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:Umbilical vascular coiling may function as a rudimentary pump that facilitates venous return from the placenta. CASES:Three consecutive twin gestations with twin-twin transfusion syndrome were evaluated prospectively at delivery. The birth weights and umbilical coiling indices of donor and recipient twins w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00057-4
更新日期:1997-05-01 00:00:00
abstract::Worldwide, sterilization (tubal sterilization and vasectomy) is used by more people than any other method of contraception. All techniques of tubal sterilization in widespread use in the United States have low risks of surgical complications. Although tubal sterilization is highly effective, the risk of pregnancy vari...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000298621.98372.62
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To assess outcomes and costs associated with around-the-clock point-of-care intrapartum group B streptococcus (GBS) polymerase chain reaction (PCR) screening. METHODS:Intrapartum PCR screening was implemented in 2010. Intrapartum PCR was compared with antenatal culture screening in an uncontrolled, single in...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1097/AOG.0000000000003057
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To assess the value of the fetal nonstress test (NST) in predicting neonatal transfusion in pregnancies complicated by red cell isoimmunization. METHODS:We retrospectively reviewed the records of all patients evaluated for isoimmunization in pregnancy for the period January 1992 to December 1994. In addition...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00180-9
更新日期:1996-09-01 00:00:00
abstract::Physical activity in all stages of life maintains and improves cardiorespiratory fitness, reduces the risk of obesity and associated comorbidities, and results in greater longevity. Physical activity in pregnancy has minimal risks and has been shown to benefit most women, although some modification to exercise routine...
journal_title:Obstetrics and gynecology
pub_type: 评论,杂志文章
doi:10.1097/AOG.0000000000001209
更新日期:2015-12-01 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::The rhizomelic form of chondrodysplasia punctata is a lethal autosomal recessive disorder of unknown cause. It is characterized by marked shortening and bowing of the proximal limbs, vertebral column abnormalities, eye and skin defects, severe mental retardation, and recurrent infection. Previously, antenatal diagnosi...
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 evaluate the laparoscopic management of adnexal masses suspicious at ultrasound. METHODS:In a prospective study, adnexal masses suspicious at ultrasound were managed by laparoscopy. Indications for laparotomy included general contraindications to laparoscopy, obviously disseminated ovarian cancer, and tec...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)81436-6
更新日期:1997-05-01 00:00:00
abstract::Minimally invasive gynecologic surgery provides a number of clinical advantages compared with open laparotomy. Over the past 25 years, important modifications and innovations have further expanded the utility of these techniques. Complications such as surgical site infection, venous thromboembolism, and wound cellulit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003588
更新日期:2020-01-01 00:00:00
abstract::Tamoxifen, a nonsteroidal antiestrogen agent, is widely used as adjunctive therapy for women with breast cancer, and it has been approved by the U.S. Food and Drug Administration for adjuvant treatment of breast cancer, treatment of metastatic breast cancer, and reduction in breast cancer incidence in high-risk women....
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000450757.18294.cf
更新日期:2014-06-01 00:00:00
abstract::The role of Neisseria gonorrhoeae in the etiology and pathogenesis of acute salpingitis and its relationship to nongonococcal salpingitis were investigated. To accomplish this goal, isolated microorganisms obtained from the fallopian tubes and cul-de-sac via laparoscopy were evaluated in relation to the number of epis...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-07-01 00:00:00
abstract:OBJECTIVE:To estimate determinants of and outcomes associated with activity restriction among women with a short cervix. METHODS:This was a secondary analysis of a randomized trial of 17-α hydroxyprogesterone caproate for prevention of preterm birth among nulliparous women with singleton gestations and cervices less t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182917529
更新日期:2013-06-01 00:00:00
abstract::A 40-year-old woman presented to her gynecologist with an apparent unilateral neuropathy of the lateral cutaneous femoral nerve of the thigh (meralgia paresthetica). On examination, the sensory disturbance extended outside the usual distribution of the lateral femoral cutaneous nerve, suggesting a more proximal lumbar...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-02-01 00:00:00
abstract::Two applications of amniocentesis for the evaluation of the patient in idiopathic premature labor, fetal lung maturity testing, and detection of occult intraamniotic infection were evaluated in a review of 59 cases. Seven patients (12%) had positive amniotic fluid cultures despite the absence of clinical signs of infe...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract::It is generally accepted that the human placenta is impermeable to free insulin and that insulin present in the fetus is entirely of fetal origin. A recent study suggested that antibody-bound animal insulin crosses the placental barrier and may exert direct effects on fetal growth. We hypothesized that mothers with in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract:OBJECTIVE:To perform a systematic review of the literature on the accuracy of prediction models in the preoperative assessment of adnexal masses. DATA SOURCES:Studies were identified through the MEDLINE and EMBASE databases from inception to March 2008. The MEDLINE search was performed using the keywords ["ovarian neo...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318195ad17
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To compare the safety and efficacy of intravaginal misoprostol versus intravenous (IV) oxytocin infusion for labor induction. METHODS:One hundred thirty patients were randomly assigned to one of two induction groups: 1) intravaginal misoprostol or 2) IV oxytocin by continuous infusion, with prior cervical ri...
