Abstract:
OBJECTIVE:The purpose of this study was to estimate the usefulness of the fetal-pelvic index (FPI) in the prediction of cesarean delivery among nulliparous and women who undergo a trial of labor after cesarean delivery (TOLAC). STUDY DESIGN:This prospective cohort study included subjects at 2 hospitals from the University of Pennsylvania Health system. The study sample included nulliparous women and women who attempted TOLAC, with nonanomalous pregnancies at ≥37 weeks of gestation in vertex presentation (n = 221 and 207, respectively). FPI score was calculated with the ultrasound-based fetal biometric measures that were performed within 2 weeks of delivery and x-ray pelvimetry that was performed within 48 hours of delivery. Multivariable logistic regression was used to develop a clinical predictive index for cesarean delivery, which included FPI and clinical factors, in nulliparous women or women who attempted TOLAC. The prediction models were tested for accuracy with the area under the receiver operating characteristics curve. RESULTS:Higher FPI scores were associated with greater odds of cesarean delivery. A unit increase in FPI score increased the odds of cesarean delivery by 15% (adjusted odds ratio, 1.15; 95% confidence interval, 1.09-1.21) for nulliparous women and 15% for women who attempted TOLAC (adjusted odds ratio, 1.15; 95% confidence interval, 1.10-1.20) after adjustment for maternal age, race, medical risk factors, and labor method. Among nulliparous women, the receiver operating characteristics analysis estimated an area under the curve of 0.88, with positive and negative predictive values of 76% and 87%, respectively. Similar findings were observed in the subgroup of women who attempted TOLAC. CONCLUSION:The FPI when combined with clinical risk factors can identify accurately women who are at a high risk for cesarean delivery.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Macones GA,Chang JJ,Stamilio DM,Odibo AO,Wang J,Cahill AGdoi
10.1016/j.ajog.2013.06.026keywords:
["cesarean delivery","fetal pelvic index","prediction","trial of labor after cesarean delivery"]subject
Has Abstractpub_date
2013-11-01 00:00:00pages
431.e1-8issue
5eissn
0002-9378issn
1097-6868pii
S0002-9378(13)00642-Xjournal_volume
209pub_type
杂志文章abstract:OBJECTIVE:The objective of this study was to test the hypothesis that fetuses destined to deliver preterm do not reach their individual growth potential. STUDY DESIGN:In a case control design, data on 44 preterm deliveries at < or =34 weeks were compared with data on a control group of next consecutive term deliveries...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.115865
更新日期:2001-08-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
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更新日期:2018-12-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
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doi:10.1016/0002-9378(86)90364-9
更新日期:1986-11-01 00:00:00
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更新日期:1992-05-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
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更新日期:2006-11-01 00:00:00
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更新日期:2000-10-01 00:00:00
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更新日期:1990-12-01 00:00:00
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更新日期:1987-08-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
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更新日期:1990-10-01 00:00:00
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doi:10.1016/0002-9378(77)90690-1
更新日期:1977-05-15 00:00:00
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更新日期:1976-07-15 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.ajog.2007.02.019
更新日期:2007-05-01 00:00:00
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更新日期:1986-10-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90461-8
更新日期:1994-07-01 00:00:00
abstract::The prostaglandin synthetase inhibitor ibuprofen was evaluated for relief of severe primary dysmenorrhea in a controlled, double-blind, cross-over study in seven patients for a total of 23 menstrual cycles. In eight untreated cycles, the amount of prostaglandin (PG) in the menstrual fluid was higher than in nondysmeno...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1979-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0002-9378(84)90447-2
更新日期:1984-04-15 00:00:00
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更新日期:1995-08-01 00:00:00
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更新日期:1992-01-01 00:00:00
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更新日期:1999-03-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2018-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-9378(92)91790-h
更新日期:1992-12-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
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更新日期:2002-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80349-6
更新日期:1987-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:1991-05-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
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更新日期:1988-01-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
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更新日期:1994-09-01 00:00:00
abstract::An attempt is made to define the quality of life in terms of the patient with gynecologic cancer. The effect of the diagnosis of cancer and its recurrence or its terminal state on the quality of life is considered. Possible methods of assessing the patient's individual feelings about the quality of her life are review...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
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更新日期:1979-08-15 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.119111
更新日期:2002-01-01 00:00:00