 23% in association with a rise in fetal vascular PO2. Fetal breathing movements were abolishe...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90628-9
更新日期:1986-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to describe the characteristics and outcomes of obstetric patients who require mechanical ventilation. STUDY DESIGN:A review was conducted of obstetric patients who required mechanical ventilation and who received care at our institutions between 1990 and 1998. Data that were co...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.68
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:Our purpose was to examine the hypothesis that hysterectomy without adnexectomy after tubal interruption is associated with the development of hydrosalpinx. STUDY DESIGN:In this case-control study, patients with a pathologic diagnosis of hydrosalpinx were compared with a group of patients undergoing adnexect...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.130212
更新日期:2002-12-01 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::Single-agent chemotherapy of advanced and recurrent squamous carcinoma of the female genital tract has been largely ineffective. Combination-drug therapy which has augmented the efficacy of chemotherapy in numerous solid and nonsolid human tumors is usually attended by a degree of toxicity that has discouraged its use...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90500-1
更新日期:1975-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine whether longitudinally sampled maternal angiogenic concentrations predict preeclampsia. STUDY DESIGN:Plasma sFlt-1 and placental growth factor (PlGF) concentrations in healthy pregnant women were quantified at 10, 17, 25, and 35 weeks' gestation. Preeclampsia was diag...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.08.010
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:To determine whether medication classes are associated with alterations in concentrations of Quad screen analytes or the screen-positive rate. STUDY DESIGN:We conducted a retrospective cohort study of women with singleton gestations who received prenatal care and had a Quad screen performed in the University...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.07.013
更新日期:2009-12-01 00:00:00
abstract::Trichomonas vaginalis isolates were obtained in the United States from three women with trichomoniasis refractory to routine treatment with metronidazole. Cure was obtained in these cases with increased dosage of metronidazole. In experimental mouse infections, all three strains showed a significantly (about 10 to 20 ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32741-7
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this report is to bring to the attention of obstetric care providers the occurrence in pregnancy of a threatening pulmonary syndrome caused by hantavirus infection. STUDY DESIGN:Two recent cases of hantavirus pneumonitis in pregnancy, one complicated by adult respiratory distress syndrome, are...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90298-4
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to describe the outcome of peripartum cardiomyopathy in patients cared for in a community hospital. STUDY DESIGN:The cases of peripartum cardiomyopathy treated at Central Baptist Hospital in Lexington, Kentucky, from January 1, 1992, to December 31, 1998, were reviewed. RESULTS...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.105402
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:There has been a gradual shift of the focus of prenatal diagnosis from genetics to ultrasonography. We assessed our primary genetics approach to determine what would be missed without the genetics component. STUDY DESIGN:We evaluated referral indications for patients with normal and abnormal prenatal finding...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70230-2
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:Mitochondfial respiratory activities were measured in neonatal rat brain to compare the influence of transient intrauterine ischemia in the preterm fetus with that in the term fetus and to evaluate the effect of alpha-phenyl-N -tert-butyl-nitrone treatment. STUDY DESIGN:Intrauterine ischemia was induced by a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.111722
更新日期:2001-03-01 00:00:00
abstract::In recent years numerous articles have reported on the inaccuracies of the dilatation and curettage procedure, citing a false-negative rate of up to 10% to 15%. Indeed, several articles have reported that, in this era of simplified endoscopy, the blind dilatation and curettage should no longer play a significant role ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90367-5
更新日期:1988-06-01 00:00:00
abstract::Two studies were conducted to investigate the effect of a progesterone-releasing intrauterine contraceptive device (IUD) on uterine secretion of prostaglandin (PG) F2alpha associated with IUD-induced luteolysis in sheep. In bilaterally ovulating ewes receiving an IUD on day 3 (estrus = day 0) intrauterine release of p...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90803-7
更新日期:1978-09-01 00:00:00
abstract:OBJECTIVE:The primary objective of this study was to identify specific educational goals for obstetrics and gynecology residents in the ambulatory setting. STUDY DESIGN:A cross-sectional study of current practice patterns in primary care, benign gynecology, and office procedures was performed with mailings to local pr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.07.070
