Abstract:
OBJECTIVE:To compare the risk of fetal death (FD) between 34 and 41 weeks' gestational age (GA) with the neonatal mortality rate to examine the best GA for delivery. STUDY DESIGN:Linked birth and infant death data for the US from the National Center for Health Statistics analyzed nonanomalous singleton pregnancies between 2003 and 2005. Pregnancies were classified as high risk or low risk based on preexisting maternal complications. Outcomes of 8,785,132 live births and 12,777 FDs between 34 and 42 completed weeks' gestation were examined. The risk of FD was determined using the following equation: The FD risk of those remaining undelivered was compared with the neonatal death rate for each week of gestation. RESULTS:Between 34 and 40 weeks' gestation, the FD risk of those remaining undelivered for all pregnancies declined and then increased at term. For high risk pregnancies, the FD risk of those remaining undelivered is substantially higher than for low risk pregnancies. The number of FDs that can be avoided by delivery exceeds the neonatal death rate between 37 and 38 weeks' gestation in low risk pregnancies and at 36 weeks' gestation in high risk pregnancies. CONCLUSION:These findings suggest that delivery at 39 weeks' gestation in both high and low risk pregnancies would result in an increased number of perinatal deaths. Decisions regarding the "optimal time for delivery" should include the risk of remaining undelivered.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Mandujano A,Waters TP,Myers SAdoi
10.1016/j.ajog.2012.12.005subject
Has Abstractpub_date
2013-03-01 00:00:00pages
207.e1-8issue
3eissn
0002-9378issn
1097-6868pii
S0002-9378(12)02200-4journal_volume
208pub_type
杂志文章abstract:OBJECTIVE:The objective of the study was to examine risk factors for bacterial vaginosis (BV) during pregnancy among African American women. STUDY DESIGN:As part of a study of preterm birth, African American women residing in Baltimore, MD, were recruited from prenatal care sites. Women enrolled prenatally (between 22...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2007.03.085
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:Our purpose was to measure erythrocyte indexes in fetuses with two grades of Doppler-defined umbilical placental insufficiency. STUDY DESIGN:A prospective study comprising 110 infants categorized into control, moderate, and severe groups by umbilical artery waveform studies was undertaken at the University o...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90090-6
更新日期:1993-08-01 00:00:00
abstract:OBJECTIVE:Our purpose was to describe subsequent pregnancy outcome and long-term maternal prognosis in women with HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) during the index pregnancy. STUDY DESIGN:This is a descriptive and analytic study of women with HELLP syndrome admitted to E.H. Crump W...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90099-3
更新日期:1995-01-01 00:00:00
abstract::Oligohydramnios is a hallmark for intrauterine growth retardation (IUGR) and has been evaluated in populations suspected of having IUGR. We chose to evaluate its incidence in a routine obstetric population. During a 16-month period, ultrasound scans were performed on 1,408 patients. Severe oligohydramnios was identifi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32235-9
更新日期:1983-10-15 00:00:00
abstract::This study was designed to test the hypothesis that the thermal response to endurance exercise is altered by the thermal adaptations to pregnancy. Accordingly, rectal temperature was monitored in 18 recreational athletes before, during, and after 20 minutes of continuous exercise before conception and every 6 to 8 wee...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90015-j
更新日期:1991-12-01 00:00:00
abstract::Progeny of women, whose thyroid function was studied gestationally, had psychological and/or neurologic examinations at 8 months, 4 years and 7 years of age. In more than 100 pregnancies (at least 3 per cent of total pregnancies) hypothyroxinemia occurred and was treated adequately or inadequately. Children were deliv...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-08-01 00:00:00
abstract::A study comparing the efficacy of cefotetan versus cefoxitin for prophylaxis in patients undergoing cesarean section was carried out at the University of Iowa. After institutional review, 36 subjects who met the study criteria and agreed to participate were entered into the study; of these, 29 were evaluable for effic...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(86)90496-5
更新日期:1986-04-01 00:00:00
abstract:OBJECTIVE:We previously demonstrated that chorion releases a factor that inhibits both spontaneous and oxytocin-stimulated myometrial contractility. Here, we investigate the mechanism of action of this unidentified substance. STUDY DESIGN:Myometrial strips from pregnant guinea pigs were mounted in an organ bath and co...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.102
更新日期:2003-01-01 00:00:00
abstract::The aggressive management of early labor has been suggested as a means to lower the cesarean section rate for dystocia. The aim of our study was to prospectively evaluate a protocol of early intervention in primigravid women with infrequent uterine contractions during early labor in relation to the course of labor, th...
