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-gynecologists (ob-gyns). METHODS:In this multicenter retrospective cohort study, women were included if they had a pathogenic BRCA mutation and underwent risk-reducing salpingo-oophorectomy between 2011 and 2017. Adherence was defined as completing all of the following: collection of washings, complete resection of the fallopian tube, and performing the Sectioning and Extensively Examining the Fimbriated End (SEE-FIM) pathologic protocol. RESULTS:Of 290 patients who met inclusion criteria, 160 patients were treated by 18 gynecologic oncologists and 130 patients by 75 ob-gyns. Surgery was performed at 10 different hospitals throughout a single metropolitan area. Demographic and clinical characteristics were similar between groups. Overall, 199 cases (69%) were adherent to the surgical protocol. Gynecologic oncologists were more than twice as likely to fully adhere to the full surgical protocol as ob-gyns (91% vs 41%, P<.01). Specifically, gynecologic oncologists were more likely to resect the entire tube (99% vs 95%, P=.03), to have followed the SEE-FIM protocol (98% vs 82%, P<.01), and collect washings (94% vs 49%, P<.01). Complication rates did not differ between groups. Occult neoplasia was diagnosed in 11 patients (3.8%). The incidence of occult neoplasia was 6.3% in gynecologic oncology patients and 0.8% in obstetrics and gynecology patients (P=.03). CONCLUSION:Despite clear surgical guidelines, only two thirds of all health care providers were fully adherent to guidelines. Gynecologic oncologists were more likely to follow surgical guidelines compared with general ob-gyns and more likely to diagnose occult neoplasia despite similar patient populations. Rates of risk-reducing surgery will likely continue to increase as genetic testing becomes more widespread, highlighting the importance of health care provider education for this procedure. Centralized care or referral to subspecialists for risk-reducing salpingo-oophorectomy may be warranted.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Wilhite AM,Oestreich MC,Olson M,Bedell SM,Westenberg D,Bangdiwala A,Ikramuddin S,Sanchez-Avila M,Madoff RD,Khalifa MA,Erickson BKdoi
10.1097/AOG.0000000000003421subject
Has Abstractpub_date
2019-09-01 00:00:00pages
520-526issue
3eissn
0029-7844issn
1873-233Xpii
00006250-201909000-00013journal_volume
134pub_type
杂志文章,多中心研究abstract::This month, we focus on current research in postpartum hemorrhage. Dr. Rouse discusses five recent publications, and each is concluded with a "bottom line" that is the take-home message. The complete reference for each can be found in on this page, along with direct links to the abstracts. ...
journal_title:Obstetrics and gynecology
pub_type: 评论,杂志文章
doi:10.1097/AOG.0b013e3182a2c357
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:To estimate the association between the ultrasonographic diagnosis of subchorionic hemorrhage and adverse pregnancy outcomes. METHODS:This was a retrospective cohort study of all consecutive women undergoing routine ultrasonography before 22 weeks with a singleton gestation at one institution from 1994 to 20...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181e90170
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To examine the effect of persistent occiput posterior position on neonatal outcome. METHODS:This is a retrospective cohort study of 31,392 term, cephalic, singleton births. Women with neonates born in persistent occiput posterior position at delivery were compared to those with occiput anterior position. Wom...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000206217.07883.a2
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To identify characteristics associated with high inpatient daily opioid consumption after cesarean delivery. METHODS:This is a retrospective cohort study of all cesarean deliveries performed under neuraxial anesthesia with neuraxial morphine, at a single institution from January 1, 2015, to December 31, 2015...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003087
更新日期:2019-02-01 00:00:00
abstract::In order to evaluate changes in hemoglobin A1 levels during nondiabetic pregnancy, 19 pregnant women were followed by determination of hemoglobin A1 with a two to four week interval. There was an early decrease in the hemoglobin A1 level already between the 12th and 16th weeks of pregnancy, with a further decrease in ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-12-01 00:00:00
abstract:OBJECTIVE:To evaluate an interferon (IFN)-gamma release assay in diagnosing latent tuberculosis infection in pregnant adolescents and women at risk for exposure to Mycobacterium tuberculosis. METHODS:This was a prospective study of women and adolescents receiving health care at Bellevue Hospital Outpatient Clinics in ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1097/AOG.0b013e3182546aff
更新日期:2012-06-01 00:00:00
abstract::Deep venous thrombosis is a major complication following gynecologic surgery. Assessing a patient's risk of developing deep venous thrombosis is important for patient selection and in choosing appropriate prophylactic methods. Four hundred eleven patients undergoing major gynecologic surgery were evaluated prospective...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-02-01 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::Sixty-four cases of stage I vulvar squamous cell carcinoma were analyzed histologically to define a patient subset at minimum risk for recurrence or nodal metastases. Three patterns of invasion were predefined: carcinoma in situ with early stromal invasion (33%), pushing (8%), and infiltrative (59%). Infiltrative patt...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVE:To compare the accuracy of D&C and office Z-sampler endometrial biopsy in predicting hysterectomy tumor grade in women with endometrial cancer. METHODS:Between September 1987 and July 1994, 183 women with endometrial cancer had D&C or office Z-sampler endometrial biopsy before hysterectomy. RESULTS:One hund...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00105-Z
更新日期:1995-07-01 00:00:00
abstract::A preliminary report is made of 11 patients of childbearing age treated for symptomatic uterine prolapse by a suspension technic employing straps of external oblique aponeurosis according to the method of Williams and Richardson. In a relatively short period of follow-up, the operative results have been excellent in a...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1967-08-01 00:00:00
abstract::From 1973 to 1983, cytogenetic analyses were performed on blood samples from 144 couples referred because of two or more spontaneous abortions. Any couple with abnormal offspring in addition to the miscarriages was excluded from the study. Two balanced translocations were found in the 288 individuals examined (0.7%). ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-02-01 00:00:00
