Abstract:
OBJECTIVE:To investigate the effect of second uterine curettage on the number of chemotherapy courses and relapse rate in low-risk postmolar gestational trophoblastic neoplasia. METHODS:In a phase III trial, patients with low risk gestational trophoblastic neoplasia were randomised (1:1) to a second curettage or no curettage group before methotrexate treatment. Eligibility criteria were serum human chorionic gonadotropin (hCG) level 5,000 international units/L or less and fit for treatment with methotrexate. Exclusion criteria were previous uterine perforation and life-threatening bleeding. With a two-sided 5% significance level and a power of 99%, a sample size of 44 patients per group was necessary to detect a mean reduction in 2.3 chemotherapy courses. The primary outcome was the number of chemotherapy courses required for hCG normalization. Secondary outcomes were needed for second-line treatment, toxicity, relapse rates, and variables associated with number of chemotherapy courses. RESULTS:From October 2011 through February 2016, 89 patients entered the study at the Mansoura Trophoblastic Clinic; in each group, 43 patients were included in the intention-to-treat analyses. Surgical complications did not occur. The mean number of chemotherapy courses required to reach hCG normalization was 4.4±2.2 SD in the control group vs 3.8±2.3 SD in the intervention group (P=.14). Groups were comparable in terms of second-line treatment needed to reach hCG normalization, and relapse within the first year. Only hCG levels related to the number of chemotherapy cycles required for hCG normalization. CONCLUSION:Second uterine curettage did not reduce the number of chemotherapy courses required or affect relapse rate in patients with low-risk postmolar gestational trophoblastic neoplasia. CLINICAL TRIALS REGISTRATION:Dutch Trial Registry, NTR3390.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Hemida R,Vos EL,El-Deek B,Arafa M,Toson E,Burger CW,van Doorn HCdoi
10.1097/AOG.0000000000003232subject
Has Abstractpub_date
2019-05-01 00:00:00pages
1024-1031issue
5eissn
0029-7844issn
1873-233Xjournal_volume
133pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:To estimate why the live birth rate per implanted embryo is higher in twin than in singleton pregnancies. METHODS:Data from 1,159 singleton and 523 dichorionic twin pregnancies, obtained after assisted conception, were included. To account for the higher live birth rate observed in twin pregnancies, two poss...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31823bf978
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:To assess the utility of umbilical cord venous blood gas measures for prediction of umbilical artery pH and base deficit acidemia. METHODS:A retrospective cohort study was conducted of all singletons with valid paired arterial and venous cord gas samples delivered at our institution from January 2006 to Marc...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000517
更新日期:2014-11-01 00:00:00
abstract::A day in obstetric-gynecologic practice in Kenya involves uterine rupture and other conditions resulting from inadequate care and facilities for labor, as well as infected abortions. Technology and equipment taken for granted in America either don't exist or don't work. Although practice is primitive in many ways, som...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVE:To compare composite maternal and neonatal adverse outcomes among women with at least a bachelor's degree by racial and ethnic groups. METHODS:This was a retrospective cohort study using the U.S. vital statistics data sets. We included women with at least a bachelor's degree who delivered a nonanomalous live...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003887
更新日期:2020-07-01 00:00:00
abstract::Cervical smears taken by the wooden Ayre spatula (widely used in the United Kingdom) and by a plastic spatula (Armovical) were compared for their ability to detect dysplastic cervical epithelium and endocervical cells. At the same time, the value of taking duplicate smears was assessed. Paired cervical smears were obt...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1982-07-01 00:00:00
abstract::A review of 25 patients with more than 1 rubella titer by hemagglutination-inhibition testing revealed 3 patients with high positive titers that were reported to be negative in subsequent pregnancies. None of the patients had received the rubella vaccine. Because the sensitivity and reliability of hemagglutination-inh...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-08-01 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:BACKGROUND:There has been one reported case of porencephaly diagnosed postnatally as a result of amniocentesis. We report the first antenatal diagnosis of porencephaly, which apparently resulted from penetration of the fetal skull during amniocentesis. CASE:A 37-year-old woman had genetic amniocentesis at 16 weeks' ge...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(94)00315-5
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:Pregnancy-induced hemolytic anemia is a rare maternal complication that occurs during pregnancy and resolves soon after delivery. The mechanism is unclear, and the disease is often referred to as unexplained hemolytic anemia associated with pregnancy. CASE:We report a case of life-threatening hemolytic anem...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000287292.74846.f2
更新日期:2008-02-01 00:00:00
abstract::Four hundred sixty-five primary cesarean sections (10.4% of total deliveries) performed during 1977 and 1978 were reviewed and compared with 465 vaginal deliveries to ascertain factors that may be related to postpartum infection. The overall morbidity (19.7%) related to postpartum infection in the primary cesarean sec...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-02-01 00:00:00
abstract:OBJECTIVE:Preeclampsia is associated with abnormal lipid metabolism, including fatty acid metabolism. Carnitine plays an indispensable role in the oxidation of fatty acids. The aim of the study was to evaluate the possible role of abnormal fatty acid oxidation in preeclampsia by comparing plasma carnitine levels betwee...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000125699.60416.03
更新日期:2004-05-01 00:00:00
abstract::The preoperative clinical and radiologic findings and staging were compared with the operative and pathological findings and surgical staging in 62 consecutive patients with endometrial carcinoma. Overall, the tumor grade was changed in 33.8% of the patients, and the histologic type of tumor was changed in 27.4% of th...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract::Fifty-five patients at less than 36 weeks' gestation with severe toxemia were treated conservatively. The pregnancies were continued for a mean duration of 19.2 days and the mean gestation at delivery was 35.2 weeks. Fifty-three percent of the deliveries were by cesarean section. Of the neonates, 56.5% showed severe i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-11-01 00:00:00
