Abstract:
:Advances in modern medicine invite the assumption that medicine can control human biology. There is a perilous logic that leads from expectations of medicine's control over reproductive biology to the expectation of having a perfect baby. This article proposes that obstetricians should take a preventive ethics approach to the care of pregnant women with expectations for a perfect baby. We use Nathaniel Hawthorne's classic short story, "The Birthmark," to illustrate the perils of the logic of control and perfection through science and then identify possible contemporary sources of the expectation of the perfect baby. We propose that the informed consent process should be used as a preventive ethics tool throughout the course of pregnancy to educate pregnant women about the inherent errors of human reproduction, the highly variable clinical outcomes of these errors, the limited capacity of medicine to detect these errors, and the even more limited capacity to correct them.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Chervenak FA,McCullough LB,Brent RLdoi
10.1016/j.ajog.2010.01.058subject
Has Abstractpub_date
2010-08-01 00:00:00pages
101.e1-5issue
2eissn
0002-9378issn
1097-6868pii
S0002-9378(10)00088-8journal_volume
203pub_type
杂志文章,评审abstract::Fifty-five patients with Stage IB adenocarcinoma of the cervix were treated by radical hysterectomy and pelvic lymphadenectomy from 1965 through 1985. Bleeding was the presenting symptom in 56% of the patients. Twenty patients underwent cone biopsy for diagnostic purposes and 70% had residual carcinoma at the time of ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90877-6
更新日期:1989-06-01 00:00:00
abstract::The results of predictive fertilization bioassays (hemizona assay, hamster ova-human sperm penetration assay), in vitro fertilization treatment, fertile donor cross-match tests with either sperm or oocytes, and oocyte micromanipulation for assisted fertilization were used to establish a pathophysiologic diagnosis in c...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90684-j
更新日期:1991-05-01 00:00:00
abstract::Primiparous mice were fed alcohol in their drinking water as 0%, 10%, 15%, 20% (v/v) solutions on days 11 through 18 of gestation. Based on blood alcohol levels and on locomotor and health impairments, these treatment groups represent situations of mild, moderate, and severe alcohol abuse. There were significant alcoh...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90028-0
更新日期:1984-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine surgical outcomes for the correction of clitoral phimosis caused by lichen sclerosus. STUDY DESIGN:Eight women with lichen sclerosus underwent surgical repair of clitoral phimosis. They were assessed 12-36 months postoperatively by an independent research assistant. A...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.08.023
更新日期:2007-02-01 00:00:00
abstract::Forelimb movements in the unanesthetized fetal lamb in utero were measured by means of transit-time ultrasound in conjunction with triceps and biceps electromyographic activity. The relationships between forelimb movements and electrocortical activity, hypoxia, and spontaneous labor were studied. There was no evidence...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90231-3
更新日期:1981-07-01 00:00:00
abstract:OBJECTIVE:To compare live birth rates following ultrasound-guided embryo transfer (ET) by reproductive endocrinology and infertility fellows versus attending physicians. STUDY DESIGN:Women who underwent their first day-3, fresh, nondonor ET between Oct. 1, 2005, and April 1, 2011, at our academic center were included ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.05.042
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:Our purpose was to describe the neonatal outcomes of 1804 very-low-birth-weight (< or = 1500 gm) infants delivered between November 1989 and October 1990 in the participating centers of the National Institute of Child Health and Human Development Neonatal Research Network. STUDY DESIGN:In an observational st...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/0002-9378(95)90557-x
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the association between vaginal douching and preterm birth. STUDY DESIGN:We enrolled hospitalized women after delivery in a case-control study. Women who were delivered of a live preterm singleton infant were assigned as cases. Women who were delivered at term were ra...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.122406
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to investigate the differences in perinatal outcomes between various Asian ethnic subgroups at a national level. STUDY DESIGN:This is a retrospective cohort study of all non-Hispanic Chinese, Japanese, Filipino, Asian Indian, Korean, Vietnamese, Samoan, Guamanian, and Hawaiian ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.06.073
更新日期:2008-10-01 00:00:00
abstract::The rates of regression of human chorionic gonadotropin (hCG) in patients with complete hydatidiform moles, partial hydatidiform moles, and nonmolar abortions were compared. No difference in rates of regression was found among the three groups, but levels of hCG immediately after uterine evacuation were significantly ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90184-4
更新日期:1984-05-15 00:00:00
abstract:OBJECTIVE:Our purpose was to study whether cardiovascular changes in pregnancy-induced hypertension are associated with the increase in sympathetic control of hemodynamics and change in sympathovagal balance. STUDY DESIGN:Fourteen women with pregnancy-induced hypertension and 16 women with uncomplicated pregnancies of...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)70041-3
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVE:We used the Danish National Birth Cohort to estimate the effect of shift work on the duration of pregnancy and birth weight. STUDY DESIGN:In the Danish National Birth Cohort (1998-2001), we identified women (and their singleton births): 32465 women with daytime work, 1038 women with fixed evening work, 400 w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2003.12.002
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:We sought to determine the long-term efficacy, safety, and urodynamic effects of the Mersilene mesh suburethral sling in treating complicated forms of genuine stress incontinence. STUDY DESIGN:Two hundred women diagnosed with genuine stress incontinence, complicated by recurrence, intrinsic sphincter deficie...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1067/mob.2001.116370
