Abstract:
OBJECTIVE:To examine whether there are: 1) regional differences in three perinatal interventions that reflect active treatment among periviable gestations and 2) racial-ethnic differences in the receipt of these perinatal interventions after accounting for hospital region. METHODS:We conducted a retrospective study on neonates born at 776 U.S. centers that participated in the Vermont Oxford Network (2006-2017) with a gestational age of 22-25 weeks. The primary outcome was postnatal life support. Secondary outcomes included maternal administration of antenatal corticosteroids and cesarean delivery. We examined rates and 99% CI of the three outcomes by region. We also calculated the adjusted relative risks (aRRs) and 99% CIs for the three outcomes by race and ethnicity within each region using modified Poisson regression models with robust variance estimation. RESULTS:Major regional variation exists in the use of the three interventions at 22 and 23 weeks of gestation but not at 24 and 25 weeks. For example, at 22 weeks of gestation, rates of life support in the South (38.3%; 99% CI 36.3-40.2) and the Midwest (32.7%; 99% CI 30.4-35.0) were higher than in the Northeast (20.2%; 99% CI 17.6-22.8) and the West (22.2%; 99% CI 20.0-24.4). Particularly in the Northeast, black and Hispanic neonates born at 22 or 23 weeks of gestation had a higher provision of postnatal life support than white neonates (at 22 weeks: black: aRR 1.84 [99% CI 1.33-2.56], Hispanic: aRR 1.80 [1.23-2.64]; at 23 weeks: black: aRR 1.14 [99% CI 1.08-1.20], Hispanic: aRR 1.12 [1.05-1.19]). In the West, black and Hispanic neonates born at 23 weeks of gestation also had a higher provision of life support (black: aRR 1.11 [99% CI 1.03-1.19]; Hispanic: aRR 1.10 [1.04-1.16]). CONCLUSION:Major regional variation exists in perinatal interventions when managing 22- and 23-week neonates. In the Northeast and the West regions, minority neonates born at 22 and 23 weeks of gestation had higher provision of postnatal life support.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Boghossian NS,Geraci M,Edwards EM,Ehret DEY,Saade GR,Horbar JDdoi
10.1097/AOG.0000000000003747subject
Has Abstractpub_date
2020-04-01 00:00:00pages
885-895issue
4eissn
0029-7844issn
1873-233Xpii
00006250-202004000-00018journal_volume
135pub_type
杂志文章abstract:BACKGROUND:Human metapneumovirus has recently been recognized as an important cause of severe respiratory viral infections and of viral infections in patients admitted to intensive care units. Little is known about the course of this infection in pregnancy. CASE:A late-preterm primigravid woman was admitted to the int...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002165
更新日期:2017-09-01 00:00:00
abstract::Published reports disagree on the risks of intraamniotic prostaglandin F2alpha (PGF2alpha) for midtrimester abortion. To evaluate the safety and efficacy of intraamniotic PGF2alpha, we compared 1241 PGF2alpha and 10,013 saline abortions performed during the 13th to the 24th menstrual week. The results were reported in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-05-01 00:00:00
abstract::There are several obstetric, medical, and surgical disorders that share many of the clinical and laboratory findings of patients with severe preeclampsia-hemolysis, elevated liver enzymes, and low platelets syndrome. Imitators of severe preeclampsia-hemolysis, elevated liver enzymes, and low platelets syndrome are lif...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000258281.22296.de
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:We describe the current state of prevention of neonatal group B streptococcal infections and present recent advances toward the development of a maternal vaccine for prevention of this disease. DATA SOURCES:We used a MEDLINE search of the Index Medicus from 1976-1992 for articles regarding group B streptococ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the quality of logistic regression reporting in the obstetrics and gynecology literature. METHODS:All original papers published in 2005 and 2006 in four leading obstetrics and gynecology journals were manually searched for the use of logistic regression. One hundred four articles that used logist...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318160f38e
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:To address the evolving trends in the choice of transabdominal or transcervical chorionic villus sampling (CVS) at a teaching hospital and to evaluate the influence of gestational age on the approach chosen. METHODS:We analyzed our CVS data base, which contained information from 1986-1991. The proportions of...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-09-01 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:OBJECTIVE:To test the hypothesis that maternal oral hydration would increase the amniotic fluid (AF) index in pregnancies with normal AF. METHODS:Forty women with a normal AF index (7.0-24.0 cm) were randomized to either the control or hydration group. Women in the hydration group drank 2 L of water and returned for t...
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:1993-01-01 00:00:00
abstract:OBJECTIVE:To examine the results of a quality-improvement study that implemented an enhanced recovery after surgery (ERAS) program for cesarean delivery. METHODS:A pre-post design was used to assess changes in opioid use, length of stay, and costs among all patients undergoing cesarean delivery before and after implem...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004023
更新日期:2020-10-01 00:00:00
abstract::The goal of epidemiology is accurate measure of the relationship between an exposure and a disease of interest. The control of covariates of the exposure-disease relationship is required to obtain a valid measure. Two types of covariates, confounders and effect modifiers, must be considered. Investigators can design s...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1991-10-01 00:00:00
abstract::Six sheep fetuses were monitored with a single-probe tissue spectrophotometer. This spectrophotometer provides continuous digital output of the index of hemoglobin that is saturated with oxygen. To vary the fetal pO2, each maternal ewe was given room air, 100% oxygen, 12% oxygen, and 100% nitrogen via rebreathing bag....
