Abstract：
:Assisted reproductive technologies have aided thousands of couples, but complications have resulted in multifetal pregnancies creating a bitter irony for infertility patients. In an effort to increase the rate of intact survival, we have successfully performed transabdominal first-trimester selective termination procedures on 22 pregnancies including one octuplet, five quintuplet, twelve quadruplet, and four triplet gestations. There have been eight sets of twins, and two singletons delivered, seven twin pregnancies are ongoing, and one early and four late losses of pregnancies. With experience we now counsel as to a high likelihood of a technically successful procedure, but we still have concerns for late losses. We have tried to balance the arguments about the direct harms of performing selective termination and the obstetric risks of not performing selective termination. We believe that selective termination should not be considered a "social" procedure. Our data do not yet make clear whether one, two, or three is the optimal number of embryos to leave. Therefore, on the basis of both current obstetric risk factors and ethical reasoning we will continue to support our protocol of optimally leaving twins.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Evans MI,May M,Drugan A,Fletcher JC,Johnson MP,Sokol RJdoi
10.1016/0002-9378(90)90922-tsubject
Has Abstractpub_date
1990-06-01 00:00:00pages
1568-72; discussion 1572-5issue
6eissn
0002-9378issn
1097-6868pii
0002-9378(90)90922-Tjournal_volume
162pub_type
杂志文章abstract：OBJECTIVE:The purpose of this study was to determine if gap junctions are a necessary component of the human laboring uterus and if their presence in myometrium is a prerequisite for both term and preterm labor. STUDY DESIGN:We obtained 27 human myometrial samples at cesarean section or nongravid hysterectomy. Gap jun...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(11)90806-0
更新日期：1993-05-01 00:00:00
abstract：:Two cases of maternal vegetative state after motor vehicle accidents are presented. Aggressive support allowed the prolongation of both pregnancies into the third trimester without neonatal compromise. After initial medical stabilization in intensive care unit environments, both patients were treated in a labor and de...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2006.01.077
更新日期：2006-07-01 00:00:00
abstract：:Two techniques were used to study the neuromuscular control of rabbit ovarian contractions. First, the ovary was denervated by stripping its artery. Spontaneous contractions were noted, as was a normal response to exogenously administered adrenergic agents. Second, the ovarian nerves were electrically stimulated in an...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(77)90679-2
更新日期：1977-05-15 00:00:00
abstract：BACKGROUND:The integrity of the pelvic autonomic nervous system is essential for proper bowel, bladder, and sexual function. OBJECTIVE:The purpose of this study was to characterize the anatomic path of the pelvic autonomic system and to examine relationships to clinically useful landmarks. STUDY DESIGN:Detailed disse...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2016.12.002
更新日期：2017-04-01 00:00:00
abstract：:The purpose of this review was to estimate the impact of timing of seasonal influenza vaccination during pregnancy on health and economic outcomes. Cost-effectiveness analysis with a dynamic model of the US population of pregnant women and infants who were <6 months incorporated seasonal variation in influenza inciden...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2011.04.009
更新日期：2011-06-01 00:00:00
abstract：:A comparison was made of the incidences of cesarean section deliveries between mothers 18 years of age or younger and those 19 to 21 years of age, all of whom were enrolled in a comprehensive program of prenatal care. Also compared were the indications for surgical delivery between the two groups. The rate of cesarean...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(85)80033-8
更新日期：1985-07-15 00:00:00
abstract：:A study of fetal activity was undertaken as the first step in a series of physiologic fetal movement studies. A simple, safe, noninvasive, clinically applicable method for studying fetal movement with a tocodynamometer is described. Four basic types of fetal movement have been seen and defined in terms of their durati...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(76)90467-1
更新日期：1976-09-01 00:00:00
abstract：:As the American physician workforce matures in age, senior physicians on the active clinical staff may become vulnerable to diminished professional performance. Many physicians compensate by using experiential rather than analytic methods to effectively solve clinical problems. Surgical expertise also may be at risk i...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2011.07.043
更新日期：2012-03-01 00:00:00
abstract：:We investigated the appearance of pulmonary lamellar bodies (LBs) in human amniotic fluid as a function of fetal age. We also studied their relationship to the lecithin/sphingomyelin (L/S) ratio and to the results of the rapid surfactant test (RST). LBs observed in amniotic fluid generally ranged in diameter from 1.5 ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(80)90565-7
更新日期：1980-01-01 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：:An electronic system for the detection of uterine contractions by impedance measurement was evaluated in 30 subjects during the first stage of labor. The advantage of the system was patient comfort and ease of application of the recording electrodes. Simultaneous recordings of uterine contraction activity with convent...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(77)90586-5
更新日期：1977-10-15 00:00:00
abstract：:The sinusoidal fetal heart rate pattern is a phenomenon of elusive pathophysiologic features and uncertain clinical significance. We present a case of sinusoidal fetal heart rate that occurred in association with fetal breathing. The degree and type of synchrony between the sinusoidal fetal heart rate and breathing mo...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(89)80060-2
更新日期：1989-03-01 00:00:00
abstract：:A reusable plastic Papanicolaou smear training model was developed to teach the techniques of the Papanicolaou smear. The model design allows immediate feedback and opportunity for skills practice, yet it is efficient and cost effective. Its use is recommended for instruction in the techniques of the Papanicolaou smea...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(87)80147-3
更新日期：1987-08-01 00:00:00
