Abstract:
OBJECTIVE:The purpose of this study was to develop a model for preeclampsia based on maternal demographic characteristics and medical history. STUDY DESIGN:This was a screening study of 120,492 singleton pregnancies at 11-13 weeks' gestation, including 2704 pregnancies (2.2%) that experienced preeclampsia. A survival-time model for the gestational age at delivery with preeclampsia was developed from variables of maternal characteristics and history. This approach assumes that, if the pregnancy was to continue indefinitely, all women would experience preeclampsia and that whether they do so or not before a specified gestational age depends on competition between delivery before or after development of preeclampsia. A 5-fold cross validation study was conducted to compare the performance of the new model with the National Institute for Health and Clinical Excellence (NICE) guidelines. RESULTS:In the new model, increased risk for preeclampsia, with a consequent shift in the Gaussian distribution of the gestational age at delivery with preeclampsia to the left, is provided by advancing maternal age, increasing weight, Afro-Caribbean and South Asian racial origin, medical history of chronic hypertension, diabetes mellitus and systemic lupus erythematosus or antiphospholipid syndrome, family history and personal history of preeclampsia, and conception by in vitro fertilization. The risk for preeclampsia decreases with increasing maternal height and in parous women with no previous preeclampsia; in the latter, the protective effect, which is related inversely to the interpregnancy interval, persists beyond 15 years. At a screen-positive rate of 11%, as defined by NICE, the new model predicted 40%, 48%, and 54% of cases of total preeclampsia and preeclampsia requiring delivery at <37 and <34 weeks' gestation, respectively, which were significantly higher than the respective values of 35%, 40%, and 44% achieved by application of NICE guidelines. CONCLUSION:A new model that is based on maternal characteristics and medical history has been developed for the estimation of patient-specific risks for preeclampsia. Such estimation of the a priori risk for preeclampsia is an essential first step in the use of Bayes theorem to combine maternal factors with biomarkers for the continuing development of more effective methods of screening for the disease.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Wright D,Syngelaki A,Akolekar R,Poon LC,Nicolaides KHdoi
10.1016/j.ajog.2015.02.018subject
Has Abstractpub_date
2015-07-01 00:00:00pages
62.e1-62.e10issue
1eissn
0002-9378issn
1097-6868pii
S0002-9378(15)00154-4journal_volume
213pub_type
杂志文章abstract::We have studied the effects of magnesium sulfate (MgSO4) administration in chronically instrumented normotensive and hypertensive pregnant sheep. Animals of 90 to 144 days' gestation were divided in two groups; those with normotensive arterial pressure and those in which renovascular hypertension had been produced. Ou...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90255-1
更新日期:1977-04-01 00:00:00
abstract::Fetal malpositions and cephalic malpresentations are well-recognized causes of failure to progress in labor. They frequently require operative delivery, and are associated with an increased probability of fetal and maternal complications. Traditional obstetrics emphasizes the role of digital examinations, but recent s...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2017.07.025
更新日期:2017-12-01 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:Early spontaneous preterm delivery is often associated with microbial invasion of the amniotic cavity and/or intraamniotic inflammation. OBJECTIVE:The objective of the study was to develop and validate clinically feasible multivariable prediction models of spontaneous delivery within 7 days and microbial in...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2020.02.049
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate temporal correlations between maternal serum placenta growth factor levels and placental perfusion in early human pregnancies. STUDY DESIGN:Systolic umbilical artery Doppler blood flow velocity indices at fetal and placental insertion sites were measured between 7...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.01.012
更新日期:2006-06-01 00:00:00
abstract::Aspiration curettage proved acceptable to patients and medical staff when incorporated into a busy outpatient practice. The diagnostic reliability of curettings obtained was shown to be 93.5 per cent accurate. In all patients where mucus only is obtained, where symptoms persist or recur, or when aspiration curettage i...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90622-5
更新日期:1975-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate factors that are associated with significant birth weight discordancy. STUDY DESIGN:As a part of an ongoing collaborative study of twins, maternal and fetal data were obtained from the medical records of twin gestations at eight medical centers. The study population ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/s0002-9378(03)00658-6
更新日期:2003-09-01 00:00:00
abstract::The premenstrual syndrome (PMS) is a major clinical entity afflicting a large segment of the female population. Available information are descriptive in nature and the etiology of this syndrome remains unclear. In this review, both biochemical and psychosocial elements of the syndrome have been explored in an effort t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(81)90417-8
