Abstract:
OBJECTIVE:To determine whether high levels of serum alpha-fetoprotein (AFP) predict increased risk of adverse pregnancy outcomes, including preterm birth (before 37 weeks), preterm birth occurring at or before 28 weeks, small for gestational age (SGA) infant, preeclampsia, and placental abnormalities, and to determine whether low levels of serum AFP predict increased or decreased risk of these outcomes. METHODS:Using the mother's first name, last name, and zip code, we linked the records of 51,008 women who participated in the California Alpha-Fetoprotein Screening Program between June 15, 1986, and October 31, 1987, with California birth certificates for singleton infants born in 1987. The accuracy of the data linkage was confirmed by manually examining complete names, mother's ethnicity, and mother's age for a sample of 500 of the mother-infant linkages. Blood samples were obtained at 15-19 weeks. RESULTS:A strong gradient of increasing risk of preterm birth with increasing levels of serum AFP was observed (test for trend, P < .01). Among women with high levels of serum AFP (at least 2.5 multiples of the median [MoM]), 24.3% had preterm births, compared with 3.8% of women with low levels of serum AFP (0.81 MoM or less), odds ratio 8.7, 95% confidence interval 7.1-10.7). This gradient persisted when preterm infants of 28 weeks or less were examined separately. Similar gradients were observed for the risk of preeclampsia and placental abnormalities. There was a weaker U-shaped relation between serum AFP level and the risk of an SGA infant. CONCLUSION:Low levels of second-trimester maternal serum AFP are associated with a very low risk of preterm birth, preeclampsia, and placental complications. High levels of serum AFP are strongly associated with preterm birth, preeclampsia, and placental abnormalities. There is a modest association between AFP levels (both low and high) and SGA birth.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Waller DK,Lustig LS,Cunningham GC,Feuchtbaum LB,Hook EBdoi
10.1016/0029-7844(96)00310-9subject
Has Abstractpub_date
1996-11-01 00:00:00pages
816-22issue
5eissn
0029-7844issn
1873-233Xpii
0029784496003109journal_volume
88pub_type
杂志文章abstract::Although the passage early in labor of thick amniotic fluid heavily stained with meconium is recognized as an indication of potential fetal asphyxia, the significance of late passage of meconium-stained fluid in labor is less certain. One hundren twenty-eight patients with late passage of meconium in labor and 134 con...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1982-03-01 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::We present a new method for vulvar reconstruction based on recently described vasculature of the lower abdominal skin and subcutaneous tissue. The superficial external pudendal artery supplies the region encompassing the suprapubic and infraumbilical skin. Thus, a pedicled skin flap based on the superficial external p...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract::Six girls with suspected Rokitansky syndrome underwent magnetic resonance imaging (MRI) and then sonography and laparoscopy to confirm the clinical diagnosis and define the precise characteristics of the malformation. The uterus was missing in all; four had müllerian rudiments in place of the uterus, which were cavita...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND:Uterine morcellation is a technique used in gynecologic surgery to facilitate a laparoscopic approach to the removal of an enlarged uterus. The safety of this technique has been a source of recent debate, as uterine morcellation can result in the intraperitoneal dissemination of undiagnosed uterine malignanc...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000549
更新日期:2015-01-01 00:00:00
abstract::A successful pregnancy occurred in the first year after liver transplantation. The patient was treated with prednisolone, azathioprine, and low-dose cyclosporine A. A healthy girl of 2260 g (fifth to tenth percentile) was born at 38 weeks. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-09-01 00:00:00
abstract::A single-transducer mechanical sector scanner was used to examine the first-trimester fetus. Fifty-six examinations of 31 patients demonstrated an orderly developmental progression of fetal activity beginning with beating of the fetal heart (7 weeks), progressing to fetal trunk movement (8 weeks), and culminating in i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract::Hemoperitoneum was identified by culdocentesis in a 26-year-old woman suffering acute abdominal pain. A pregnancy test was positive. Operation indicated a ruptured ovarian pregnancy, and histologic examination revealed primary intrafollicular ovarian pregnancy in a cystic teratoma. Ovarian pregnancy in an ovarian tumo...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198409001-00014
更新日期:1984-09-01 00:00:00
abstract::It has been demonstrated that in selected cases of subfertility in men, the first portion of the split ejaculate is superior to the specimen considered as a whole with regard to sperm density, sperm motility, and sperm morphology and also in those cases where there is increased seminal viscosity in the whole ejaculate...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract:BACKGROUND:A pregnancy with Gorham disease (massive osteolysis syndrome) is described. To our knowledge, this is the first reported case of a pregnancy associated with this disease. CASE:A 25-year-old woman was seen for pre-conception counseling with the diagnosis of Gorham disease. Before pregnancy, magnetic resonanc...
