Abstract:
:All pregnant women, regardless of age, should be offered screening or invasive testing for chromosomal abnormalities at <20 weeks' gestation. Noninvasive prenatal screening for fetal aneuploidy with the use of cell-free DNA (cfDNA) is a screening method that offers high sensitivity and specificity in validation studies and has reduced the need for unnecessary invasive procedures. Laboratories often advertise and report a test's sensitivity and specificity as a means to describe the test's accuracy. The positive predictive value (PPV) of a screening test (the proportion of positive results that are truly positive) is a function of the prevalence of the condition in a population and often is not reported in direct-to-patient advertising. False-positive cfDNA screening tests have been reported, and there is evidence that some women are deciding to terminate their pregnancy without confirmatory testing. We believe that laboratories should disclose the patient-specific PPV of cfDNA screening for aneuploidy on result reports. To assist with counseling patients about the benefits, risks, and limitations of aneuploidy screening with the use of cfDNA and to demonstrate the relationship between an a priori risk and PPV, we developed a web-based calculator to estimate the PPV of the 4 commercially available cfDNA testing platforms for which data have been published. Estimates are made with the use of a patient's age and gestational age-related risk of trisomy 21, 18 and 13 or an a priori risk that is based on other findings. This web-based calculator is an aid for providers and genetic counselors to illustrate the relationship between disease prevalence and a test's PPV. It has enhanced our counseling of patients both before they elect noninvasive prenatal screening and after they receive a positive result.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Grace MR,Hardisty E,Green NS,Davidson E,Stuebe AM,Vora NLdoi
10.1016/j.ajog.2015.05.004subject
Has Abstractpub_date
2015-07-01 00:00:00pages
30.e1-30.e4issue
1eissn
0002-9378issn
1097-6868pii
S0002-9378(15)00453-6journal_volume
213pub_type
杂志文章abstract:OBJECTIVE:Our goal was to evaluate an antibiotic protocol for treatment of postcesarean endometritis. STUDY DESIGN:Endometritis was diagnosed as a persistent fever > or =100.4 degrees F beyond 24 hours after cesarean delivery and one or more of the following: uterine tenderness, tachycardia, foul lochia, or leukocytos...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.103249
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:The objective was to evaluate whether the rate of neonatal group B streptococcal infection could be reduced by screening for group B streptococci during the third trimester of pregnancy. STUDY DESIGN:Two periods in which different screening and treatment protocols were applied were compared. In period A all ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70063-8
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:Our purpose was to test the hypothesis that lipopolysaccharide potentiates the transcription of human placental prostaglandin H synthase-2 gene, a rate-limiting enzyme in prostaglandin synthesis. STUDY DESIGN:We transfected normal term cytotrophoblasts with a reporter vector containing either prostaglandin H...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70422-3
更新日期:1998-03-01 00:00:00
abstract::Two hundred seventy-eight high-risk patients were managed by a comprehensive assessment of the anatomic, biochemical, and functional environment of the fetoplacental unit utilizing predetermined guidelines. Decisions to terminate pregnancy were reserved for patients who demonstrated a positive OCT. Perinatal outcome i...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90835-4
更新日期:1979-07-01 00:00:00
abstract:OBJECTIVE:Blunt vs sharp expansion of the uterine incision at cesarean delivery has been investigated as a technique primarily to reduce intraoperative blood loss. The objective of this systematic review was to compare the effects of either intervention on maternal outcomes. STUDY DESIGN:A systematic review with metaa...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ajog.2012.10.886
更新日期:2013-01-01 00:00:00
abstract::Ultrasonography can accurately determine phenotypic sex differences from those of the genetic sex. Two cases were identified; they were the result of a translocation of the SRY gene from the Y chromosome to the X chromosome during meiosis. An ultrasonographic difference may represent an otherwise unsuspected genetic a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70673-3
更新日期:1999-04-01 00:00:00
