Abstract:
:This report summarizes the cumulative experience of 3313 pregnancies represented in 59 prospective clinical trials in which intracervical or intravaginal prostaglandin E2 gel was used for cervical ripening before induction of labor. Results indicate that local prostaglandin E2 is superior to placebo or no therapy in enhancing cervical effacement and dilation, reducing initial induction failures, shortening the induction-delivery interval, reducing oxytocin use, and lowering the rate of cesarean section because of failure to progress. Certain advantages also exist for labor induction in the presence of a favorable cervical state. Uterine hyperstimulation or pathologic fetal heart rate patterns before oxytocin administration occur in less than 1% of reported cases and are usually dose related, self contained, and reversible with the use of beta-adrenergic tocolytic therapy. Maternal systemic effects in these low doses are negligible. Worldwide clinical experience has clearly demonstrated that prostaglandin E2 gel administered before induction of labor is of major therapeutic benefit and should become commercially available for more than investigational use. :Prostaglandin E2 gel is a useful agent for ripening and dilating the cervix. Since it is not available in the US, it must be prepared by thawing and grinding a 20 mg prostaglandin E2 suppository, mixing in a small amount of methylcelulose gel, and blending. The resulting gel is stored frozen in a 3 ml plastic syringe. The gel may be administered intracervically, intravaginally, or extraamniotically. Cervical administration of .5 mg prostaglandin E2 in 2-3 ml of viscous gel is most popular, but intravaginal administration is easiest, although it requires a higher dose (1-5 mg prostaglandin E2 in 2-10 ml of gel). The condition of the cervix is usually favorable for labor induction within 12 hours (range 4-24 hours). 59 clinical trials were conducted among 3313 pregnancies. In patients with unfavorable cervix induction of labor was successful in 83% of those treated with the gel but in only 53% of untreated patients. In women with an unfavorable cervix the gel is more effective if administered intracervically. In patients with favorable cervix, 66% of nulliparas and 82% of multiparas were delivered without oxytocin. Prostaglandin E2 gel has been used successfully even in women with prolonged pregnancy, hypertension, ruptured membranes, and fetal death. It can also be used to induce late 1st trimester abortion. Side effects of the gel are mild and minor. Prostaglandin E2 gel has thus been shown to effect cervical ripening and dilatation, reduce induction failures, shorten the induction-delivery interval, reduce oxytocin use, and lower the need for cesarean sections. Prefabricated prostaglandin E2 delivery systems should be approved by the Food and Drug Administration for commercial use.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Rayburn WFdoi
10.1016/s0002-9378(89)80020-1subject
Has Abstractpub_date
1989-03-01 00:00:00pages
529-34issue
3eissn
0002-9378issn
1097-6868pii
S0002-9378(89)80020-1journal_volume
160pub_type
临床试验,杂志文章,评审abstract::Eighteen women aged 12 to 20 years with congenital cervicovaginal atresia were treated with a new technique of surgical canalization. All are now having regular menses. Two pregnancies have been achieved, with delivery of viable neonates. Surgical correction of this anomaly during adolescence may aid in restoration of...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.105740
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Chlamydia trachomatis infection is common and largely asymptomatic in women. If untreated, it can lead to sequelae such as pelvic inflammatory disease and infertility. It is unknown whether a patient's self-reported history of Chlamydia trachomatis infection is a valid marker of past infection. OBJECTIVE:Ou...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.12.005
更新日期:2017-04-01 00:00:00
abstract::To study the effects of ritodrine on fetal and placental blood flow and maternal prostacyclin and thromboxane A2, 14 women with premature uterine contractions between the thirty-first and thirty-sixth weeks of pregnancy were treated with intravenous infusions of ritodrine, with incremental doses up to 200 micrograms p...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90374-6
更新日期:1985-04-15 00:00:00
abstract::Fifty-four pregnancies that were subsequently complicated by preeclampsia had platelet parameters and uric acid levels measured during pregnancy. The expected fall in platelet count and rise in platelet volume parameters and uric acid levels beyond those that occur in normal pregnancy were seen only in the week before...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90555-1
更新日期:1985-08-15 00:00:00
abstract:OBJECTIVE:We assessed the screening and remediation of home lead hazards prenatally in a high-risk population, hypothesizing that average blood-lead level and the number of poisonings would drop by 25%. STUDY DESIGN:One hundred fifty-two women underwent prenatal home inspections by certified lead inspectors. The hazar...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.01.001
