Abstract：
OBJECTIVE:To analyze the diagnostic accuracy and alteration in treatment planning from interinstitution (different institution) pathologic consultation. METHODS:We reviewed pathologic reports from 720 referred patients. The diagnosis rendered from a gynecologic pathologist was compared with the original diagnosis. Discrepancies were coded as none, minor, or major. A discrepancy was major if it led to treatment alteration. A discrepancy was minor if it did not lead to treatment alteration. The judgment to declare a discrepancy was made by a gynecologic pathologist, a gynecologist, and three gynecologic oncologists. The review cost was $150 per case. The Cochran-Mantel-Haenszel test evaluated any systematic pattern in discrepancies. RESULTS:Seven hundred twenty specimens consisted of 113 vulvar, 170 uterine, 289 cervical, 105 ovarian, and 43 vaginal tissues. Six hundred one (84%) pathologic diagnoses showed no discrepancy. There were 104 (14%) minor and 15 (2%) major discrepancies. After reviewing 15 major discrepancies, six surgeries were canceled, two surgeries were modified, one adjuvant radiation treatment was added, one chemotherapy treatment was modified, and five adjuvant chemotherapy treatments were cancelled. No systematic error was identified with regard to the sources (tissue origin) or methods of obtaining the specimen (P = .675). The cost of reviewing 720 specimens was $108,000. The cost of identifying each major discrepancy was $7200. CONCLUSION:Reviewing pathology slides before definitive treatment reveals notable discrepancies in diagnoses. The cost of pathology review is globally expensive but has consequential impact on proper treatment planning for the individual patient.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Santoso JT,Coleman RL,Voet RL,Bernstein SG,Lifshitz S,Miller Ddoi
10.1016/s0029-7844(98)00032-5subject
Has Abstractpub_date
1998-05-01 00:00:00pages
730-4issue
5 Pt 1eissn
0029-7844issn
1873-233Xjournal_volume
91pub_type
杂志文章abstract：:Pregnancy complicated by ovarian endometrioma is rare; only four cases have been reported. Although infertility and endometriosis are closely related, endometriosis may be found with pregnancy and, although it has been written that endometriosis will regress with pregnancy, occasionally complications may occur. This r...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1983-10-01 00:00:00
abstract：OBJECTIVE:To determine the influence of maternal blood contamination on amniotic fluid (AF) glucose and white blood cell count (WBC). METHODS:Amniotic fluid from 23 preterm, nondiabetic pregnant women was studied. Maternal blood was added to the AF at increasing concentrations, and glucose and WBCs were assessed. RES...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0029-7844(95)00354-1
更新日期：1996-02-01 00:00:00
abstract：OBJECTIVE:To determine the correlation between the maximal urethral closure pressure and the stress leak-point pressure in patients with genuine stress incontinence, and to define a critical stress leak-point pressure value to detect patients with a low-pressure urethra, as defined by a maximal urethral closure pressur...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0029-7844(95)00014-i
更新日期：1995-05-01 00:00:00
abstract：OBJECTIVE:To evaluate sonographic measurements of endometrial thickness in postmenopausal women taking adjuvant tamoxifen therapy for breast cancer, and to correlate sonographic and pathologic findings to symptoms and duration of tamoxifen therapy. METHODS:Medical records and sonograms of 80 postmenopausal women treat...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(98)00418-9
更新日期：1999-03-01 00:00:00
abstract：:A 19-year-old phenotypic female with primary amenorrhea and 45X,0/46X,Y chromosomal mosaicism was found to have asymmetrical gonadal dysgenesis. Her lack of virilization precludes her precise categorization in the current nomenclature of gonadal dysgenesis and she is considered a unique variant of the syndrome of mixe...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1977-10-01 00:00:00
abstract：:Vaginal hysterectomy fulfills the evidence-based requirements as the preferred route of hysterectomy for benign gynecologic disease. Despite proven safety and effectiveness, the vaginal approach for hysterectomy has been and remains underused in surgical practice. Factors associated with underuse of vaginal hysterecto...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000000398
更新日期：2014-09-01 00:00:00
abstract：OBJECTIVE:To evaluate changes over the past decade in the mode of delivery and second-stage duration in nulliparous women. METHODS:We conducted a retrospective cohort study at a single institution of nulliparous women reaching complete cervical dilation with singleton gestations 36 weeks or greater from January 1, 201...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000000872
更新日期：2015-07-01 00:00:00
