Abstract:
OBJECTIVE:Fetal interventions have clearly decreased mortality, but the neurological outcomes of survivors are of critical concern. Here we consolidated available data on long-term neurological outcomes after common fetal interventions to guide counseling, management, and future research. STUDY DESIGN:Published studies assessing long-term neurological outcomes after common fetal interventions from 1990 through 2014 were collected. We included all studies with a cohort of more than 5 patients and with follow-up of 1 year or longer. We divided procedures into those performed for singletons and for multiples. Singleton procedures included amnioinfusion for preterm premature rupture of membranes, intrauterine transfusion for red cell alloimmunization-associated anemia, intrauterine transfusion for parvovirus-associated anemia, vesicoamniotic shunts, thoracoamniotic shunts, ventriculoamniotic shunts, fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia, and open fetal cases by myelomeningocele and others. Multiple procedures included those done for monochorionic twins including serial amnioreduction, selective fetoscopic laser photocoagulation, and selective termination. RESULTS:Of 1341 studies identified, 28 met the inclusion criteria. We combined available literature for all procedures. Studies varied in their length of follow-up and method of assessing neurological status. Neurological outcome after intervention varied by procedure but was normal in 40-93%, mildly impaired in 3-33%, and severely impaired in 1-40%. Follow-up to school age was rare with the exception of procedures for monochorionic twins. CONCLUSION:Fetal treatments have been successful in achieving survival in previously hopeless cases, but success should also be determined by the outcomes of survivors. Except for monochorionic twins, there is a dearth of reported long-term outcomes. Standardized reporting of long-term neurological sequelae is imperative so that meaningful analysis and study comparisons can be made.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Gebb J,Dar P,Rosner M,Evans MIdoi
10.1016/j.ajog.2014.10.1092subject
Has Abstractpub_date
2015-04-01 00:00:00pages
527.e1-9issue
4eissn
0002-9378issn
1097-6868pii
S0002-9378(14)02147-4journal_volume
212pub_type
杂志文章,评审abstract:OBJECTIVE:The purpose of this study was to compare cardiac dynamics of high-risk and low-risk fetuses using beat to beat variability. STUDY DESIGN:This study obtained 214 fetal magnetocardiography recordings from a group of high-risk fetuses with maternal conditions associated with placental insufficiency with the ris...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.02.017
更新日期:2007-06-01 00:00:00
abstract::A 24-year-old nulliparous woman underwent laparotomy for a large pelvic mass. Grapelike tumor extending from the uterus into the broad ligaments and peritoneal cavity was found. A diagnosis of sarcoma appeared likely, but radical surgery was avoided when frozen sections indicated a histologically benign smooth muscle ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90378-x
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Type 2 diabetes (T2D) in lean individuals is not well studied and up to 26% of diabetes occurs in these individuals. Although the cause is not well understood, it has been primarily attributed to nutritional issues during early development. OBJECTIVE:Our objective was to develop a lean T2D model using gesta...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.02.004
更新日期:2016-04-01 00:00:00
abstract::Brachial artery Doppler flow velocity waveforms were recorded from 10 nonpregnant women and 19 women with uncomplicated pregnancies. The pregnant group showed higher peak systolic frequencies (3.24 compared with 2.26, p = 0.01), higher maximum end-diastolic frequencies (0.62 compared with 0.25, p = 0.01), and lower pu...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90026-n
更新日期:1991-12-01 00:00:00
abstract::In the next decade many women will turn to the medical community for advice on maintaining or improving health after menopause. Estrogen replacement therapy, with or without progestins, alleviates menopausal symptoms, prevents or manages osteoporosis, and reduces the increased cardiovascular disease risk that results ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1067/mob.2001.109656
更新日期:2001-02-01 00:00:00
abstract::Capillary hydrostatic pressure has been calculated in normal pregnancy and preeclampsia. In humans, capillary hydrostatic pressure cannot be measured directly but may be calculated when the colloid osmotic pressure in plasma and interstitial fluid and interstitial fluid hydrostatic pressure are known (Starling equatio...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80355-1
更新日期:1987-07-01 00:00:00