abstract::Oral contraceptives are combinations of estrogens and progestogens or, in the case of the mini-pills, progestogens alone. With specific test procedures in laboratory animals or human subjects, it is possible to assign potency evaluations to the components relative to the progestational, estrogenic, or antiestrogenic a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90804-8
更新日期:1976-08-15 00:00:00
abstract::In order to examine the relationship between circadian rhythms in different steroids, cortisol (F), estrone E1), estradiol (E2), and estriol (E3) were measured by radioimmunoassay in maternal venous plasma taken at 30 to 60-minute intervals over 24 hours from 11 healthy women at 34 to 35 weeks' gestation. Maternal F w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90393-4
更新日期:1979-11-15 00:00:00
abstract:BACKGROUND:As compared with singleton gestations, twin pregnancies are associated with a significantly higher risk of preterm birth and maternal complications as well as fetal and neonatal morbidity and mortality. Multifetal pregnancy reduction is a technique developed in the 1980s to reduce the fetal number in higher-...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2019.04.001
更新日期:2019-09-01 00:00:00
abstract::Thirteen women with infertility thought due to anovulation were treated with LRH. Etiologic diagnoses of amenorrhea included hypothalamic or "idiopathic" and PCOD. All patients had normal gonadotropins and otherwise normal endocrinologic and infertility evaluations; none had ovulated with clomiphene. Patients were stu...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(79)90819-6
更新日期:1979-12-01 00:00:00
abstract::Relaxin is a peptide hormone produced by the corpus luteum during pregnancy in human beings. There are no extraluteal sites of production of relaxin in women. By means of a heterologous porcine radioimmunoassay, serial serum relaxin concentrations were determined in three women throughout pregnancy and into labor. All...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-09-01 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:BACKGROUND:There are a number of poor birth outcomes with advancing maternal age. Although there is some evidence of a higher risk of trauma to obstetric anal sphincter and the levator ani muscle with advancing age, findings to date are inconclusive. OBJECTIVE:The aim of this study was to assess the risk of pelvic flo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.04.032
更新日期:2016-10-01 00:00:00
abstract::Connective tissue in biopsy specimens taken from the lower part of the uterine cervix in 40 pregnant women at various gestational ages was compared to that in similar biopsy specimens from 15 nonpregnant women. The concentrations of collagen, sulfated glycosaminoglycans, and hyaluronic acid decreased during pregnancy....
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)90446-5
更新日期:1983-11-15 00:00:00
abstract:OBJECTIVE:This study was undertaken to review pregnancy course and outcome in 56 pregnancies after the placement of a cervicoisthmic cerclage transvaginally. STUDY DESIGN:Fifty-three pregnant patients with unique indications such as previous failure of conventional cerclages or compromised cervical anatomy, underwent ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.02.127
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:We used validated sensitive and specific questions associated with clinically confirmed diagnoses of unexplained vulvar pain (vulvodynia) to compare the cumulative incidence of vulvar pain and prevalence of care-seeking behavior in Boston metropolitan area (BMA) and in Minneapolis/Saint Paul metropolitan area...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.09.033
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Inadequate or excessive total gestational weight gain is associated with increased risks of small- and large-for-gestational-age births, respectively, but evidence is sparse regarding overall and trimester-specific patterns of gestational weight gain in relation to these risks. Characterizing the interrelati...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2017.05.013
更新日期:2017-09-01 00:00:00
abstract::This study was designed to test the hypothesis that the thermal response to endurance exercise is altered by the thermal adaptations to pregnancy. Accordingly, rectal temperature was monitored in 18 recreational athletes before, during, and after 20 minutes of continuous exercise before conception and every 6 to 8 wee...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90015-j
更新日期:1991-12-01 00:00:00
abstract::Pelvic blood flow was serially determined in 19 pregnant ewes before and after the induction of one-kidney renal hypertension. The six twin gestations and 13 singleton gestations behaved similarly for all parameters, except renal blood flow. After the renal preparatory surgical procedure, there was a 19% increase in m...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32681-3