abstract:OBJECTIVE:To compare children's cognitive, motor, and language development at 2 years of age after assisted reproductive technologies (ARTs) relative to natural conception. METHODS:The 3D-Study (2010-2012) is a prospective cohort study, which sought to improve the understanding among perinatal events, obstetric outcom...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001837
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:To estimate the efficacy of paracervical block compared with saline for pain relief during office hysteroscopic sterilization. METHODS:This study was a randomized, placebo-controlled study of women desiring hysteroscopic sterilization. A paracervical block of 1% lidocaine or normal saline was administered be...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/AOG.0b013e3181c51ace
更新日期:2010-01-01 00:00:00
abstract::Some of the fears and myths of the gender-discrimination role-reversal in gynecology are explored. Women entered male-advantaged medicine by acquiring skills traditionally believed to be masculine strengths (such as mathematics, chemistry, and analytical skills); by the same token, men may be able to adapt to the curr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:To quantify the current perinatal consequences associated with intrapartum detection of meconium in the amniotic fluid (AF). METHODS:We compared retrospectively the outcomes in 8136 term singleton cephalic pregnancies with meconium and 34,573 similar pregnancies with clear AF. RESULTS:Virtually all measures...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::The presence of an estrogen-regulated protein of Mr 24,000 (24K) was studied in 43 patients diagnosed as having endometrial adenocarcinoma. using an anti-24K monoclonal antibody, a modified immunoperoxidase system (avidinbiotin complex) was used to detect the presence of 24K in formalin-fixed, paraffin-embedded tissue...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract::Over half the patients with proven ectopic pregnancies have negative urinary slide or tube pregnancy tests at the time they present with symptoms. Because of the morbidity and mortality associated with unrecognized ectopic pregnancy, the need for an accurate, rapid, sensitive, and specific method for measuring low lev...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-11-01 00:00:00
abstract::The aortic diameters of 89 normotensive pregnant women were compared with those of nine rigorously defined preeclamptic women and 59 women who required antihypertensive therapy. Over the course of normal pregnancy, the diameter increased significantly; it was larger in preeclamptic than in normotensive women throughou...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND:Amniotic fluid embolism is seldom recognized in nonperipartum patients. The pathophysiology is uncertain and diagnosis imprecise, making management after stabilization difficult. CASE:A 37-year-old woman at 28 weeks' gestation presented with signs and symptoms consistent with amniotic fluid embolism includi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(03)00630-6
更新日期:2003-09-01 00:00:00
abstract::Cytologic diagnosis of adenocarcinoma metastatic to the peritoneal surface is often hampered by the difficulty of differentiating between reactive mesothelial cells and macrophages from malignant epithelial cells by light microscopy. With in vitro tissue culture technics, the fibroblastic dedifferentiation of mesothel...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-197507000-00015
更新日期:1975-07-01 00:00:00
abstract::The technique of managing allergies by optimum-dose (provocative neutralization) testing and treatment using aqueous progesterone has been studied in 132 women having progesterone-related symptoms due to the menstrual cycle, pregnancy, or exogenous hormone administration. When extremely small doses of progesterone (0....
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1982-05-01 00:00:00
abstract:OBJECTIVE:To evaluate whether the menopausal transition is associated with worsening of urinary incontinence symptoms over 6 years in midlife women. METHODS:We analyzed data from 2,415 women who reported monthly or more incontinence in self-administered questionnaires at baseline and during the first six annual follow...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31816386ce
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Placental abscess formation is rarely recognized prenatally. We present a case detected ultrasonographically that developed from a central line infection and caused recurrent maternal bacteremia. CASE:A young woman with a 21-week twin gestation presented with recurrent fevers. She had received treatment for...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000165268.09352.ed
更新日期:2006-02-01 00:00:00
abstract::Ultrasonography plays an integral part in the prenatal diagnosis of neural tube defects. However, experienced sonographers with careful evaluation are successful in accurately diagnosing spina bifida only 80-90% of the time. This study was conducted to evaluate the accuracy and reliability of certain cranial ultrasoun...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVE:The purposes of this prospective investigation were to determine the frequency of glove perforation during obstetric and gynecologic procedures and to assess the value of double gloving in preventing damage to the inner glove. METHODS:During a 2-month period, surgeons in the Department of Obstetrics and Gyne...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract::To determine whether amnio-polymerase chain reaction (amnio-PCR) can replace conventional cytogenetic study for confirming the karyotype of fetuses in women with positive biochemical screening for fetal Down syndrome. To check the accuracy of this technique in our laboratory, we first compared the amnio-PCR results wi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(03)00222-9
更新日期:2003-05-01 00:00:00
abstract::One hundred women were admitted to the hospital between 7 and 18 weeks' gestation because of vaginal bleeding and threatened abortion. Serum concentration of estradiol-17 beta was determined by radioimmunoassay. Ultrasound examination using a gray-scale scanner was performed as well. The values for prediction of abort...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198003000-00011
更新日期:1980-03-01 00:00:00
abstract:OBJECTIVE:To evaluate galactography and cytology in women with nipple discharge without clinical or mammographic evidence of cancer. METHODS:During a 12.5-year period, 384 women (15-85 years, mean age 47.5 +/- 14 years) were referred for galactography and smear cytology for recent onset of spontaneous, non-milky nippl...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)01229-1
更新日期:2001-04-01 00:00:00