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:Our aim was to examine the relationship between the levels of cytokines in peritoneal fluid and its embryo toxicity. STUDY DESIGN:The levels of interleukin-1 and tumor necrosis factor were measured in peritoneal fluid from infertile women who did not have endometriosis (n = 21), who had untreated endometrios...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91672-x
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to provide a morphometric profile of endometrial granulated lymphocytes and to investigate qualitative and quantitative differences in leukocyte subsets in precisely timed luteal phase endometrial biopsies. STUDY DESIGN:Endometrial biopsies were obtained from 24 normal fertile ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91568-3
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVE:The study aims to investigate the prevalence of maternity blues and examine the risk factors involved in a group of Nigerian postpartum women. STUDY DESIGN:Five hundred and two postpartum women who had a normal vaginal delivery in 5 health centers in Ilesa Township were assessed with the Maternity Blues Scal...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2005.02.085
更新日期:2005-10-01 00:00:00
abstract::We have examined the ability of activators of adenylate cyclase and cyclic adenosine monophosphate to affect the output of prostaglandins E and F by dispersed cells of amnion and decidua collected from women following spontaneous labor. Cyclic adenosine monophosphate production by amnion and decidua cells was stimulat...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90592-7
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVE:Lipopolysaccharide pretreatment potentiates hypoxic ischemic injury. We hypothesized that docosahexaenoic acid pretreatment would improve function and reduce brain volume loss in this rat model of perinatal brain injury and inflammation. STUDY DESIGN:Seven-day-old rats were divided into 3 groups: intraperito...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.01.076
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to provide a viable alternative to routine postpartum hematocrit measurement, by a determination of the clinical risk factors that identify patients with anemia and an examination of the resulting cost savings. STUDY DESIGN:In this retrospective review, cases (postpartum hematoc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.121255
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:In preterm labor increased concentrations of interleukin-1 and tumor necrosis factor are present in amniotic fluid. These cytokines may promote labor by stimulating the production of prostaglandins by intrauterine tissues. In many biologic processes, transforming growth factor-beta modifies the actions of cyt...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91662-7
更新日期:1992-07-01 00:00:00
abstract::The activity of polyamine oxidase in human pregnancy serum was measured by our new specific method with radioisotopic N1-acetylspermine as substrate. The activity in pregnancy serum was very low and did not increase during gestation; it was not higher than that in nonpregnancy serum. The high polyamine oxidase activit...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90390-d
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare neonatal outcomes of pregnancies with preeclampsia or gestational hypertension with those of normotensive pregnancies that delivered at 35, 36, or 37 weeks of gestation separately. STUDY DESIGN:Secondary analysis of neonatal outcomes by week of delivery between 35 and...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ajog.2007.06.059
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:Absent end-diastolic blood flow in the umbilical artery identifies growth-restricted fetuses at high risk of perinatal mortality and severe morbidity. We explored antenatal variables predictive of perinatal mortality or severe neonatal morbidity in such fetuses. STUDY DESIGN:We accessed a cohort of 39 single...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.07.032
更新日期:2005-09-01 00:00:00
abstract::Certain neurological disorders are particularly liable to occur during pregnancy or may be profoundly influenced by it. Moreover, neurological disorders may influence the management of otherwise uncomplicated obstetric cases. Despite the practical importance of this subject, however, little attention has been devoted ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(78)90902-x
更新日期:1978-10-01 00:00:00
abstract::In a previous study, it was suggested that the presence of a grade III placenta correlates 100% with a mature lecithin/sphingomyelin (L/S) ratio and may replace amniocentesis in confirming fetal lung maturity. In this study that hypothesis was tested in 563 pregnancies. All patients underwent amniocentesis and simulta...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(82)90478-1
更新日期:1982-08-15 00:00:00
abstract::A case of primary hypothyroidism associated with postpartum galactorrhea-amenorrhea is reported. The configuration of the sella was compatible with pituitary adenoma, but prolactin dynamics did not support an autonomous secretory state. Replacement therapy with thyroxine led to complete reversal of clinical, radiologi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)33129-5
更新日期:1978-08-15 00:00:00
abstract:OBJECTIVE:Our purpose was to identify the age-related increased risks of the elderly gravida by clarifying the effects of age and parity, their combination, and their interaction. STUDY DESIGN:We studied 9556 singleton pregnancies in women aged 20 to 29 years or > or = 35 years delivered over an 8-year period. Data we...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)91409-9
更新日期:1995-06-01 00:00:00