Abstract:
OBJECTIVE:To evaluate differences between fasting and nonfasting bile acid levels in asymptomatic and symptomatic pregnant women. METHODS:This is a report of two prospective cohort studies describing bile acid levels in the fasting and nonfasting state in pregnancy. The first cohort included asymptomatic women with singleton pregnancies. Women with a diagnosis of cholestasis, symptoms of cholestasis, or intolerance to components of a standardized meal were excluded. Bile acid levels were measured during the second and third trimesters after fasting and again 2 hours after a standardized meal. The second cohort included symptomatic women with singleton pregnancies in whom fasting and nonfasting bile acid levels were measured at the time of symptom evaluation. A cutoff of 10 micromoles/L was used for diagnosis. RESULTS:A total of 27 women were included in the asymptomatic cohort. Median [interquartile range] fasting bile acid levels were significantly lower than nonfasting levels in both the second trimester (4.65 micromoles/L [1.02-29.57] vs 13.62 micromoles/L [2.03-40.26]; P<.001) and third trimester (8.31 micromoles/L [1.14-51.26] vs 17.35 micromoles/L [1.77-62.93]; P<.001). Bile acid levels exceeded 10 micromoles/L in 21% of the fasting samples and in 58% of the nonfasting samples in the third trimester. A total of 26 women were included in the symptomatic cohort. Median [interquartile range] fasting bile acid levels were significantly lower than nonfasting values (11.5 micromoles/L [7-56] vs 13.5 micromoles/L [9-142]; P<.001). Six patients in the symptomatic cohort (23%) had nonfasting bile acid levels greater than 10 micromoles/L that dropped below 10 micromoles/L when fasting. CONCLUSION:Fasting bile acid levels are significantly lower when compared with nonfasting values in both asymptomatic and symptomatic pregnant women. In asymptomatic women, nonfasting bile acid levels often exceeded 10 micromoles/L whereas fasting values did not. In symptomatic women, fasting bile acid levels resulted in 23% fewer diagnoses of cholestasis when compared with nonfasting values. These findings suggest that fasting evaluation of bile acid levels or a higher threshold for diagnosis of cholestasis should be considered.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Smith DD,Kiefer MK,Lee AJ,Davis SB,Summerfield TL,Landon MB,Rood KMdoi
10.1097/AOG.0000000000004160subject
Has Abstractpub_date
2020-12-01 00:00:00pages
1204-1210issue
6eissn
0029-7844issn
1873-233Xpii
00006250-202012000-00020journal_volume
136pub_type
杂志文章abstract::Perinatal asphyxia at term is a major cause of mortality and morbidity. In many instances obstetric or maternal complications during pregnancy, labor, or delivery account for the asphyxia, but there is a group of infants in whom asphyxia occurs without any recognizable risk factors. The histories of 1602 infants were ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-08-01 00:00:00
abstract::Nine pregnant women near term, with medical indications for internal monitoring during labor, were studied to determine the transmission of sound across maternal soft tissues during vibroacoustic stimulation with an electronic artificial larynx. A miniaturized hydrophone was placed transcervically at the level of the ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-06-01 00:00:00
abstract:OBJECTIVE:To determine in fetal sheep the effect of betamethasone on myelination in relation to stage of myelination, number of treatment courses, dose, and route of administration. METHODS:Fetal expression of myelin basic protein (MBP), a marker of mature oligodendrocytes and myelin, was determined between 0.27 and 0...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181924d3b
更新日期:2009-01-01 00:00:00
abstract::The relation between bodily build and susceptibility to eclampsia has been controversial for nearly two centuries and the issue has been confused by modern studies of women with nonconvulsive hypertensive disorders in whom the diagnosis of preeclampsia is frequently erroneous. The present study is based upon 193 previ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-09-01 00:00:00
abstract::Non-Hodgkin lymphoma was diagnosed initially in a curettage specimen of a puerperal uterus 3 weeks after normal delivery of a healthy infant. The disease, which probably existed during the last trimester of pregnancy, was classified as clinical stage IVb. Combination chemotherapy resulted in immediate improvement and ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::The reliability of intrauterine pressure measurements was studied by placing two catheters in the same uterus in women in labor. Nineteen parturients were studied, five with two Intran I catheters in different pockets of amniotic fluid, five with two Intran II catheters in different pockets, and nine with two Intran I...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVE:To identify the relationship between maternal cigarette smoking and ultrasound-confirmed placenta previa. METHODS:A matched case-control design was used. Cases were drawn from the New England Medical Center and Cambridge Hospital from July 1992 through March 1994. Each case was delivered by cesarean after 24...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00471-8
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:To develop and validate a predictive risk calculator for cesarean delivery among women undergoing induction of labor. METHODS:We performed a population-based cohort study of all women who had singleton live births after undergoing induction of labor from 32 0/7 to 42 6/7 weeks of gestation in the United Stat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003696
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:To compare the patterns of perioperative blood transfusion in patients undergoing radical hysterectomy in time periods before and after the discovery of transfusion-related human immunodeficiency virus (HIV) infection. METHODS:We reviewed the medical records of all patients who underwent radical hysterectomy...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:To evaluate whether early oral intake after cesarean delivery has an effect on gastrointestinal outcomes during postpartum recovery. DATA SOURCES:Electronic searches of published studies between 1980 and 2011 were conducted using PubMed, Medline, CINAHL, ClinicalTrials.gov, and Airiti databases. METHODS OF ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/AOG.0b013e318293698c
更新日期:2013-06-01 00:00:00
abstract::We compared the TDx Fetal Lung Maturity test and the fluorescence polarization method using 1-palmitoyl-2(6-[(7-nitro-2,1,3-benzoxadiazol-4- yl)amino]caproyl)phosphatidylcholine (NBD-phosphatidylcholine). Using 76 paired human amniotic fluid samples, the fluorescence polarization values of the two methods were found t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-12-01 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