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract::Women who present with pain and bleeding in the first trimester are at risk for ectopic pregnancy, a life-threatening condition. Conditions that predispose a woman to ectopic pregnancy are damaged fallopian tubes from prior tubal surgery or previous pelvic infection, smoking, and conception using assisted reproduction...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000198632.15229.be
更新日期:2006-02-01 00:00:00
abstract::Cystadenofibromas are benign ovarian neoplasms containing both epithelial and stromal components. The epithelial component is usually of simple serous type resembling fallopian tube epithelium. Occasionally, tumors with unusual epithelial pattenrs are encountered. In this study, 16 cystadenofibromas with unusual epith...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-12-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy and safety of routine electronic fetal monitoring (EFM) of labor with intermittent auscultation, using the results of published randomized controlled trials (RCTs). DATA SOURCES:We identified RCTs by searching the MED-LINE data base for the period 1966-1994, contacting experts, and re...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVE:To determine the frequency and topography of pelvic and para-aortic node involvement in cervical carcinoma and to identify the appropriate level for resection of the lymphatic chains. METHODS:Between 1985 and 1994, 421 women with stage Ib or II cervical carcinoma were treated by surgery in combination with i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00696-0
更新日期:1998-03-01 00:00:00
abstract::Carrier screening, whether targeted or expanded, allows individuals to consider their range of reproductive options. Ultimately, the goal of genetic screening is to provide individuals with meaningful information that they can use to guide pregnancy planning based on their personal values. Ethnic-specific, panethnic, ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001947
更新日期:2017-03-01 00:00:00
abstract::The obstetric hospitalist and the obstetric and gynecologic hospitalist evolved in response to diverse forces in medicine, including the need for leadership on labor and delivery units, an increasing emphasis on quality and safety in obstetrics and gynecology, the changing demographics of the obstetric and gynecologic...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0000000000001235
更新日期:2016-02-01 00:00:00
abstract::Individuals with Down syndrome have abnormally short long bones. Sonography has previously revealed slightly shortened femurs and thickened nuchal folds in affected second-trimester fetuses. Humeral and femoral lengths and nuchal folds were evaluated in 400 normal second-trimester controls and in 24 consecutive Down s...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199102000-00012
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVE:Neonatal alloimmune thrombocytopenia is caused by platelet antigen incompatibility between the mother and fetus. Affected fetuses may have severe thrombocytopenia leading to intracranial hemorrhage before or at birth. We sought to treat this condition in utero to prevent these hemorrhages. METHODS:Eighteen w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00
abstract::A preterm birth prevention program consisting of risk scoring, intensive weekly observation including cervical examinations, and detailed education about preterm labor signs and symptoms was tested in a predominantly black, indigent population. One thousand high-risk women were randomized to treatment or control group...
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:1990-06-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of stress, urge, and mixed urinary incontinence and associated risk factors in postmenopausal women. METHODS:Before enrollment in a 4-year, randomized trial of combination hormone therapy to prevent coronary heart disease, 2763 participants completed questionnaires on prevalence a...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0029-7844(99)00263-x
更新日期:1999-07-01 00:00:00
abstract::The present study is concerned with surveillance/management programs for hereditary ovarian cancer syndromes. These syndromes lack distinguishing premonitory physical signs or biomarkers; therefore, in these genotypic settings, ovarian cancer risk must be assessed by analysis of the patient's pedigree. The authors des...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1982-05-01 00:00:00
abstract::A new technique is presented for funipuncture under ultrasound guidance using a biopsy guide and a 20/25-gauge needle combination. The 20-gauge needle was used for uterine entry and the 25-gauge needle for the actual cord puncture. The method was used for sampling fetal blood in 262 pregnancies with 264 fetuses (two s...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
abstract::Heating of metallic IUDs during ultrasound examination has been suggested as a possible hazard to surrounding tissues. Serial temperature measurements of such devices during insonation with commercially available ultrasound equipment show no temperature changes during prolonged exposure. The results indicate that the ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-07-01 00:00:00
abstract:OBJECTIVE:To evaluate health care provider adherence to the surgical protocol endorsed by the National Comprehensive Cancer Network and the American College of Obstetricians and Gynecologists at the time of risk-reducing salpingo-oophorectomy and compare adherence between gynecologic oncologists and obstetrician-gyneco...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/AOG.0000000000003421
更新日期:2019-09-01 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:BACKGROUND:It has been suggested that Q fever infection in pregnancy is associated with various maternal and neonatal adverse outcomes, including intrauterine growth restriction, stillbirth, preterm delivery, intrauterine fetal death, and oligohydramnios. CASE:We describe the cases of two pregnant women remote from te...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318260590f
更新日期:2012-08-01 00:00:00
abstract::The authors describe a pregnancy complicated by rhesus sensitization and the May-Hegglin anomaly. The principal objective in caring for the patient was prevention of maternal and fetal hemorrhage. Transfusion of type-specific platelets corrected the patient's abnormal bleeding time. Cesarean section resulted in delive...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVE:To estimate whether the timing of bladder emptying affects focal myometrial contraction development and image adequacy. METHODS:Women at 14 0/7-32 0/7 weeks of gestation undergoing a transvaginal ultrasound examination from January 1, 2012, to September 1, 2012, were eligible for this blinded randomized cont...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/AOG.0b013e3182860b8d
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:An existing model for fourth-degree laceration repair uses beef tongue with plastic or vinyl tubing. This modified model substitutes beef tripe for the anal mucosa and chicken leg muscles for the anal sphincter muscle analogs to create a realistic model. METHOD:Tripe is tunneled through the body of the trim...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001908
更新日期:2017-03-01 00:00:00