Abstract:
OBJECTIVE:To define the strengths and weaknesses of existing research on the natural history of cervical squamous intraepithelial lesions (SIL) and to estimate rates of progression and regression without treatment. DATA SOURCES:Studies of women whose cervical smears showed squamous atypia or worse and who were observed for a minimum of 6 months were identified by a search of MEDLINE from 1966 to 1996, Current Contents, the Federal Research in Progress database, and references of review articles and identified studies, and by experts in the field. METHODS OF STUDY SELECTION:Fifteen of 81 studies were eligible for data extraction. To be eligible, studies had to report a minimum of 6 months' follow-up without treatment; relate entry cytologic findings to outcomes; and report entry cytologic findings so that the study population could be stratified into categories of atypical cells of undetermined significance (ASCUS), low-grade SIL, or high-grade SIL. Studies published before 1970 were excluded. TABULATION, INTEGRATION, AND RESULTS:Eligible studies, representing 27,929 patients, were stratified according to entry cytologic findings. The following rates of progression to high-grade SIL at 24 months were found: ASCUS, 7.13% (95% confidence interval [CI] 0.8%, 13.5%); low-grade SIL, 20.81% (6.08%, 35.55%); and high-grade SIL, 23.37% (12.82%, 32.92%). The following rates of invasive cancer at 24 months were found: ASCUS, 0.25% (0%, 2.25%); low-grade SIL, 0.15% (0%, 0.71%); and high-grade SIL, 1.44% (0%, 3.95%). The following rates of regression to normal were found: ASCUS, 68.19% (57.51%, 78.86%); low-grade SIL, 47.39% (35.92%, 58.86%); and high-grade SIL, 35.03% (16.57%, 53.49%). Study heterogeneity was not explained by regression analysis of study level variables. CONCLUSION:Our findings for borderline and low-grade abnormal cervical cytologic results suggest a relatively low risk of invasive cervical cancer with observation up to 24 months and support the clinical policy of early colposcopy for high-grade lesions.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Melnikow J,Nuovo J,Willan AR,Chan BK,Howell LPdoi
10.1016/s0029-7844(98)00245-2subject
Has Abstractpub_date
1998-10-01 00:00:00pages
727-35issue
4 Pt 2eissn
0029-7844issn
1873-233Xjournal_volume
92pub_type
杂志文章,meta分析abstract::A patient undergoing evaluation for primary infertility with regular menses had a normal hysterosalpingogram in the follicular phase and underwent diagnostic laparoscopy the next day, with the finding of a tubal pregnancy. The patient had a negative serum pregnancy test. Although a normal hysterosalpingogram and negat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::This study reports serum levels of relaxin in normal and special-interest pregnancies using an homologous radioimmunoassay for human relaxin. The mean levels in uncomplicated antenatal patients were lower than those reported in studies using heterologous assays, but the trend in serum levels was similar. Serum levels ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-04-01 00:00:00
abstract:BACKGROUND:Acrocephalosyndactyly is a syndrome characterized by congenital malformation of the skull with craniosynostosis, midface hypoplasia, and symmetrical webbed fusion of the fingers and toes. We describe a possible pathophysiologic mechanism for chylous ascites that developed several months after menarche in a w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)01162-5
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Endocardial fibroelastosis is a congenital heart disease known to cause congestive heart failure in early infancy. We report a case using new modalities for early prenatal diagnosis of endocardial fibroelastosis causing fetal heart failure. CASE:A multipara with two children, who died of endocardial fibroel...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01505-8
更新日期:2001-11-01 00:00:00
abstract::Pelvic endometriosis associated with massive ascites is an unusual occurrence. Only 12 cases have been reported since 1954 when Brews first described this entity. The authors present two cases recently encountered at Saga Medical School Hospital. Clinical courses and operative findings are described and other cases fr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract::A simple, rapid, sensitive, and reliable ELISA test for the detection of urinary human chorionic gonadotropin (hCG) has been developed using penicillinase (EC no. 3.5.2.6) as the label and a microtiter ELISA plate as a solid support for antibody. The results of the test is assessed visually for the dark blue that indi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-02-01 00:00:00