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 investigate the relation between the biochemical markers of umbilical venous erythropoietin and umbilical arterial pH and morphologic placental abnormalities in fetal hypoxia. METHODS:Placentas from 300 high-risk newborn infants (gestational age 24-42 weeks) were examined macroscopically and microscopical...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:To determine changes in length of incompetent cervices after cerclage, using transvaginal ultrasound. METHODS:Patients were enrolled in a prospective, observational study under an Institutional Review Board-approved protocol. McDonald or Shirodkar sutures were placed according to physician preference. Pre- a...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00568-7
更新日期:1999-07-01 00:00:00
abstract::The safety of pregnancy after myocardial infarction remains a significant dilemma for both the obstetrician and the cardiologist. Only 20 cases of pregnancy after myocardial infarction have been reported. To clarify this problem, we add our experience of four such cases in which conception occurred 9 months to 9 years...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract::An unusual case is presented of advanced dysgerminoma in a patient with Swyer syndrome, 46,XY pure gonadal dysgenesis. Unexpected regional invasion necessitated bowel resection, total abdominal hysterectomy, and bilateral salpingogonadectomy for a complete en bloc excision of the primary tumor mass and the dysgenetic ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract::Cellular immunity of the delayed type in women with intraepithelial carcinoma (carcinoma is situ) of the vulva was investigated by an in vitro assay of mitogen-induced lymphocyte transformations. Test results from 9 patients were compared to those of 23 age-matched control subjects. Lymphocyte transformation responses...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-09-01 00:00:00
abstract::A chemotherapeutic combination consisting of VM-26-vincristine-cisplatin was used to treat 44 consecutive patients with primary advanced or recurrent endometrial carcinomas. Nine complete remissions (20.5%) and 14 partial remissions (31.8%) were recorded. The median duration of remission in responders was 8 months (ra...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
abstract::Two hundred women were studied in a randomized controlled trial of induction of labor using high-dose (3 mg) or low-dose (0.5 mg) prostaglandin E2 vaginal pessaries. Induction using 3-mg pessaries was more successful, with a shorter overall induction-delivery interval and less requirement for analgesia, although uteri...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract:OBJECTIVE:We studied the effects of the thromboxane (Tx)A2-receptor antagonists AH 23848 and BM 13.177 in small isolated human uteroplacental arteries. METHODS:Fetal stem villous arteries and maternal intramyometrial arteries were dissected from placental specimens and from myometrial biopsies obtained at cesarean or ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-08-01 00:00:00
abstract::Health care in the United States has become a privilege rather than a right. Patients who have the greatest need are the ones most likely to be denied this privilege. Despite recent advances in disease detection and treatment, many patients do not receive even the bare minimum of care. The high complexity of the healt...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318165f1a9
更新日期:2008-03-01 00:00:00
abstract::Fifty-six primigravid women at 28-32 weeks' gestation were studied prospectively to compare the roll-over test with the stand-up pressor test in the prediction of gestational hypertension. Blood pressures were measured in the different positions continuously using an automated machine. Twenty patients developed gestat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:To determine whether calcium supplementation prevents progression to severe disease in preterm nulliparous women with mild preeclampsia. METHODS:Seventy-five women hospitalized at 24-36 weeks' gestation because of mild preeclampsia were randomized to receive either 2 g/day of elemental calcium (36 women) or ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0029-7844(95)00052-s
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE:To study the clinical course and perinatal outcome of twin pregnancies discordant for anencephaly, without selective termination. METHODS:We conducted a descriptive retrospective study of 14 cases of dichorionic twin pregnancies discordant for anencephaly, which were managed expectantly in five Israeli perin...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00309-F
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:Primary vaginal stones in children are extremely rare but important because they are often mistaken for bladder calculi on plain film. CASE:A 13-year-old girl was admitted to the hospital with abdominal pain. Physical and serial radiologic examinations found a hard mass anterior to the rectum. By vaginoscop...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVE:To estimate variation across hospitals in the rate of postpartum sterilization. METHODS:All hospitals with deliveries in California and Texas in 2009 were included. Proportion of live singleton deliveries with postpartum sterilization was calculated by hospital, insurance status (Medicaid compared with priva...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/aog.0b013e318278f241
更新日期:2013-01-01 00:00:00
abstract::The analgesic properties and motor effect of epidural 0.25% bupivacaine (8 mL) were compared with those of epidural morphine (2 mg in 10 mL saline) followed by 8 mL of 0.25% bupivacaine. The study was performed on two groups of parturients (30 in each group) in active labor. Pain relief in the morphine-bupivacaine gro...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198602000-00009
更新日期:1986-02-01 00:00:00
abstract::Two patients with severe postpartum hemorrhage refused blood product transfusion for religious reasons. The patients' hemoglobin level had dropped to 3.0% or less after operative intervention, and the cardiac indexes on transfer to the tertiary care center were 8.0 and 7.3 L/minute per m2, respectively. Each received ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:Monoamniotic twin pregnancies are frequently associated with cord entanglement, but such entanglement rarely involves the co-twin's trunk, extremities, or neck. CASE:We report a set of monoamniotic twins in which color Doppler imaging revealed that the cord of twin B was wrapped around the neck of its dead ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract::Variability of the baseline fetal heart rate is correlated with good fetal outcome, and loss of baseline variability has been observed as a sign of fetal distress. Central nervous system depressing drugs may also decrease fetal heart rate variability, and thus recognition of the effect of medication on the baseline fe...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::Periodic assessments offer an excellent opportunity for obstetricians and gynecologists to provide preventive screening, evaluation, and counseling. The American College of Obstetricians and Gynecologists' Committee on Gynecologic Practice recommends routine assessments in primary and preventive care for women based o...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0b013e318219226e
更新日期:2011-04-01 00:00:00
abstract::Over an 11-year period (1971 to 1981), 212 urinary conduit surgeries were performed by the Department of Gynecology at the University of Texas, M. D. Anderson Hospital and Tumor Institute at Houston. The urinary diversions were performed as part of the pelvic exenteration operation in 154 patients, for radiation injur...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198605000-00015
更新日期:1986-05-01 00:00:00