更新日期:1981-01-01 00:00:00
abstract:OBJECTIVE:Excess soluble vascular endothelial growth factor receptor, fms-like tyrosine kinase-1 (sFlt-1), and reduced placental growth factor (PlGF) mediate the genesis of preeclampsia. Cigarette smoking reduces the risk of preeclampsia. We hypothesized that placental secretion of sFlt-1 and PlGF was affected by expos...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.06.025
更新日期:2007-10-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to compare transobturator tape (MONARC) with tension-free vaginal tape in patients with borderline low maximum urethral closure pressure. STUDY DESIGN:Historical cohort analysis of 3-month outcomes in 145 subjects (MONARC = 85; tension-free vaginal tape = 60). A cut-off point...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.07.011
更新日期:2006-12-01 00:00:00
abstract::In 1970 Morgan described an operation designed to meet the problem created by scarring and fibrosis resulting from previous operative procedures to the urethra and bladder neck. In the method, a 2 cm wide polypropylene (Marlex) mesh is placed as a broad hammock to elevate and support the urethrovesical junction with l...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90681-1
更新日期:1979-02-01 00:00:00
abstract:OBJECTIVE:Our aim was to determine the effects of blocking prostaglandin synthesis, by infusion of indomethacin into the fetal circulation, on factors regulating amniotic fluid volume and on plasma composition in the mother and fetus. STUDY DESIGN:Indomethacin was administered to fetal sheep during 8 hours at 124.0 +/...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70406-6
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:Conventional diagnosis of bacterial vaginosis contains some controversial points. To understand accurately the relationship between clinical stages and the microbiotas, the intravaginal microbial flora was analyzed by the clone library method. STUDY DESIGN:Vaginal fluid samples from 31 patients were examined...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.04.018
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:Our purpose was to compare the incidence and interrelationships of uteroplacental vasculopathy and chronic inflammatory and placental vasoocclusive lesions in preeclampsia and spontaneous delivery before 32 weeks' gestation. STUDY DESIGN:Review of singleton live-born nonanomalous infants born at 22 to 32 wee...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)91333-5
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine how closely the surgically induced sheep myelomeningocele (MMC) model resembles the central nervous system derangements seen in human disease, and identify which aspects of MMC are the result of the early neuronal developmental defect, and which are secondary to the ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.02.110
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:Cervical inflammation has been proposed as a cofactor in the development of cervical cancer. The purpose of this study was to document the prevalence of cervical (pre)neoplastic changes in asymptomatic women with a cytologically diagnosed Gardnerella vaginalis infection. STUDY DESIGN:Data were collected from...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.04.036
更新日期:2008-11-01 00:00:00
abstract::Charts from 482 singleton pregnancies undergoing cerclage placement in patients over a 6-year period were reviewed. Cervical dilatation at time of surgery, number of previous spontaneous losses, and gestational age at placement were key determinants of outcome. The most frequent complication, premature rupture of the ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90283-w
更新日期:1991-09-01 00:00:00
abstract::Maternal serum alpha-fetoprotein concentration was measured at 14 to 20 weeks' gestation in 138 twin pregnancies. All patients had at least one ultrasonographic examination (86% before 20 weeks' gestation). Two pregnancies were discordant for open fetal defects (one anencephaly, one gastroschisis). The median serum al...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)91308-y
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to provide a morphometric profile of endometrial granulated lymphocytes and to investigate qualitative and quantitative differences in leukocyte subsets in precisely timed luteal phase endometrial biopsies. STUDY DESIGN:Endometrial biopsies were obtained from 24 normal fertile ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91568-3
更新日期:1992-09-01 00:00:00
abstract::The investigation of estrogen and/or androgen administration on physical and psychological symptoms in the surgical menopause was carried out in a prospective, double-blind, crossover design. When patients who received either a combined estrogen-androgen drug or androgen alone were compared with those who received est...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(85)90001-8
更新日期:1985-01-15 00:00:00
abstract:OBJECTIVES:This study was undertaken to evaluate whether prenatal zinc supplementation affects maturation of fetal cardiac patterns. STUDY DESIGN:A randomized double-blind controlled trial among 242 low-income Peruvian women was performed. Beginning at 10 to 16 weeks' gestation, women received supplements containing 6...
