Abstract:
OBJECTIVE:To test the hypothesis that digital placement of a balloon catheter is not inferior to the speculum method in terms of rate of maternal infection. METHODS:In an open-label noninferiority randomized trial, pregnant women who were undergoing induction of labor with unfavorable cervix (less than 3 cm dilated and less than 60% effaced) were randomly assigned to balloon catheter that was placed either digitally or using a sterile speculum. The primary outcome was a composite of maternal infection, defined by occurrence of fever (temperature 38°C or higher), chorioamnionitis, or endometritis (diagnoses were made by the managing obstetric physician or midwife). Prespecified secondary outcomes included outcomes in the primary composite, cesarean delivery rates, and maternal and neonatal outcomes. A patient satisfaction survey was also obtained. On the basis of a noninferiority margin of 10% and an expected primary outcome frequency of 10%, a sample size of 372 women was needed (90% power to confirm noninferiority with 90% protocol adherence). RESULTS:From February 2018 through February 2019, 372 women were randomized (185 digital placement, 187 sterile speculum). Baseline characteristics were similar between groups. The composite maternal infection rate was not different between groups (digital placement arm: 15.7% vs speculum arm: 12.8%), with an absolute difference with respect to the sterile speculum arm of 2.8% (95% CI -4.3 to 9.9%), indicating noninferiority for the prespecified margin. Secondary outcomes were not different between groups, except for a higher need for a second balloon catheter in the sterile speculum arm. Maternal and neonatal adverse events were not different between groups. Irrespective of method of placement, women were equally satisfied with the explanation of the method before placement, anxiety regarding the procedure, and pain during placement. More women in the sterile speculum group would choose the digital placement method for the subsequent pregnancy (37.6% vs 25.7%; P=.02.). CONCLUSION:Digital placement of a balloon catheter for preinduction cervical ripening is noninferior to the sterile speculum method, in terms of maternal infection. Women in the sterile speculum group more frequently required a second round of the mechanical dilator. The blind digital approach is a reasonable option for balloon placement for cervical ripening. CLINICAL TRIAL REGISTRATION:ClinicalTrials.gov, NCT03450408.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Kuhlmann MJ,Spencer N,Garcia-Jasso C,Singh P,Abdelwahab M,Vaughn M,Marshall K,Prasad N,Soulsby-Monroy R,Saade GR,Saad AFdoi
10.1097/AOG.0000000000004182subject
Has Abstractpub_date
2021-01-01 00:00:00pages
139-145issue
1eissn
0029-7844issn
1873-233Xpii
00006250-202101000-00018journal_volume
137pub_type
杂志文章abstract:BACKGROUND:Endometriosis is rarely a cause of recurrent hemorrhagic ascites. This report draws attention to this uncommon condition, which could present a diagnostic dilemma. CASE:A young African-American woman who had experienced recurrent hemorrhagic ascites for more than 2 years underwent laparotomy and was found t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000268283.99315.58
更新日期:2007-08-01 00:00:00
abstract::An unbalanced translocation, 46,XX,der(5)t(5;11) (p15;q25)mat was ascertained by prenatal diagnosis. The mother previously had a liveborn child with cri du chat syndrome. The subtlety of the chromosome rearrangement in this case illustrates the need for the most detailed cytogenetic investigations in cri du chat cases...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVE:To describe the prevalence of urinary incontinence during exercise in women, estimate whether exercise intensity is related to leakage severity, and report women's assessments of incontinence as a barrier to exercise. METHODS:Questionnaires were mailed to 5,130 women aged 18-60 years drawn from National Fami...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000168455.39156.0f
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility of using cytologic examination of ovarian cyst fluid for distinguishing between benign and malignant tumors. METHODS:Cyst fluid was aspirated at surgery in 83 women with benign and 35 women with malignant (25 invasive and ten borderline) ovarian tumors and submitted for routine cyto...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract::The cesarean delivery rate has quadrupled during the past two decades, resulting in considerable attention focused on alternatives to cesarean birth. One option, vaginal birth after one previous cesarean, has come to be recognized as an acceptable alternative to routine elective repeat cesarean delivery. The purpose o...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-02-01 00:00:00
abstract:OBJECTIVE:To estimate normal ranges for postpartum maternal vital signs. METHODS:We conducted a multicenter prospective longitudinal cohort study in the United Kingdom. We recruited women before 20 weeks of gestation without significant comorbidities and with accurately dated singleton pregnancies. Women recorded thei...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004239
更新日期:2021-02-01 00:00:00
abstract::Interpregnancy care aims to maximize a woman's level of wellness not just in between pregnancies and during subsequent pregnancies, but also along her life course. Because the interpregnancy period is a continuum for overall health and wellness, all women of reproductive age who have been pregnant regardless of the ou...