更新日期:2012-03-01 00:00:00
abstract::A case report of hemolytic uremic syndrome with placental involvement in 2 of 3 consecutive pregnancies highlights the impact on the fetal placental compartment and the importance of diligent antenatal care in subsequent pregnancies. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.116829
更新日期:2001-11-01 00:00:00
abstract::As part of a multicenter prospective study, second-trimester human chorionic gonadotropin and alpha-fetoprotein concentrations were evaluated. Data included maternal age, human chorionic gonadotropin level, alpha-fetoprotein level, weight, race, and pregnancy outcome of 3428 pregnancies at between 15 and 20 weeks' ges...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90305-b
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the relationship between gestational age and outcomes of outborn versus inborn preterm infants. STUDY DESIGN:Multivariable logistic regression analysis was used to examine gestational age-specific, risk-adjusted outcomes of 2962 singleton infants who were born at <32 ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.139
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:Review alternative approaches to oral metronidazole for the treatment of bacterial vaginosis. STUDY DESIGN:Assessment of clinical trials on the treatment of bacterial vaginosis with regimens other than 5 to 7 days of metronidazole. RESULTS:Single-dose metronidazole, 2 gm orally, is as effective as 5- to 7-d...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(93)90346-k
更新日期:1993-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to characterize the spinal distribution of afferent and efferent pathways that innervate the levator ani (LA) muscle in the female squirrel monkey. STUDY DESIGN:Cholera toxin B (CTB) was injected unilaterally into the LA muscle of 5 monkeys to identify primary sensory neurons in...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.10.607
更新日期:2005-05-01 00:00:00
abstract::If protective immunity were to develop following an episode of gonococcal pelvic inflammatory disease (salpingitis), PID should recur with organisms bearing antigens that do not react with these immune mechanisms. To test this hypothesis, gonococci from 15 women with gonococcal PID, who experienced 19 subsequent episo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(80)91091-1
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVES:This study details the incidence, by gestational age and birth weight, of specific neonatal morbidities in singleton neonates without major congenital anomalies. STUDY DESIGN:Data were prospectively collected on all deliveries at five tertiary centers in the United States during the years 1983 through 1986....
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91551-k
更新日期:1992-06-01 00:00:00
abstract::One hundred forty-nine consecutive patients who had surgery from May 1890 through December 1986 were evaluated to assess the functional and anatomic results of the paravaginal defect repair for stress urinary incontinence. All patients had their preoperative assessment, operative procedure, and postoperative follow-up...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90867-3
更新日期:1989-06-01 00:00:00
abstract::Four cases of immature teratoma of the ovary are presented and the recent literature is reviewed. The majority of these tumors were confined to one ovary at the time of diagnosis, and more than 75% occurred in women under 25 years of age. The two most important prognostic parameters were stage of disease and histologi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(83)90813-x
更新日期:1983-06-15 00:00:00
abstract::Clear cell carcinoma originating in the abdominal wall is rare and usually develops within endometriotic implants in the scar. We describe 2 patients: a 42 year old with a 15 cm mass on the abdominal wall treated with neoadjuvant chemotherapy and excision and a 51 year old with a 6 cm abdominal mass treated with excis...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2012.05.029
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the rates of late preterm inductions without a medical indication from birth certificate data and to compare them with rates that were obtained from medical charts. STUDY DESIGN:The Ohio Perinatal Quality Collaborative, which comprises 20 hospitals in Ohio that came...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.07.004
更新日期:2010-09-01 00:00:00
abstract::Vibroacoustic stimulation is widely used in the United States as a test for fetal well-being, yet little information is available on the adequacy of the electronic artificial larynx that is commonly used as the stimulator. To determine whether the intraabdominal sound pressure level was dependent on the static force a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90602-n
更新日期:1991-04-01 00:00:00
abstract::Color Doppler imaging could easily and rapidly detect the absence of an umbilical artery, despite the presence of oligohydramnios in one case and multiple cord loops involving a normal cord in the other case. In the third case, which on gray-scale imaging appeared as an indeterminate cystic structure of the cord, colo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90663-7