abstract：:The reported frequency of alcohol abuse during pregnancy was studied in a large urban public hospital in Dallas, Texas. During 1977-1980, 5602 pregnant women were surveyed and 0.7% (95% confidence interval 0.6-0.8%) reported abusing alcohol during pregnancy. In 1987, 1.4% (95% confidence interval 1.3-1.5%) of 1032 pre...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1989-10-01 00:00:00
abstract：:Aggressive surgery may improve the outcome of patients with ovarian cancer. To assess the risk of operative complications, we analyzed 472 primary and 299 repeat operations for ovarian cancer in 536 women between 14-91 years of age. Intraoperative bleeding estimated to be over 1000 mL (N = 107) was more common after p...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1992-02-01 00:00:00
abstract：:Anemia, the most common hematologic abnormality, is a reduction in the concentration of erythrocytes or hemoglobin in blood. The two most common causes of anemia in pregnancy and the puerperium are iron deficiency and acute blood loss. Iron requirements increase during pregnancy, and a failure to maintain sufficient l...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,实务指引
doi：10.1097/AOG.0b013e3181809c0d
更新日期：2008-07-01 00:00:00
abstract：OBJECTIVE:To report our experience with first-trimester screening for trisomy 21 by using the combination of nuchal translucency thickness and nasal bone assessment. METHODS:Pregnant women from a predominantly Latin American population consisting of patients at both low risk and high risk for chromosomal defects under...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/01.AOG.0000259311.87056.5e
更新日期：2007-05-01 00:00:00
abstract：:The poor health status of Sioux Indians residing on reservations in South Dakota has been recognized for many years. The present report documents evidence of a high incidence of socioeconomic health-related disorders and pregnancy-related complications by comparing 342 pregnant white women and 405 pregnant Sioux India...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
abstract：:Two cases of thrombocytopenia, one resulting in bleeding, are reported in patients treated with prophylactic low-dose heparin. The evidence indicates that low-dose heparin was responsible. A review of the literature indicates that heparin-induced thrombocytopenia may be a common event. Since low-dose heparin has been ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1978-07-01 00:00:00
abstract：:Sixty percent of American Indian and Alaska Native women live in metropolitan areas. Most are not eligible for health care provided by the federal Indian Health Service (IHS). The IHS partly funds 34 Urban Indian Health Organizations, which vary in size and services. Some are small informational and referral sites tha...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/01.AOG.0000410162.34363.0b
更新日期：2012-01-01 00:00:00
abstract：:Perineal lacerations are a common occurrence with vaginal delivery. Although perineal lacerations are tracked easily from coding data, there are a variety of problems with using rates of such tears as a quality measure. The rate of severe perineal lacerations should not be used as a measure of obstetric quality for th...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000001146
更新日期：2015-11-01 00:00:00
abstract：OBJECTIVE:To determine the effect of patient position on the mobility of the urethrovesical junction. METHODS:Q-tip tests in the supine and standing positions were performed on forty-six consecutive female patients with a variety of urogynecologic complaints. Wilcoxon signed-rank test and McNemar test were used to com...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0029-7844(95)93705-5
更新日期：1995-08-01 00:00:00
abstract：:An analysis of 41 patients with histologically documented Stage II adenocarcinoma of the endometrium treated between 1969 and 1974 is presented. The 3-year survival for all patients was 46%. Patients treated with radiation therapy alone (tandem, ovoids, and external radiation therapy) had 29% survival while patients t...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1978-07-01 00:00:00
abstract：:Granulosa and theca cell tumors are rather common gonadal stromal tumors. A postmenopausal patient with a granulosa cell tumor, who complained chiefly of breast tenderness and enlarging, abdomen, is presented. Preoperative and postoperative studies including serum estrone, estradiol, prolactin, FSH, and LH,as well as ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1976-07-01 00:00:00
abstract：:Nitrous oxide analgesia was introduced into obstetrics by a young Polish-Russian physician who manufactured the gas himself, mixed it with oxygen, humidified the mixture with water vapor, and devised a mouthpiece for self-administration. After assessing the results on himself, he evaluated the effects on pain relief, ...