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/s0002-9378(87)80288-0
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVE:Our purpose was to examine and contrast associations of risk factors with spontaneous preterm birth and indicated preterm birth. STUDY DESIGN:Separate multiple logistic regression analyses were performed of indicated and spontaneous preterm births in a large database of births in Cardiff, Wales. RESULTS:Spo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90288-0
更新日期:1995-08-01 00:00:00
abstract::A somewhat paradoxic aspect of childbirth is the association of this physiologic process with acute pain. The experience of pain during labor is the result of complex processing of multiple physiologic and psychosocial factors on a woman's individual interpretation of nociceptive labor stimuli. The nature of labor pai...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1067/mob.2002.121427
更新日期:2002-05-01 00:00:00
abstract::This study compares associated high-risk factors and perinatal outcome between 273 symmetric and 445 asymmetric infants with intrauterine growth retardation. No differences were seen in 17 obstetric, medical, and environmental-behavioral high-risk factors between symmetric and asymmetric intrauterine growth retardatio...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)91433-w
更新日期:1991-06-01 00:00:00
abstract:OBJECTIVE(S):To determine how the type of embryo fragmentation on day 3 affects progression of human embryos to blastocyst and pregnancy rates following embryo transfer. STUDY DESIGN:Retrospective analysis of all in vitro fertilization cycles in patients < or =40 years of age or younger from January 2002 through Decem...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.02.048
更新日期:2005-06-01 00:00:00
abstract::The ability of the calcium antagonist nifedipine to inhibit uterine contractions during labor and in the postpartum period was measured in the ewe. The hemodynamic effects of tocolytic doses of this drug were measured and compared with the hemodynamic effects of equivalent doses of ritodrine. Intravenous nifedipine wa...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90397-7
更新日期:1985-04-15 00:00:00
abstract::Seven pregnant women with early-onset (less than 32 weeks' gestation) intrauterine growth retardation were studied to examine fetal heart rate and fetal activity patterns after vibratory acoustic stimulation. All studies were done between 26 and 32 weeks' gestation. All fetuses but one were not acidotic at birth. Ther...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90111-7
更新日期:1989-01-01 00:00:00
abstract::Perimenopause represents a transition period lasting about 5 years before the permanent cessation of spontaneous menses. During this transition, the emphasis of clinical care changes. Although women still need effective contraception during perimenopause, issues including loss of bone mineral density, menstrual cycle ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1067/mob.2001.116525
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:We tested the hypothesis that oxytocin (OT) contracts blood vessels via vasopressin V1A (VP) receptors, and that this depends on pregnancy. STUDY DESIGN:Concentration-contraction relationships (CCR) to OT and VP (10(-12)-10(-6) mol/L) were obtained in different blood vessels. CCR were obtained in uterine art...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.05.006
更新日期:2006-01-01 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::Two infants, who presented at birth with isoimmune thrombocytopenic purpura, are the basis for this report. The problems confronting the physician in treating an affected infant, as well as in the management of subsequent pregnancies after an infant with isoimmunization has been delivered, are discussed. In view of th...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90008-9
更新日期:1976-01-01 00:00:00
abstract::The present investigation was designed to reassess the fractional postcoital test (PCT). Specifically, the study addressed the question of whether the internal cervical mucus sperm count is significantly different from the sperm counts at other cervical levels. By means of standardized methodology, 25 normal postcoita...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90056-5
更新日期:1979-02-15 00:00:00
abstract::Two fetuses with obstructive uropathy characterized by striking oligohydramnios and dilatation of the urinary collecting system were identified by ultrasound and treated by percutaneous insertion of a long-term vesicoamniotic silicone rubber shunt. Both fetuses were less than 16 weeks' gestation at diagnosis and less ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)90685-3
更新日期:1983-04-01 00:00:00
abstract::The source of amniotic fluid prolactin was investigated with the use of amnion, chorion, placenta, and decidual tissue taken from term human pregnancy. Decidua alone of these tissues contained significant quantities of prolactin. The release of decidual prolactin was affected by the presence or absence of oxygen and p...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)33248-3
更新日期:1977-01-15 00:00:00
abstract:OBJECTIVE:The purpose of our study was to examine the neuronal outcome after a standardized period of umbilical cord occlusion. STUDY DESIGN:The umbilical cord was clamped for 10 minutes in nine experimental and four control chronically instrumented fetal sheep. Three days later the animals were killed for histologic ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91728-1
更新日期:1992-11-01 00:00:00
abstract::Local cerebral glucose utilization was measured by the [14C]-deoxyglucose method in five near-term fetal sheep in whom bilateral ablation of the cochleae had been accomplished aseptically 5 to 8 days earlier. The tympanic membrane and ossicles were removed and all turns of each cochlea were unroofed with destruction c...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80240-5
更新日期:1987-12-01 00:00:00
abstract::We used the minimal model technique to obtain concurrent measurements of whole-body insulin sensitivity and pancreatic B-cell responsiveness to glucose during the third trimester of pregnancy. Insulin sensitivity in normal pregnant women (n = 8) was reduced to only one third that of a group of nonpregnant women (n = 7...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)91306-w
更新日期:1990-04-01 00:00:00
abstract::To identify causes and risk factors for pregnancy-related mortality in New York City, we analyzed 224 pregnancy-related deaths that occurred from 1980 to 1984. The leading causes of death were ectopic pregnancy complications, embolism, intrapartum cardiac arrest, and hypertension. Mortality ratios were determined by c...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)80031-1
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVE:Preterm premature rupture of fetal membranes has been associated with infection, cigarette smoking, and bleeding. Hypochlorous acid (a reactive oxygen species) is central to the body's response to infection, yet it may damage surrounding tissue while destroying pathogens. We examined in vitro the tissue-damag...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.106676
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine whether postterm patients with oligohydramnios differ in their fetal and umbilical blood flow distribution from those with a normal volume of amniotic fluid. STUDY DESIGN:Pulsed-wave Doppler imaging was used prospectively to determine the resistance index in the fetal middle cere...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90276-7
更新日期:1995-08-01 00:00:00
abstract::We studied sociocultural and medical factors in the Teso District in eastern Uganda and the Ankole District in western Uganda to discover the cause of the low and high fertility rates in these respective districts. The findings related to gonorrhea in women are presented in this article. Gonococcal cervicitis and clin...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(80)91083-2
更新日期:1980-12-01 00:00:00
abstract::The prophylactic use of oral terbutaline was studied in 28 normal, healthy, low-risk women with twin gestations. The mean birth weights were significantly increased over those in a similar group of control patients. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90481-3
更新日期:1986-04-01 00:00:00