abstract::Unsustainable health care costs combined with suboptimal patient outcomes have led health policy experts and payers to consider value-based payment or alternative payment models. Replacing fee-for-service reimbursement, these models link payment to value by rewarding efforts to enhance the quality of care at similar o...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002753
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Abdominal sacral colpopexy with permanent mesh has become the preferred abdominal technique for correcting posthysterectomy vaginal vault prolapse. Although rare, mesh erosion after sacral colpopexy is often challenging to manage. We report on 3 cases of mesh erosion after abdominal sacral colpopexy managed ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000123242.69217.93
更新日期:2004-05-01 00:00:00
abstract::Severe fetal hydrops was diagnosed at 34 weeks' gestation. Funipuncture revealed a normal 46,XX karyotype and a hematocrit of 20%. Cesarean delivery was performed. Neonatal blood testing showed blood type B positive, positive direct and indirect Coombs, and an anti-B antibody titer of 1:64. The maternal blood group wa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract::The recently developed sperm penetration assay (SPA) tests the functional capacity of sperm. It is based upon the ability of in vitro capacitated human spermatozoa to penetrate zona-free hamster eggs in vitro. The SPA was superior to seminal fluid analysis in predicting both fertility and infertility; in the predictio...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-05-01 00:00:00
abstract::Fifty-five patients at less than 36 weeks' gestation with severe toxemia were treated conservatively. The pregnancies were continued for a mean duration of 19.2 days and the mean gestation at delivery was 35.2 weeks. Fifty-three percent of the deliveries were by cesarean section. Of the neonates, 56.5% showed severe i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-11-01 00:00:00
abstract:OBJECTIVE:To determine in pregnant women with preterm labor the relative efficacy of the amniotic fluid index (AFI) and the two-diameter pocket to detect abnormalities in amniotic fluid volume (AFV), and to relate these findings to pregnancy outcome. METHODS:Fifty-seven healthy women with preterm labor underwent amnio...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199406000-00012
更新日期:1994-06-01 00:00:00
abstract:INTRODUCTION:The first transdermal drug delivery system was introduced in the United States over 20 years ago. Created as an alternative route of administration to improve patient compliance as well as to reduce side effects, the transdermal delivery of drugs now represents a $1.5 to $2 billion market and is growing ra...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000161958.70059.db
更新日期:2005-05-01 00:00:00
abstract::Delayed umbilical cord clamping appears to be beneficial for term and preterm infants. In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. There is a small increa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000001860
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To describe the human papillomavirus (HPV) genotype distribution in invasive vaginal cancers diagnosed before the introduction of the HPV vaccine and evaluate if survival differed by HPV status. METHODS:Four population-based registries and three residual tissue repositories provided formalin-fixed, paraffin-...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000171
更新日期:2014-04-01 00:00:00
abstract::The effects of repeated freezing and thawing. on certain properties of early gestation amniotic fluid were studied. Six anmiotic fluids from 15- to 17-week gestations were investigated. Total protein determinations revealed that there was no significant loss of total protein with rapid freezing and thawing up to 10 ti...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1975-09-01 00:00:00
abstract::Congenital heart block is an unusual cause of fetal bradycardia. Until recently, the diagnosis could be confirmed only by evaluation of the fetal cardiac electrical activity. Two cases are reported in which the diagnosis of atrio-ventricular (A-V) dissociation was confirmed in the antepartum period by real-time ultras...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-03-01 00:00:00
abstract::The clinical and laboratory effects of low-dose heparin prophylaxis was prospectively studied in a controlled trial of 182 patients undergoing major surgery for gynecologic malignancy. Low-dose heparin was given in 5000 U subcutaneously two hours preoperatively and every 12 hours for seven days postoperatively. Low-do...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