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVES:Our purpose was to determine whether birth weight discordance is a risk factor for preterm birth of twins, and to further characterize the relationships involved. STUDY DESIGN:Maternally linked 1978-1990 Missouri birth certificates were used to analyze gestations resulting in live twins. We used contingency...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.105346
更新日期:2000-07-01 00:00:00
abstract::Since previous data suggested hyperresponsiveness to human menopausal gonadotropin by women with low body weight, the daily dose was reduced to 1.5 ampules in patients undergoing in vitro fertilization weighing less than 55 kg. This allowed the extension of treatment to a minimum of 6 days. These changes were associat...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90778-8
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to show and discuss an association between fetal inflammatory response syndrome (FIRS) and an adverse neonatal outcome defined as combined severe neonatal morbidity and mortality in preterm neonates hospitalized in our neonatal intensive care unit. STUDY DESIGN:This was an observati...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.08.030
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:There has been a gradual shift of the focus of prenatal diagnosis from genetics to ultrasonography. We assessed our primary genetics approach to determine what would be missed without the genetics component. STUDY DESIGN:We evaluated referral indications for patients with normal and abnormal prenatal finding...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70230-2
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:Our purpose was to report transient complications associated with operative hysteroscopy with glycine used as the distending medium. STUDY DESIGN:All the operative hysteroscopies performed over a 6-month period by a single operator were examined. The blood oxygenation and end-tidal carbon dioxide concentrati...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70377-9
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine the safety and tolerance of levonorgestrel contraceptive implants (Norplant, Wyeth-Ayerst, Philadelphia) when inserted immediately post partum, to document the effects on weight and blood pressure, and to determine the side effects. STUDY DESIGN:After vaginal delivery, 250 women ...
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:10.1016/0002-9378(95)90109-4
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to report the clinical experience collated from the 1995 and 1997 case list summary sheets of United States and Canadian active candidates who were completing the American Board of Obstetrics and Gynecology oral examination for the first time. STUDY DESIGN:Data from the case lis...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.119181
更新日期:2001-12-01 00:00:00
abstract::Transferrin receptors have been identified on the villous trophoblast of normal chorionic villi by immunohistochemical techniques. The current study investigated the expression of transferrin receptors on molar chorionic villi by using a monoclonal antibody in immunofluorescence assays. The villous trophoblast of mola...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90438-7
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:We sought to evaluate postsurgical adhesions in women of different races with or without keloids. STUDY DESIGN:This was a prospective study evaluating postsurgical adhesions after a cesarean delivery in 429 women with or without keloids. The outcome measures were the prevalence and extent of adhesions in wom...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.09.005
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:Our purpose was to evaluate the placental pathology in women with preeclampsia occurring at varying gestational ages. STUDY DESIGN:This was a secondary analysis of a prospective observational study of placentas from prespecified complicated pregnancies routinely submitted for standardized examination. For th...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.09.010
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:The incidence and outcomes for community-acquired pneumonia during a pregnancy ending with a live birth in the province of Alberta, Canada, were analyzed. STUDY DESIGN:Hospital abstracts and vital statistics data between April 1, 1994, to March 31, 1999, were used. RESULTS:The incidence of hospitalization f...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.175
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:Our purpose was to study the effects of isradipine, a dihydropyridine calcium channel blocker, on mother and fetus in the treatment of hypertensive disorders of pregnancy. STUDY DESIGN:The investigation was performed as a two-group, parallel, double-blind multicenter study of isradipine versus placebo. Fifty...
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:10.1016/0002-9378(95)90357-7
更新日期:1995-09-01 00:00:00