Abstract:
OBJECTIVE:To compare the efficacy and safety of routine electronic fetal monitoring (EFM) of labor with intermittent auscultation, using the results of published randomized controlled trials (RCTs). DATA SOURCES:We identified RCTs by searching the MED-LINE data base for the period 1966-1994, contacting experts, and reviewing published references. METHODS OF STUDY SELECTION:Our search identified 12 published RCTs addressing the efficacy and safety of EFM; no unpublished studies were found. The studies included 58,855 pregnant women and their 59,324 infants in both high- and low-risk pregnancies from ten clinical centers in the United States, Europe, Australia, and Africa. DATA EXTRACTION AND SYNTHESIS:Data were abstracted, and their accuracy was confirmed independently. A single reviewer assessed study quality based on criteria developed by others for RCTs. Data reported from similar studies were used to calculate a combined risk estimate for each of nine outcomes. Overall, a statistically significant decrease was associated with routine EFM for a 1-minute Apgar score less than 4 (relative risk [RR] 0.82, 95% confidence interval [CI] 0.65-0.98) and neonatal seizures (RR 0.5, 95% CI 0.30-0.82). The protective effect of EFM for a 1-minute Apgar score less than 4 was apparent only in the non-United States studies, and the protective effect for neonatal seizures was evident only in studies with high-quality scores. No significant differences were observed in 1-minute Apgar scores less than 7, rate of admissions to neonatal intensive care units, and perinatal death. An increase associated with the use of EFM was observed in the rate of cesarean delivery (RR 1.33, 95% CI 1.08-1.59) and total operative delivery (RR 1.23, 95% CI 1.15-1.31). Risk of cesarean delivery was greatest in low-risk pregnancies. CONCLUSION:The only clinically significant benefit from the use of routine EFM was in the reduction of neonatal seizures. Because of the increase in cesarean and operative vaginal deliveries, the long-term benefit of this reduction must be evaluated in the decision reached jointly by the pregnant woman and her clinician to use EFM or intermittent auscultation during labor.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Thacker SB,Stroup DF,Peterson HBsubject
Has Abstractpub_date
1995-10-01 00:00:00pages
613-20issue
4 Pt 1eissn
0029-7844issn
1873-233Xjournal_volume
86pub_type
杂志文章,评审abstract::In the period 1950 through 1966, 357 patients with cancer metastatic to the ovaries were treated at the Mayo Clinic. The majority of primary tumors arose in the gastrointestinal tract. Factors influencing survival included the site of the primary cancer, histologic grade of the neoplasm, menstrual status, and the type...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1975-04-01 00:00:00
abstract:OBJECTIVE:To compare a "no touch" approach to diagnostic hysteroscopy without anesthesia with traditional diagnostic hysteroscopy after intracervical injection of mepivacaine hydrochloride 3%. METHODS:A total of 130 women undergoing diagnostic hysteroscopy were included in the study and were randomized, using a comput...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.AOG.0000227750.93984.06
更新日期:2006-08-01 00:00:00
abstract::An in-depth analysis of numbers of obstetric and gynecologic operations from 1979 to 1984 was performed using data from the National Center for Health Statistics. During the study period, there was a decrease in total numbers of obstetric and gynecologic procedures of 1%. During the same five-year period the numbers o...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198606000-00001
更新日期:1986-06-01 00:00:00
abstract::The issue of race and ethnicity within obstetrics and gynecology has come to the forefront in the current social and political climate. Understanding the ill effects of racism within the clinical space requires an acknowledgment of both the ongoing problem and current limitations in the state of knowledge and praxis a...
journal_title:Obstetrics and gynecology
pub_type: 社论
doi:10.1097/AOG.0000000000002868
更新日期:2018-10-01 00:00:00
abstract::One hundred and thirty-three subarachnoid phenol blocks were performed in 90 patients with intractable pain secondary to gynecologic cancer at the University of Iowa Hospitals in the period 1961 to 1975. Excellent to moderate pain relief was obtained in 77% of 117 evaluable blocks. Fifty-two percent of the blocks gave...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract::Dating of maturity of the endometrium by histologic examination was correlated with four methods of ovulation detection in 13 cycling parous women. Histologic dating was assessed independently by two pathologists and correlated with the postovulatory duration as determined by daily transvaginal ultrasound scanning, se...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To estimate the overall reduction in ovarian cancer risk associated with the use of oral contraceptive pills (OCPs) and whether reduction in risk is affected by specifics of OCP use, such as formulation or duration of use. DATA SOURCES:We searched PubMed, Embase, the Cochrane Database of Systematic Reviews, ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/AOG.0b013e318291c235
更新日期:2013-07-01 00:00:00
abstract::Restriction enzyme digestion and Southern blot hybridization were used to analyze deoxyribonucleic acid (DNA) extracted from exfoliated cervical cells for the presence of human papillomavirus sequences and these results were correlated with cytologic findings on Papanicolaou smears. Specimens (N = 204) were obtained f...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the appropriateness of recommendations for hysterectomies done for nonemergency and non-oncologic indications. METHODS:We assessed the appropriateness of recommendations for hysterectomy for 497 women who had the operation between August 1993 and July 1995 in one of nine capitated medical groups ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00519-0
更新日期:2000-02-01 00:00:00
abstract::Women who develop preeclampsia during pregnancy excrete less calcium than healthy pregnant women. Whether this reduction in calcium excretion precedes or follows hypertension is unknown. We prospectively measured urinary calcium excretion in 103 consecutive nulliparous women at risk for preeclampsia and presenting for...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of delaying colposcopy in women with negative Papanicolaou smears and positive speculoscopy results. METHODS:This was a prospective study of asymptomatic women ages 13-60 years, regularly scheduled for pelvic examinations. All women had Papanicolaou smears and magnified visual examinat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00515-3