abstract::Twenty-one subjects with pregnancy-induced hypertension were investigated with regard to the relationship between maternal hemodynamics and fetal growth. Five of the infants were small for gestational age (SGA) (less than tenth percentile) and 16 were appropriate for gestational age (AGA) (greater than tenth percentil...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-02-01 00:00:00
abstract::Rapid and accurate detection of neonatal bacteremia is an important part of the management of the neonate with suspected sepsis. This study compared the incidence of positive umbilical cord blood cultures (UCBCs) to the incidence of positive peripheral venous blood cultures and determined whether a meticulous UCBC tec...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-02-01 00:00:00
abstract::A case of ectopic pancreas in the fallopian tube is reported. This small, polypoid, benign tumor was in a fallopian tube contralateral to a ruptured tubal pregnancy. The patient had a tubal ligation performed six years previously. To the best of our knowledge this is the first reported case of isolated ectopic pancrea...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-07-01 00:00:00
abstract::There is well-known difficulty in controlling hemorrhage from presacral vessels. There are reports on the use of thumbtacks to secure hemostasis in the face of presacral hemorrhage. This communication reports the successful use of thumbtacks to establish presacral hemostasis and describes a simple instrument designed ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:Abdominal pregnancy is a rare, life-threatening variant of ectopic pregnancy, and thus its diagnosis and management remain controversial. CASE:A multigravida was admitted for complaints of abdominal swelling that had been occurring for 2 years and symptoms of pregnancy in the 3 months before admission. Radi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31819ecc82
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:A spontaneous fall in the radioimmunoassay for the beta subunit of hCG to less than 2 mIU/mL documents regression of hydatidiform mole following evacuation of a molar pregnancy. Continued negative hCG levels for the year after evacuation indicates the absence of risk for persistent gestational trophoblastic ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost-effectiveness of human papillomavirus (HPV) DNA testing as a primary screening test in combination with cervical cytology in women aged 30 years or more. METHODS:A state-transition mathematical model was used to simulate the natural history of HPV and cervical cancer in a cohort of U.S. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000120143.50098.c7
更新日期:2004-04-01 00:00:00
abstract::Pelvic organ prolapse (POP) is a common, benign condition in women. For many women it can cause vaginal bulge and pressure, voiding dysfunction, defecatory dysfunction, and sexual dysfunction, which may adversely affect quality of life. Women in the United States have a 13% lifetime risk of undergoing surgery for POP ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003520
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the power transmission, spot size, power density, and energy density of a new isotopic carbon dioxide (13CO2) laser compared with a conventional CO2 laser. METHODS:Experiments were performed in a laboratory using a conventional CO2 laser and an isotopic 13CO2 laser. Two laparoscopes with 5-mm and...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:To identify risk factors for febrile morbidity after hysterectomy for nonmalignant indications. METHODS:We performed a retrospective cohort study of 686 women who had a hysterectomy between January and September 1997 by abdominal (n = 408), laparoscopic-assisted vaginal (n = 90), or vaginal (n = 188) approac...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000109219.24211.30
更新日期:2004-01-01 00:00:00
abstract::A prospective, double blind study was initiated to compare flow cytometry to cytopathology in detecting malignant cells within peritoneal washings. Deoxyribonucleic acid (DNA) histograms were generated using 4',6-diamidino-2-phenylindole (DAPI) as a DNA fluorochrome. Evaluation of these data revealed a correlation of ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198605000-00014
更新日期:1986-05-01 00:00:00
abstract:BACKGROUND:There are various causes of shortness of breath in a young, pregnant woman. The importance of entertaining a broad differential diagnosis is highlighted in this case. CASE:A young, pregnant African-American woman presented in her third trimester with acute onset of shortness of breath. A team approach by di...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000267318.56856.2a
更新日期:2007-06-01 00:00:00