abstract:OBJECTIVE:Our purpose was to assess the impact of glucocorticoid administration on the rate of regional anesthesia in women with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. STUDY DESIGN:Maternal records of pregnancies with HELLP syndrome managed between April 1994 and December 1999 were...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.121074
更新日期:2002-03-01 00:00:00
abstract::Vasomotor symptoms after menopause are multifactorial in origin but result primarily from the loss of estrogen as ovarian function ceases. Although hot flushes typically last for 0.5 to 5.0 years after natural menopause, they may persist for as long as 15 years in a small percentage of postmenopausal women. In contras...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0002-9378(99)70725-8
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to identify differences in antepartum uterine contraction frequency (UCF) in twin pregnancies with and without preterm labor (PTL). STUDY DESIGN:Twin gestations enrolled for outpatient surveillance with twice daily electronic uterine activity monitoring and telephonic nursing as...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.10.781
更新日期:2008-05-01 00:00:00
abstract::To determine whether anesthesia lowers fetal oxygen consumption, sodium pentobarbital (10 mg/kg) was given intravenously to seven chronically instrumented pregnant ewes (123 to 144 days' gestation). Oxygen consumption fell by 23% in association with a rise in fetal vascular PO2. Fetal breathing movements were abolishe...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90628-9
更新日期:1986-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess patient demographics, clinical presentation, response to previous treatment, and current evaluation of prepubertal girls referred for gynecologic care of labial agglutination. STUDY DESIGN:A retrospective chart review of all prepubertal female patients with labial aggl...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.126201
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to determine incontinence pessaries' mechanism of action by measuring changes on urodynamic studies (UDS) and dynamic magnetic resonance imaging (MRI) with and without pessaries in place. STUDY DESIGN:Women with stress incontinence had UDS and MRI performed with and without inc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.01.047
更新日期:2008-05-01 00:00:00
abstract::Total cesarean section rates and rates of various indications for primary cesarean section were reviewed for four yearly periods during the past decade. The time periods studied were chosen to follow the introduction of new obstetric practices and technologic advances in monitoring fetal condition. The total cesarean ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90426-5
更新日期:1979-10-15 00:00:00
abstract:OBJECTIVES:This study aimed to determine whether administration of lamivudine to pregnant women with chronic hepatitis B in the third trimester is a cost-effective strategy in preventing perinatal transmission. STUDY DESIGN:We developed a decision analysis model to compare the cost-effectiveness of 2 management strate...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.06.001
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:Visual estimation of blood loss has been shown to be inaccurate. The objective of this study was to evaluate the impact of a didactic training program on the accuracy of the estimation of blood loss and to compare the effectiveness of training provided by a web-based vs live session. STUDY DESIGN:Multidiscip...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.10.881
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:The health and economic benefits of paid parental leave have been well-documented. In 2016, the American College of Obstetricians and Gynecologists released a policy statement about recommended parental leave for trainees; however, data on adoption of said guidelines are nonexistent, and published data on pa...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2018.04.017
更新日期:2018-08-01 00:00:00
abstract::Twenty-five pregnant women without complications underwent fetal heart rate evaluation during a program involving exercise at a relative intensity of 61% to 73% of maximal capacity during the course of the pregnancy. Assessment of the influence of gestational age on the fetal heart rate response to exercise and evalua...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90277-7
更新日期:1985-02-15 00:00:00
abstract::Preterm birth remains a major cause of perinatal morbidity and mortality. A short cervix is strongly associated with spontaneous preterm birth. Professional organizations support cervical length screening for singleton gestations with a prior spontaneous preterm birth and second-trimester cervical length measurements ...