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To use nationally representative data to produce prevalence estimates of combination estrogen-progestin therapy and estrogen-only therapy by covariates, and to evaluate differences between current use of short duration (less than 5 years) and current long-term use. METHODS:We analyzed data from female respon...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.obstetgynecol.2003.09.024
更新日期:2003-12-01 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
doi:10.1097/AOG.0000000000004167
更新日期:2020-12-01 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::The cause(s) of the low plasma antithrombin III activity in women with preeclampsia is unknown. The purpose of this study was to evaluate the relationship between plasma antithrombin III activity and both clotting parameters (platelet count and fibrinopeptide A) and renal parameters (serum creatinine and uric acid con...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198812000-00006
更新日期:1988-12-01 00:00:00
abstract::A review of 540 patients evaluated by the Gynecologic Colposcopy Clinic for abnormal cervical cytology revealed that 372 (68.9%) had cervical intraepithelial neoplasia (CIN), microinvasive carcinoma, or frank invasive carcinoma. The repeat cytologic smear taken before biopsy was falsely negative in 26.4%. An endocervi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198309000-00016
更新日期:1983-09-01 00:00:00
abstract::The vesicovaginal fistula from prolonged obstructed labor is a condition that is no longer seen in the affluent, industrialized world, yet it continues to exist in epidemic proportions in sub-Saharan Africa, where several million women are estimated to suffer from this condition. The unremitting urinary incontinence t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)02498-5
更新日期:2002-12-01 00:00:00
abstract::Thirty-three gravidas with syphilis were monitored with hourly vital signs and examinations for 24 hours after treatment with benzathine penicillin G. Fifteen (45%) of the subjects had a Jarisch-Herxheimer reaction, including all three, 12 of 20 (60%), and none of ten of those with primary, secondary, and latent syphi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::A light microscopic, an electron microscopic, and a ultrahistochemical study have been made of seven placentas from women with mild and excellently controlled chemical gestational diabetes. Only one placenta showed no significant abnormality; the remainder showed, to a varying degree, changes in the syncytiotrophoblas...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract:OBJECTIVE:To determine if nucleated red blood cell counts(RBC) are different in infants who develop intraventricular hemorrhage and periventricular leukomalacia in the first week of life and in those who do not. METHODS:Nucleated RBCs were obtained from 441 infants weighing more than 499 g and less than 1751 g. Neonat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00436-x
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVE:To assess the relationship between preeclampsia or eclampsia and stroke, myocardial infarction (MI), subsequent cardiovascular outcomes, and long-term survival. METHODS:Using the Myocardial Infarction Data Acquisition System in New Jersey (1994-2009), we analyzed cardiovascular outcomes in women with and wit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31826ae78a
更新日期:2012-10-01 00:00:00
abstract::The second case is reported of renal failure in association with XY gonadal dysgenesis. The random association of these conditions appears unlikely. Recognition of a possible association is important because of potential fatality due to renal failure or gonadoblastoma in unrecognized cases. In groups at risk, follicle...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-12-01 00:00:00
abstract::A 10-year retrospective study of acute puerperal inversion of the uterus was undertaken at Women and Infants Hospital of Rhode Island. There were 11 inversions in 70,481 deliveries for an incidence of one in 6407. The age ranged from 19-31 years. Seventy-three percent occurred in nulliparous women. All cases were reco...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-04-01 00:00:00
abstract::Tubal pregnancy specimens from a patient with undetectable serum beta-hCG levels and a control case with a low beta-hCG titer by radioimmunoassay were analyzed using peroxidase-antiperoxidase immunocytochemical localization of placental proteins. The results indicated that deficient production of beta-hCG by ectopic t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:To compare extra-amniotic infusion of diluted prostaglandin (PG) E2 solution with saline infusion in balloon cervical ripening and labor induction. METHODS:Women with pregnancy complications and Bishop scores of 3 or lower (n = 116) were assigned randomly to receive extra-amniotic infusion (1 mL/minute) of n...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0029-7844(00)01168-6
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVE:To use a decision-analytic model to assess a comprehensive set of outcomes of prenatal genetic testing strategies among women of varying ages. METHODS:We assessed outcomes of six testing strategies incorporating diagnostic testing with chromosomal microarray, multiple marker screening, cell-free DNA screenin...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001029
更新日期:2015-10-01 00:00:00
abstract::A case of nonfatal air embolism from orogenital sex in the 30th week of pregnancy is described. Because of a delay in the diagnosis, the patient did not receive hyperbaric oxygen therapy until 39 hours after the incident. Severe neurologic dysfunction persisted despite hyperbaric therapy. The world literature on oroge...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-05-01 00:00:00
abstract:OBJECTIVE:To estimate the rate of histologic chorioamnionitis in the presence of diagnosed clinical chorioamnionitis and determine whether clinical markers of maternal and neonatal infection are associated with histologic chorioamnionitis. METHODS:We identified singleton pregnancies from 1996 in which discharge diagno...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00416-0
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:To determine the factors that influence the survival of patients with endometrial carcinoma histologically confined to the uterus. METHODS:Retrospective analysis was conducted of 262 surgically staged cases using multiple regression (Cox proportional hazards model). RESULTS:After excluding patients with cle...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:The importance of a broad differential diagnosis is highlighted by a complex patient case. CASE:A young woman returned from her honeymoon complaining of activity-limiting pain. The evaluation revealed multiple constitutional symptoms, a breast mass, a large pelvic mass, pulmonary abnormalities, an external ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000244102.38691.d3
更新日期:2006-11-01 00:00:00