abstract：:A case of Gordon's syndrome (short stature, defective dentition, hyperkalemic, hyperchloremic acidosis, and chronic hypertension) complicating pregnancy is presented. Rigid salt restriction with diuretic therapy not only controlled the hypertension but also reversed the metabolic abnormalities. This is the first case ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(87)90120-7
更新日期：1987-05-01 00:00:00
abstract：:Denaturing gradient gel electrophoresis was used to identify single-base differences in the cytochrome P-450 21-hydroxylase (CYP21) genes of 132 unrelated control individuals and family members of three unrelated patients with 21-hydroxylase deficiency. The salt-wasting variety was caused by gene deletion and gene con...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(92)91857-7
更新日期：1992-01-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to examine the presence and frequency of antegrade late diastolic arterial blood flow (ALDAF) in the fetus and to determine its contribution to cardiac output. STUDY DESIGN:We evaluated the presence of ALDAF in 457 fetal and 21 postnatal echocardiograms. The timing of ALDAF to t...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2013.02.053
更新日期：2013-06-01 00:00:00
abstract：:We previously reported a significant relationship between the hematocrit levels of anemic fetuses and information derived from ultrasonographic and Doppler flow-velocity waveforms. In this study we prospectively tested two formulas for the prediction of hematocrit values, by use of gestational age, presence or absence...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(89)90516-4
更新日期：1989-08-01 00:00:00
abstract：:The effects of fasting on maternal glucose metabolism were investigated in nonpregnant and 29-day pregnant conscious rabbits. Pregnancy decreased the glucose metabolic index by 60% in maternal red postural muscles. Fasting induced similar modifications in nonpregnant rabbits and exaggerated the changes observed in fed...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(88)90257-8
更新日期：1988-05-01 00:00:00
abstract：OBJECTIVE:Before parturition are there useful and valid predictors of successful or unsuccessful vaginal birth after previous cesarean birth that could be used to enhance the obstetric care of a patient and her pregnancy? STUDY DESIGN:The clinical course and outcome of all patients who attempted vaginal birth after ce...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(92)91572-r
更新日期：1992-06-01 00:00:00
abstract：OBJECTIVE:The relationship among decreased fetal arterial oxygen saturation, the subsequent systemic metabolic acidosis, and changes in cerebral metabolite concentrations in the fetal lamb brain was investigated by means of quantitative proton magnetic resonance spectroscopy. STUDY DESIGN:Fetal hypoxia was induced in ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(99)70401-1
更新日期：1999-12-01 00:00:00
abstract：:Nicardipine, a calcium antagonist, suspended the spontaneous activity of the excised rabbit uterus at a concentration of 1 microgram/ml and abolished the electrical excitability at a concentration of 10 microgram/ml. In situ, single doses of 100 and 500 microgram reversibly suspended the spontaneous activity of the po...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(82)90749-9
更新日期：1982-03-01 00:00:00
abstract：:There have been 203 copper-7 IUD insertions performed in 199 women. The data from 2,230 woman-months of use have been analyzed and compared with other published reports. The copper-7 IUD was an acceptable contraceptive method in regard to effectiveness, continuation, and lack of serious complications. ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(76)90756-0
更新日期：1976-11-01 00:00:00
abstract：OBJECTIVE:Review alternative approaches to oral metronidazole for the treatment of bacterial vaginosis. STUDY DESIGN:Assessment of clinical trials on the treatment of bacterial vaginosis with regimens other than 5 to 7 days of metronidazole. RESULTS:Single-dose metronidazole, 2 gm orally, is as effective as 5- to 7-d...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/0002-9378(93)90346-k
更新日期：1993-08-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to compare the effectiveness of low-molecular-weight heparin with regular heparin in the prevention of fetal resorption in mice with the antiphospholipid syndrome. STUDY DESIGN:Antiphospholipid syndrome was passively induced in ICR mice by injecting them with anticardiolipin ant...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(93)90100-w
更新日期：1993-08-01 00:00:00
abstract：OBJECTIVE:Our purpose was to examine the hypothesis that corticosteroids, when administered extraamniotically, can enhance the labor process and reduce the induction-to-delivery interval. STUDY DESIGN:A double-blind, randomized study was conducted on 98 women with a gestational age of 36 to 42 weeks, an unfavorable ce...
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(97)70031-0
更新日期：1997-11-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to test whether a quantitative high-throughput molecular screen can be used to probe human endometrium and initiate the development of molecular diagnostic tools with potential for identification of therapeutic targets in women with menstrual complaints. STUDY DESIGN:Endometrium...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2006.05.002
更新日期：2006-08-01 00:00:00
abstract：:In Finland an organized mass screening program covers the total female population. Based on the material (429,832) from a nationwide mass screening registry it was estimated that the female population not subjected to electrocoagulation of the uterine cervix (362,511) had a sixfold risk of frankly invasive carcinoma, ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(78)90115-1
更新日期：1978-07-01 00:00:00
abstract：:We first performed a vaginosonic scan and then determined the serum human chorionic gonadotropin (beta-hCG) concentration (Second International Standard) in 52 women at an early gestational age to establish criteria for the earliest possible identification of an intrauterine pregnancy by this new ultrasound technique....
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(88)90039-7
更新日期：1988-03-01 00:00:00
abstract：:Although the fetus is considered to be an "allograft" there is little information concerning the role of lymphokines in human pregnancy. Lymphokines are polypeptides secreted by stimulated lymphocytes that direct the immune response by enabling immune effector cells to communicate with each other. To characterize lymp...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(90)90769-4
更新日期：1990-12-01 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