journal_title:American journal of obstetrics and gynecology
pub_type: 社论
doi:10.1016/j.ajog.2016.07.019
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:Because the diagnosis of postpartum hemorrhage (PPH) depends on the accoucheur's subjective estimate of blood loss and varies according to mode of delivery, we examined temporal trends in severe PPH, defined as PPH plus receipt of a blood transfusion, hysterectomy, and/or surgical repair of the uterus. STUDY...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.07.007
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:Gonadotropin-releasing hormone agonist-induced partial pituitary suppression with low-grade estrogen production may be useful in long-term treatment of uterine leiomyomas. STUDY DESIGN:Twenty-seven women with uterine leiomyomas were treated with a standard dose of triptorelin for 8 weeks. Patients were then ...
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(96)70030-3
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:To determine whether severe preeclampsia is associated with increased maternal hypotension or fetal heart rate abnormalities after epidural anesthesia placement during labor. STUDY DESIGN:Retrospective cohort study of 100 women with severe preeclampsia and 100 normotensive controls who underwent epidural ane...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.07.029
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:To examine the effects of preprocedure misoprostol on intrauterine device (IUD) placement in nulliparous women. STUDY DESIGN:In this randomized controlled double-blind trial at the University of New Mexico reproductive health clinic, nulliparous women requesting an IUD were randomized to 400 mcg of buccal mi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ajog.2013.11.018
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:Our goal was to improve the accuracy of estimating fetal weights among macrosomic fetuses with the traditional measurements of abdominal circumference, femur length, and head circumference. STUDY DESIGN:We used 4831 cases without anomalies from an ultrasonography laboratory database with an estimated fetal w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1067/mob.2000.106853
更新日期:2000-06-01 00:00:00
abstract::Although the mortality rate after herpes simplex virus type 2 inoculation was not significantly different between pregnant mice and nonpregnant mice, systemic interferon production was very high during late pregnancy compared with that in nonpregnant mice. Antiviral activity was detected in placentas from all noninfec...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(85)80127-7
更新日期:1985-10-01 00:00:00
abstract::Samples of cervical tissue were obtained from women immediately following term delivery from spontaneous labor or oral PGE2-induced labor and from a small nunber of nonpregnant women in the reproductive years undergoing hysterectomy for benign gynecologic disease. The measured strips were placed in a well-oxygenated b...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90278-7
更新日期:1976-09-15 00:00:00
abstract::The article below summarizes a roundtable discussion of a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed: Marc I, Rainville P, Masse B, et al. Hypnotic analgesia intervention during first-trimester pregnancy termi...
journal_title:American journal of obstetrics and gynecology
pub_type: 评论,杂志文章
doi:10.1016/j.ajog.2008.09.013
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:Our aim was to examine the effect of the nitric oxide donor isosorbide mononitrate on the uterine cervix at term and to evaluate possible adverse effects of this treatment. STUDY DESIGN:Term pregnant women were randomly selected to receive either 40 mg vaginally administered isosorbide mononitrate or placebo...
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(03)00865-2
更新日期:2003-12-01 00:00:00
abstract::Plasma levels of estrogen were measured daily by radioimmunoassay for 28 consecutive days in 12 healthy euthyroid women and 15 thyrotoxic women (10 with hypomenorrhea and 5 with amenorrhea) before commencement of therapy (except in one case) in an effort to increase understanding of the relationship between the thyroi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90732-2
更新日期:1975-08-01 00:00:00
abstract:BACKGROUND:In routine antenatal care, blood pressure is used as a screening tool for preeclampsia and its associated adverse outcomes. As such women with a blood pressure greater than 140/90 mm Hg undergo further investigation and closer follow-up, whereas those with lower blood pressures receive no additional care. In...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2019.12.272
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine the objective and subjective efficacy of transvaginal electrical stimulation for treatment of common forms of urinary incontinence in women. STUDY DESIGN:A prospective, double-blind, randomized clinical trial included 121 women with either urinary incontinence caused by detrusor ...
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)70142-x
更新日期:1997-09-01 00:00:00