更新日期:2001-07-01 00:00:00
abstract::The effect of estradiol infusion on uterine activity and peripheral levels of prostaglandin F and progesterone in pregnant women at term were investigated. 5 normal women at term and 4 women with pre-eclampsia at term were given estradiol-17 beta by infusion over 2-4 hours. Radioimmunoassay was used to measure perip...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(73)90646-7
更新日期:1973-09-15 00:00:00
abstract:OBJECTIVE:We sought to describe the peripartum outcome of women weighing >300 pounds (135 kg) who were candidates for trial of labor after a prior cesarean delivery. STUDY DESIGN:All pregnant women who weighed in excess of 300 pounds and had a prior cesarean delivery were included in this prospective investigation. St...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.116729
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate factors that are associated with significant birth weight discordancy. STUDY DESIGN:As a part of an ongoing collaborative study of twins, maternal and fetal data were obtained from the medical records of twin gestations at eight medical centers. The study population ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/s0002-9378(03)00658-6
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:The purposes of this study were to examine endothelial nitric oxide synthase expression in endothelial cells and to determine whether the inhibition of endothelial nitric oxide synthase could impair endothelial barrier function in preeclampsia. STUDY DESIGN:Messenger RNA and protein expression for endothelia...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2003.09.049
更新日期:2004-03-01 00:00:00
abstract::This case report describes the antenatal diagnosis of a fetal pulmonary anomaly. Early detection afforded detailed parental counseling and prompt neonatal diagnosis and treatment. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90433-8
更新日期:1985-01-01 00:00:00
abstract::To determine the role of carbon dioxide in the generation of fetal respiratory movements, the effect of induced maternal hypocapnia and hypercapnia on fetal breathing movements, gross body movements, and fetal heart rate was studied in 12 healthy pregnant women near term. Patients were studied for a 1-hour control per...
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(88)90147-0
更新日期:1988-02-01 00:00:00
abstract::Outpatient endometrial aspiration was offered to patients who suspected that they were pregnant, but were within 5 to 21 days after failure of expected menstruation and had a uterus of normal size on pelvic examination. This is a report of 500 consecutive cases treated between September, 1973, and April, 1975. Histolo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90567-6
更新日期:1976-06-01 00:00:00
abstract:OBJECTIVE:We sought to determine the ability of single-nucleotide polymorphism-based noninvasive prenatal testing (NIPT) to identify triploid, unrecognized twin, and vanishing twin pregnancies. STUDY DESIGN:The study included 30,795 consecutive reported clinical cases received for NIPT for fetal whole-chromosome aneup...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.10.012
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to test the hypothesis that paternal race influences the risk for preterm birth. STUDY DESIGN:We conducted a population-based cohort study to examine the association of paternal race with preterm birth using the Missouri Department of Health's birth registry from 1989-1997. Birt...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.03.035
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:To determine maternal and perinatal outcome in women with severe preeclampsia at <26 weeks according to gestational age at the onset of expectant management and the presence of severe fetal growth restriction (<5th percentile). STUDY DESIGN:Fifty-one patients (53 fetuses; 2 twins) were retrospectively studie...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.06.062
更新日期:2011-11-01 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::The early neoplastic lesions of the cervix offer an excellent model to study the neoplastic process in the human; In vitro studies indicate that these lesions are intermediate between normal epithelium and invasive carcinoma in many aspects. More recent studies show that the in vitro cells retain many of the character...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1975-03-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to find out whether the effects of thermal stress on plasma catecholamines and plasma renin activity are altered by pregnancy. STUDY DESIGN:Nonpregnant (n = 15) and pregnant (13 to 14 weeks, n = 23; 36 to 37 weeks, n = 23) healthy women were examined. Samples were taken before t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91590-7
更新日期:1992-09-01 00:00:00
abstract::Sixty percent of neonates with Down syndrome have hypoplasia of the middle phalanx of the fifth digit. We demonstrate this finding sonographically between 17 and 20 weeks' gestation in four of five fetuses with Down syndrome. The appearance of this abnormal phalanx as well as the abnormal curvature of the fifth digit ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90517-0
更新日期:1988-07-01 00:00:00
abstract::Because serum CA-125 concentrations are increased in women with endometriosis, our objective was to determine whether CA-125 levels could be used to differentiate endometriotic from nonendometriotic benign cysts. During a 2-year period, all women who had an endometrioma (n = 33) or a nonendometriotic cyst (n = 27) tha...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80237-5
更新日期:1987-12-01 00:00:00
abstract:BACKGROUND:In contemporary practice many nulliparous women require intervention during childbirth such as operative vaginal delivery or cesarean delivery (CD). Despite the knowledge that the increasing rate of CD is associated with increasing maternal age, obesity and larger infant birthweight, we lack a reliable metho...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2017.02.017
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Uterine inflammatory processes trigger prolabor pathways and orchestrate on-time labor onset. Although essential for successful labor, inflammation needs to be regulated to avoid uncontrolled amplification and resolve postpartum. During labor, myometrial smooth muscle cells generate ATP mainly via anaerobic ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.09.072
更新日期:2017-01-01 00:00:00