journal_title：Obstetrics and gynecology
pub_type： 历史文章,杂志文章
doi：
更新日期：1992-10-01 00:00:00
abstract：BACKGROUND:Endometrial stromal nodule is a rare subtype of endometrial stromal tumor. Although such nodules are benign, hysterectomy has been considered the treatment of choice, because evaluation of the margin is required for diagnosis. The similarity between low-grade stromal sarcoma and stromal nodule suggests that ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(98)00332-9
更新日期：1999-05-01 00:00:00
abstract：OBJECTIVE:To evaluate positive predictive values of CA 125 or transvaginal ultrasonography screening for ovarian cancer according to family history of breast or ovarian cancer. METHODS:In the screening arm of a randomized controlled trial of screening compared with usual care, 28,460 women with family history data rec...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,随机对照试验
doi：10.1097/01.AOG.0000239105.39149.d8
更新日期：2006-11-01 00:00:00
abstract：OBJECTIVE:To compare bleeding patterns between a 21/7-day triphasic norgestimate/ethinyl estradiol (E2) 25-microgram oral contraceptive pill (OCP) and a 24/4-day drospirenone/ethinyl E2 20-microgram OCP. METHODS:In a three-cycle, open-label, multicenter study, healthy, sexually active women were assigned randomly to a...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1097/AOG.0b013e3181beab47
更新日期：2009-12-01 00:00:00
abstract：:A 26-year-old woman was admitted with a diagnosis of septic incomplete abortion. Subsequently she was discovered to have bilateral tubal ectopic pregnancies. The right tube was not badly damaged. Its contents were removed by linear salpingotomy and the tube was repaired. Fifteen months later the patient delivered a li...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1982-11-01 00:00:00
abstract：OBJECTIVE:To estimate whether race or ethnic and socioeconomic strata are independently associated with advanced-stage ovarian cancer-specific survival after adjusting for adherence to National Comprehensive Cancer Network treatment guidelines. METHODS:The design was a retrospective population-based cohort study of pa...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000000643
更新日期：2015-04-01 00:00:00
abstract：OBJECTIVE:To measure the ultrasonographic cervical length in undelivered women after successful tocolysis for preterm labor, and to determine whether this could improve the predictive value of cervical length measured before initiation of tocolysis on the risk of preterm delivery. METHODS:This was a prospective study ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/01.AOG.0000143254.27255.e9
更新日期：2004-11-01 00:00:00
abstract：BACKGROUND:Up to 20% of ovarian epithelial tumors are classified as being of low malignant potential. Most of these low malignant potential tumors are detected at an early stage and have an excellent prognosis. This is a report of a woman with cardiac metastasis from an ovarian low malignant potential tumor. CASE:This...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(97)81429-9
更新日期：1997-05-01 00:00:00
abstract：:A case of intravenous leiomyomatosis with cardiac extension was treated successfully with a two-stage operation: resection of the intracardiac and intracaval mass for the first stage and total hysterectomy with bilateral salpingo-oophorectomy for the second. Tumors were located either within or in continuity to dilate...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：:Topical 5-fluorouracil (5-FU) has proven effective in epidermoid cancers of the head and neck. Its effectiveness has been correlated with the ability of the patient's immunologic system to recognize new antigens. In this study, 8 patients with carcinoma in situ of the vulva were evaluated and treated with topical 5-FU...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1978-06-01 00:00:00
abstract：OBJECTIVE:Our objective was to estimate whether a transvaginal endometrial stripe of less than 5 mm in premenopausal women would exclude endometrial polyps and intracavitary leiomyomata, thereby eliminating the need for sonohysterography. METHODS:Data from 206 consecutive sonohysterograms performed in premenopausal wo...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/01.AOG.0000130065.49187.c8
更新日期：2004-07-01 00:00:00
abstract：OBJECTIVE:To determine whether there is an association between history of sexual abuse and development of chronic pelvic pain. METHODS:We studied 36 women with chronic pelvic pain, 23 with chronic low back pain, and 20 healthy women with reference to experience of sexual abuse, physical violence, and emotional neglect...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(00)01072-3
更新日期：2000-12-01 00:00:00