journal_title:Obstetrics and gynecology
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1097/AOG.0000000000003026
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:To prospectively validate the Sepsis in Obstetrics Score, a pregnancy-specific sepsis scoring system, to identify risk for intensive care unit (ICU) admission for sepsis in pregnancy. METHODS:This is a prospective validation study of the Sepsis in Obstetrics Score. The primary outcome was admission to the IC...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002260
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To assess the association between Chlamydia trachomatis antibodies, antibodies to C trachomatis heat shock proteins 60 and 10, and C-reactive protein (CRP) levels in maternal serum measured by highly sensitive CRP assay during the first trimester and spontaneous preterm delivery before 37 weeks of gestation. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000164464.11979.5d
更新日期:2005-07-01 00:00:00
abstract::The author recounts her recent "high-risk" pregnancy. She relates the feelings experienced by many women in this situation, with the added insights of a certified nurse midwive. The author observes how these insights can be applied by health professionals who deliver care to expectant families. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-07-01 00:00:00
abstract::A simple, rapid, economical, and accurate test to assess fetal pulmonary maturity on a 24-hour basis, 7 days a week, is urgently needed. A 15-minute test has been developed that correlates well with fetal pulmonary maturity. Optical density (OD) readings at 650 nm of greater than or equal to 0.15 in pigment-free, cent...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract::A prospective randomized study was undertaken in 100 patients undergoing cesarean section to evaluate the efficacy of cefotaxime when given as a single-dose versus the more traditional triple-dose regimen for prophylaxis. Analysis of the results demonstrated no significant differences in febrile morbidity (14 versus 2...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1985-02-01 00:00:00
abstract:OBJECTIVE:To compare perioperative outcome measures of abdominal and vaginal hysterectomies in obese women. METHODS:We reviewed the charts of all obese women (body mass index more than 30 kg/m(2)) who underwent abdominal or vaginal hysterectomy for benign gynecologic conditions in our institution between 1997 and 2002...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000140685.30899.24
更新日期:2004-10-01 00:00:00
abstract::This study supports the thesis that the physical findings of pelvic relaxation, such as cystourethrocele, are the results of isolated defects in the pelvic fascia rather than the results of generalized stretching or attenuation of the supporting structures. The most frequently encountered defect resulting in cystouret...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-03-01 00:00:00
abstract::Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension; severe diastolic hypertension; or both require urgent antihypertensive th...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000002019
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:To describe the natural history and outcomes of a large cohort of expectantly managed angular pregnancies diagnosed in the first trimester by specific ultrasound criteria. METHODS:We conducted a prospective case series of women with prenatally diagnosed angular pregnancy at a single academic tertiary care ce...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003595
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To characterize risk and timing of postpartum stroke readmission after delivery hospitalization discharge. METHODS:The Healthcare Cost and Utilization Project's Nationwide Readmissions Database for calendar years 2013 and 2014 was used to perform a retrospective cohort study evaluating risk of readmission fo...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002372
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that preeclamptic women are more readily inducible than are nonpreeclamptic women, regardless of cervical condition. METHODS:One hundred eighty-three preeclamptic women and 461 nonpreeclamptic women requiring labor induction were studied prospectively. Patients were categorized by Bish...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/S0029-7844(97)00043-4
更新日期:1997-04-01 00:00:00