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/j.ajog.2003.09.072
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to provide evidenced-based guidance for surgical decisions during cesarean delivery. STUDY DESIGN:We performed MEDLINE, PubMed, EMBASE, and COCHRANE searches with the terms cesarean section, cesarean delivery, cesarean, pregnancy, randomized trials, and each technical aspect of ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2005.03.063
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to investigate the association of maternal vitamin D and maternal asthma and infant respiratory infection severity. STUDY DESIGN:The study included cross-sectional analyses of 340 mother-infant dyads enrolled from September to May 2004-2008 during an infant viral respiratory in...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.04.002
更新日期:2011-09-01 00:00:00
abstract::Engaging women in discussions about reproductive goals in health care settings is increasingly recognized as an important public health strategy to reduce unintended pregnancy and improve pregnancy outcomes. "Reproductive life planning" has gained visibility as a framework for these discussions, endorsed by public hea...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.10.004
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:Amniotic fluid embolism syndrome is a fatal disease in pregnant women. The exact role of platelets and neutrophils in amniotic fluid embolism syndrome is not clear. We examined whether amniotic fluid could affect platelet-neutrophil aggregation and activation and the possible mechanisms. STUDY DESIGN:Blood s...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.01.012
更新日期:2013-04-01 00:00:00
abstract::With the "double PG impact" (DPGI) technique in 100 sedated first- and second-trimester volunteers, pregnancy was terminated successfully in 99 with a total extraovular PGF2alpha dose of 19.0 +/- 1.5 mg. in 16.9 +/- 0.9 hours. Two thirds of the patients received only the initial dose of 11.6 +/- 0.5 mg. of PG and abor...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90002-8
更新日期:1976-01-01 00:00:00
abstract::Serum corticosteroid-binding globulin (CBG) concentrations in blood respond to endogenous or exogenous estrogens in a dose-response manner and serve as a biologic assay for estrogens. Because endometrial carcinoma is associated with unopposed or excessive estrogen stimulation, the CBG binding capacity of sera of patie...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90480-4
更新日期:1981-03-15 00:00:00
abstract::A case of late recurrence of uterine inversion is presented. Symptoms included constipation and urinary retention without uterine bleeding. Symptoms resolved 3 months after the replacement of the uterus. It is hypothesized that the symptoms were related to stretch injury to the pelvic parasympathetic nerves. Timely in...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.03.027
更新日期:2004-07-01 00:00:00
abstract::We analyzed the ultrasound examinations and medical records of 75 pairs of twins who were delivered between January, 1983, and December, 1984, to study the relationship between increased amniotic fluid volume, fetal abnormalities, and preterm labor. Ten of these 75 twin pregnancies demonstrated elevated amniotic fluid...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90752-0
更新日期:1986-05-01 00:00:00
abstract::Despite current recommendations against its use, activity restriction remains a common intervention used to prevent preterm birth in multiple clinical settings. Hypertensive disorders of pregnancy, preterm premature rupture of membranes, multiple gestations, vaginal bleeding, short cervical length, placenta previa, an...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1016/j.ajog.2020.04.031
更新日期:2020-08-01 00:00:00