abstract:OBJECTIVE:To analyze the change in serial human chorionic gonadotropin (hCG) levels in women symptomatic with pain or bleeding who presented with nondiagnostic ultrasonography but were ultimately confirmed to have a viable intrauterine pregnancy. METHODS:The rise in serial hCG measures were modeled over time, with the...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000128174.48843.12
更新日期:2004-07-01 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::Studies were conducted in 343 women on the clinical utility of the newly developed tumor-associated mucin-type glycoprotein, CA 54/61, as a tumor marker in serum for ovarian cancer. The overall positivity rate of the new marker was 60%, lower than the rate of 88% obtained with CA 125 measured concurrently. Concerning ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-09-01 00:00:00
abstract::A total of 4517 successful antepartum nonstress tests (NST) was performed on 2003 high- (28%) and low- (72%) risk obstetric patients. Most patients were monitored from 32 to 34 weeks' gestation onward. A reactive NST was defined as 2 accelerations in 10 minutes--15 beats/min minimum amplitude; 15 seconds minimum durat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-197907000-00006
更新日期:1979-07-01 00:00:00
abstract::Obesity is a medical condition that may be associated with bias among health care professionals, and this bias may result in disrespectful or inadequate care of patients with obesity. Obstetrician-gynecologists regularly care for patients with obesity and play an integral role in advocating for best practices in healt...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000003015
更新日期:2019-01-01 00:00:00
abstract::Percutaneous, transcatheter Gelfoam embolization of the hypogastric arteries was utilized in a patient to control vaginal hemorrhage secondary to far-advanced carcinoma of the cervix. The advantages of this method are outlined, and consideration of its use is recommended for patients in similar situations. The various...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-03-01 00:00:00
abstract::As the human immunodeficiency virus (HIV) epidemic affects more women, clinicians are increasingly observing pelvic inflammatory disease (PID) in HIV-infected women. The extent to which PID is a factor in the recognition of HIV or HIV is a factor in the recognition of PID is unknown. Even less is known about how HIV i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract:OBJECTIVE:To test the effectiveness of intraperitoneal local anesthesia in relieving postoperative pain after laparoscopic sterilization. METHODS:In a double-blind, placebo-controlled randomized study of two groups of 25 subjects each, women scheduled for tubal sterilization under general anesthesia received 80 mL of ...
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:1994-11-01 00:00:00
abstract:BACKGROUND:Neuroleptic malignant syndrome (NMS) is characterized by a tetrad of mental status changes, extrapyramidal symptoms, hyperpyrexia, and autonomic instability and can develop after the use of antipsychotics. CASE:A young, multiparous woman presented at 26 weeks of gestation with acute psychosis and was treate...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31822864af
更新日期:2012-02-01 00:00:00
abstract::Fourteen cases of mixed mesodermal tumor of the ovary are presented. The actuarial survival of patients with these tumors was 2.5 months. Eighty-six percent of patients were stage III or IV at the time of diagnosis. The stromal or carcinomatous component of the tumor could not be correlated with survival. Both our two...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVE:To describe our clinical experience with detection and analysis of cell-free fetal DNA derived from maternal plasma for prenatal sexing and fetal rhesus-D typing. METHODS:Real-time quantitative polymerase chain reactions (PCRs) of rhesus-D sequences and the SRY gene were validated and offered to patients wit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000103996.44503.F1
更新日期:2004-01-01 00:00:00
abstract::Following is a report and a review of literature concerning the supernumerary ovary. Up to now only 7 cases have been reported, and our case appears to be the eighth. The anatomic situation in this case was unusual since it was found in the mesentery. Of the cases previously reported, 2 have been associated with benig...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1975-03-01 00:00:00
abstract::This study reports serum levels of relaxin in normal and special-interest pregnancies using an homologous radioimmunoassay for human relaxin. The mean levels in uncomplicated antenatal patients were lower than those reported in studies using heterologous assays, but the trend in serum levels was similar. Serum levels ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-04-01 00:00:00
abstract::Autoimmune oophoritis is a rare cause of premature ovarian failure. Previous studies of autoimmune oophoritis have detailed the clinical, immunologic, and histologic findings. The gross pathologic features of the involved ovaries have detailed the clinical, immunologic, and histologic findings. The gross pathologic fe...
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 explore disparities in prematurity and low birth weight (LBW) by maternal race and ethnicity among singletons conceived with and without assisted reproductive technology (ART). METHODS:We performed a retrospective cohort study using resident birth certificate data from Florida, Massachusetts, and Michigan...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002031
更新日期:2017-06-01 00:00:00
abstract::Two appropriate-for-dates term infants were born after uncomplicated labors and atraumatic deliveries. They were depressed at birth, developed seizures on the first day of life, and followed clinical courses compatible with hypoxic-ischemic encephalopathy. However, the umbilical cord vessel pH and blood gases were nor...
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 explore the pregnancy and childbirth experiences and preferences of women with a history of sexual trauma in order to identify trauma-informed care practices that health care providers may use to improve obstetric care. METHODS:We conducted a qualitative study consisting of semistructured interviews with ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002956
更新日期:2018-12-01 00:00:00
abstract::A new analog of luteinizing-hormone-releasing factor, (Des-Gly-NH-2-10, Pro-ethylamide-9)-LHRF, was tested in healthy women with regular menstrual cycles. This synthetic nonapeptide amide was injected intravenously in a dose of 200 mug into 15 normal female volunteers in the follicular, preovulatory, and luteal phases...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1975-03-01 00:00:00