abstract::To evaluate the effectiveness of a physician-based intervention to promote smoking cessation during pregnancy, we conducted this randomized controlled trial in the resident-staffed prenatal clinics at the University of North Carolina Women's Hospital . Two hundred fifty prenatal patients who smoked were enrolled at th...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0029-7844(95)00492-0
更新日期:1996-04-01 00:00:00
abstract::An unusual case is presented of advanced dysgerminoma in a patient with Swyer syndrome, 46,XY pure gonadal dysgenesis. Unexpected regional invasion necessitated bowel resection, total abdominal hysterectomy, and bilateral salpingogonadectomy for a complete en bloc excision of the primary tumor mass and the dysgenetic ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract::Acknowledgement of the importance of patient autonomy and increased patient access to information has prompted more patient - generated requests for surgical interventions not necessarily recommended by their physicians. Decision making in obstetrics and gynecology should be guided by the ethical principles of respect...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000291581.16747.24
更新日期:2008-01-01 00:00:00
abstract::Severe fetal hydrops was diagnosed at 34 weeks' gestation. Funipuncture revealed a normal 46,XX karyotype and a hematocrit of 20%. Cesarean delivery was performed. Neonatal blood testing showed blood type B positive, positive direct and indirect Coombs, and an anti-B antibody titer of 1:64. The maternal blood group wa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract::Halogenated anesthetic agents have been used to supplement nitrous oxide during balanced general anesthesia for cesarean delivery to decrease maternal awareness. However, these agents can interfere with uterine contractility and hence have the potential to increase blood loss at the time of cesarean section. To ascert...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-03-01 00:00:00
abstract::The effect on labor of administering ritodrine after a premature rupture of the membranes (PROM) was studied in a double-blind trial in 30 patients. The patients were selected according to the following criteria: 28 to 36 weeks' gestation, only 1 fetus, cervix dilated 4 cm or less, and absence of pyrexia or other sign...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract::beta-Adrenergic agents are used to inhibit preterm labor and glucocorticoids to accelerate fetal pulmonary maturation. A study was designed to investigate the metabolic effects of intravenous infusion of ritodrine (150 to 100 microgram/min) or isoxsuprine (200 to 150 microgram/min) in a series of 28 patients with gest...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-197803000-00007
更新日期:1978-03-01 00:00:00
abstract:OBJECTIVES:To estimate, from the literature, when nonlactating postpartum women regain fertility. DATA SOURCES:We searched PubMed and Cochrane Library databases for all articles (in all languages) published in peer-reviewed journals from database inception through May 2010 for evidence related to the return of ovulati...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0b013e31820ce18c
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of urinary dysfunction in Hong Kong Chinese women. METHODS:A telephone survey was conducted in the territory of Hong Kong. The subjects were a sample of women between the ages of 10 and 90 years. The main outcome determined was the prevalence of urinary dysfunction. RESULTS:We ma...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/S0029-7844(96)00335-3
更新日期:1996-12-01 00:00:00
abstract::A case of endometrioid carcinoma arising in endometriosis of the fallopian tube is described. One case of tubal endometrioid carcinoma has been reported previously, but the entity has not hitherto been recognized among primary fallopian tube tumors. The clinical presentations, histopathology, and pathogenesis of this ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-07-01 00:00:00
abstract:OBJECTIVE:The association of intraoperative neurologic injuries with gynecologic surgical procedures is well established. The sequelae of such injuries are usually transient and resolve with minimal intervention, although long-term disability can and does occasionally occur. The purpose of this study was to examine the...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000110542.53489.c6
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:To identify facilitators of and barriers to pregnant women being vaccinated against seasonal influenza by identifying factors associated with influenza vaccination during pregnancy among women who had recently given birth to a live infant. METHODS:We analyzed pooled data from Georgia (n=2,692) and Rhode Isla...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181f1039f
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Opportunistic salpingectomy at the time of hysterectomy is currently recommended to reduce the lifetime risk of ovarian cancer. The vaginal route is least invasive, but surgeons sometimes may choose to perform this procedure laparoscopically or robotically when anticipating adnexal surgery as a result of lim...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002746
更新日期:2018-08-01 00:00:00
abstract::During a five-year period, 2815 patients undergoing 5685 fetal heart rate (FHR) tests produced 147 positive contraction stress tests. Baseline FHR patterns were considered reactive if three or more accelerations occurred during 30 minutes of the contraction stress test and nonreactive if fewer or no accelerations were...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract::For certain medical conditions, available data and expert opinion support optimal timing of delivery in the late-preterm or early-term period for improved neonatal and infant outcomes. However, for nonmedically indicated early-term deliveries such an improvement has not been demonstrated. Morbidity and mortality rates...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000428649.57622.a7
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Renal cell carcinoma is a potentially fatal tumor that occasionally presents during pregnancy. Based on our experience with three patients and a review of the recent cases in the literature, we believe there has been a change in presentation of this lesion over that described in previous reviews. CASES:Two ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract::Six girls with suspected Rokitansky syndrome underwent magnetic resonance imaging (MRI) and then sonography and laparoscopy to confirm the clinical diagnosis and define the precise characteristics of the malformation. The uterus was missing in all; four had müllerian rudiments in place of the uterus, which were cavita...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:To assess the value of first trimester screening by ultrasonography in detecting structural anomalies of the fetus in a general obstetric population. METHODS:During 1993-1998, 20,465 consecutive pregnant women who resided in a defined geographic area participated in ultrasonographic screening for major malfo...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)02590-5
更新日期:2003-02-01 00:00:00