更新日期:1981-12-15 00:00:00
abstract:OBJECTIVE:The aim of this study was to test the hypothesis that obstetricians' choice of delivery method is influenced by their risk attitude and perceived risk of complaints and malpractice litigation. STUDY DESIGN:The choice of delivery method in ambiguous cases was studied in a nationwide survey of Norwegian obstet...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.07.021
更新日期:2009-01-01 00:00:00
abstract::Reproductive coercion involves behavior that interferes with contraceptive and pregnancy choices of women and occasionally men. This includes birth control sabotage (intentional destruction of a woman's chosen method of contraception), pregnancy pressure (behaviors to coerce pregnancy against one's wishes), and pregna...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2015.08.045
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:Our objective was to study the effect of estrogen administration and moderate hypertension on left ventricular size, pump function, and contractility in chronically instrumented ewes. STUDY DESIGN:Ewes were either given 0.06 mg/kg 17beta-estradiol intramuscularly (n = 8) or were made hypertensive (n = 6) by ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70053-5
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:To define the incidence of hypoglycemia and identify risk factors in neonates from term, singleton, nondiabetic pregnancies. STUDY DESIGN:We conducted a matched case-control study of term, singleton infants weighing more than 2500 g in nondiabetic pregnancies. Cases with hypoglycemia (glucose < 50 mg/dL) wer...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.10.015
更新日期:2009-05-01 00:00:00
abstract::Retrospective review of 457 breech deliveries failed to reveal a significant improvement in neonatal mortality and morbidity rates for those delivered by cesarean section vs. vaginal delivery. A slight but insignificant improvement in salvage was found for the 1,000 to 1,500 gram weight category when delivery was by c...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90638-0
更新日期:1979-07-15 00:00:00
abstract::The purpose of this study was to determine the activity and toxicity of hexamethylmelamine chemotherapy in patients with persistent or recurrent epithelial ovarian cancer. Forty-nine women received hexamethylmelamine 100 to 150 mg/day for 14 days, repeated at 4-week intervals. All patients had previously received at l...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(91)90287-2
更新日期:1991-09-01 00:00:00
abstract::Previous studies in our laboratory have suggested that measurement of methylumbelliferylguanidinobenzoate (MUGB) reactive proteases in midtrimester amniotic fluid is potentially of value for the intrauterine detection of cystic fibrosis. Thirty-nine pregnancies of obligate heterozygotes of cystic fibrosis and 12 cases...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32679-5
更新日期:1981-12-15 00:00:00
abstract:OBJECTIVE:Maternal diabetes alters placental glucose metabolism and maternofetal glucose transport. The purpose of this study was to determine whether genes involved in placental glucose uptake and transport were concomitantly altered, resulting in the observed changes in the state of maternal diabetes. STUDY DESIGN:B...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90154-6
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:Before parturition are there useful and valid predictors of successful or unsuccessful vaginal birth after previous cesarean birth that could be used to enhance the obstetric care of a patient and her pregnancy? STUDY DESIGN:The clinical course and outcome of all patients who attempted vaginal birth after ce...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91572-r
更新日期:1992-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to identify the factors that affect the quality of cytologic cervical cancer screening conducted in public sector clinics in Sonora, Mexico. STUDY DESIGN:We assessed the quality of cervical cytology before and after a 2-hour training session and the implementation of cervical sp...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/s0002-9378(03)00490-3
更新日期:2003-08-01 00:00:00
abstract::Posterior vaginal repair is often poorly understood and ineffectively performed. The goals of reconstructive surgery emphasize relief of symptoms and restoration of normal anatomic relationships and of function. A useful method to preoperatively determine posterior vaginal wall weakness is outlined along with a surgic...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90503-j
更新日期:1991-03-01 00:00:00