abstract::Blood coagulation and fibrinolytic inhibitors and the balance between and within the two systems were investigated in 26 normal pregnant women during pregnancy and the puerperium. The concentration of the coagulation inhibitors antithrombin and protein C remained within normal levels, whereas the mean level of free pr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVE:To assess the effect of insulin-lowering treatment on menstrual cyclicity in polycystic ovary syndrome (PCOS). METHODS:Forty oligoamenorrheic women with PCOS were recruited in a prospective clinical study to receive metformin for a minimum period of 6 months. Twenty-two women completed the study. Serum LH, F...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/s0029-7844(97)00296-2
更新日期:1997-09-01 00:00:00
abstract::Apgar scores are used routinely to assess early neonatal status, but are less accurate in the preterm neonate because of developmental immaturity. Attention has been directed to umbilical cord gases as a method of neonatal evaluation. Using a retrospective chart review of all viable preterm births (24-36 weeks' gestat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract:OBJECTIVE:Posttraumatic stress disorder (PTSD) is a serious anxiety disorder triggered by the experience of trauma. One in 4 individuals exposed to trauma will develop PTSD. Victims of trauma are frequent users of health care, but screening is rarely done and most sequelae remain undetected. Our objectives were 1) to d...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000140683.43272.85
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:A rare type of placentation leading to cesarean delivery and hysterectomy is described. CASE:A young multigravida in the 26th week of gestation was referred to our department with a history of vaginal bleeding and suspected placenta previa. Three previous children were delivered by elective cesarean. Ultras...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(03)00629-x
更新日期:2003-09-01 00:00:00
abstract::Comparing and contrasting two patients with pseudocyesis made it clear that differing psychodynamic factors specific to each patient resulted in divergent ways in which they sought out and used medical care. The propensity of these patients to distort reality was observed to interfere with the usefulness of sonography...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract:OBJECTIVES:To estimate the rate of pregnancy hospitalizations for women with two groups of myocardial disorders, cardiomyopathy and other myocardial disorders, and report the rate of severe obstetric complications among these hospitalizations in delivery and postpartum periods. METHODS:We performed a cross-sectional s...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181c4ee8c
更新日期:2010-01-01 00:00:00
abstract::The case report of a fatal result in an abortion requested because X-ray diagnostic studies of the gallbladder and intestine had been made during an undiagnosed early pregnancy is presented. A uterine vacuum aspirator had not been purchased by the hospital. A portable laboratory vacuum pump with an appropriate sucti...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1972-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the pregnancy characteristics, methods of delivery, and neonatal outcomes of fetuses affected by osteogenesis imperfecta. METHODS:We reviewed medical records of 1016 individuals whose cells were sent to the University of Washington Collagen Diagnostic Laboratory between 1987 and 1994 for confirma...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)01100-5
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:To systematically review studies examining the relationship between hyperemesis gravidarum and Helicobacter pylori (H pylori) infection. DATA SOURCES:A 1966 to January 2007 search using MEDLINE/PubMed, EMBASE, and Web of Science included MeSH terms: "Helicobacter pylori," "Helicobacter infections," "hypereme...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000278571.93861.26
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:To investigate the association between maternal use of sulfamethizole near term and the risk of neonatal jaundice. METHODS:We conducted a nationwide population-based retrospective cohort study using Danish registers. All Danish women giving birth between 1995 and 2007 were included from the Danish Fertility ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318298314f
更新日期:2013-07-01 00:00:00
abstract::Use of a scalp electrode facilitates and adds precision to electronic fetal monitoring. We report an instance of neonatal osteomyelitis due to infection of the electrode insertion site. Electrode-associated soft and bony tissue infections are most commonly mediated by cervicovaginal microflora and appear clinically an...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00