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:1993-03-01 00:00:00
abstract:OBJECTIVE:To review the experience of women who conceived after developing mastocytosis and who were observed at the National Institutes of Health. METHODS:We reviewed our patient database for the years 1984-1998 to identify women with mastocytosis who had conceived. We then reviewed each woman's record, asked each wo...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00591-8
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To examine the effect of underlying maternal morbidities on the odds of maternal death during delivery hospitalization. METHODS:We used data that linked birth certificates to hospital discharge diagnoses from singleton live births at 22 weeks of gestation or later during 1995-2003 in New York City. Maternal ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182a06f4e
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:To estimate the change in indications for scheduled deliveries during the Ohio Perinatal Quality Collaborative's initiative to decrease scheduled deliveries for nonmedical indications before 39 weeks of gestation. METHODS:Documented indications for scheduled deliveries between 36 0/7 and 38 6/7 weeks were ca...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318260d9b2
更新日期:2012-08-01 00:00:00
abstract::The adult respiratory distress syndrome is a common cause of acute hypoxemic respiratory failure in the adult that is associated with a high mortality. There is a limited experience with managing this entity in the gravid patient. A case of successful management of mother and fetus through spontaneous delivery is pres...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract:OBJECTIVE:To assess the risk of adverse obstetric, perinatal, and fetal outcomes for pregnant women participating in prenatal sequential integrated screening through the California Prenatal Screening Program who had a false-positive screening result. METHODS:Women who underwent first- and second-trimester prenatal int...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000145
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:To assess changes in the prescribing practices, knowledge, attitudes, and perceptions of health care providers after an educational program about emergency contraception. METHODS:Health care providers completed self-administered questionnaires before and 1 year after full implementation of the project. The 1...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01365-5
更新日期:2001-06-01 00:00:00
abstract:OBJECTIVE:To investigate whether pregnancy-induced regulatory T cells are generated specifically for paternal antigens or expanded by hormonal changes and to study regulatory T cell-related mechanisms during pregnancy. METHODS:We used murine models of normal, abortion-prone, and pseudopregnancy to characterize regulat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000284625.10175.31
更新日期:2007-11-01 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::A new method to replace fetal membranes that have prolapsed through an incompetent cervix, which includes overfilling of the urinary bladder, was successful in four consecutive patients who presented with this clinical entity. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the rate of live birth and the duration of survival after termination of pregnancy without feticide. METHODS:We conducted a retrospective analysis of 241 terminations of pregnancy without feticide for fetal anomalies or genetic abnormalities between 20 0/7 and 24 0/7 weeks of gestation at a singl...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002503
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:Diverging findings concerning the rate of postoperative wound infections in patients undergoing breast surgery have been reported, and little is known regarding the possible risk factors for these infections and their relative importance. We assessed risk factors for wound infection, placing particular emphas...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(03)00044-9
更新日期:2003-04-01 00:00:00
abstract::Although not all multifetal pregnancies occur after the use of assisted reproductive technology, fertility treatments have contributed significantly to the increase in multifetal pregnancies. In almost all cases, it is preferable to avoid the risk of higher-order multifetal pregnancy by limiting the number of embryos ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000002302
更新日期:2017-09-01 00:00:00
abstract::Postpartum hemorrhage is a common and serious complication of the third stage of labor resulting in anemia and increased morbidity in the puerperium. Administration of uterotonic drugs and suitable mechanical assistance in delivery of the placenta may significantly reduce this hazard. Ergometrine and oxytocin have bee...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-12-01 00:00:00