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:BACKGROUND:Hysterectomies are the most common benign gynecologic surgical procedures performed in the United States. Currently, there are no tissue models that exist to teach trainees the techniques for colpotomy during laparoscopic hysterectomy. To address this educational gap, we have created a laparoscopic colpotomy...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003333
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Goodpasture syndrome, an immunologic disorder characterized by glomerulonephritis and pulmonary hemorrhage, rarely presents in pregnancy. CASE:We describe a patient who was diagnosed with Goodpasture syndrome in her second trimester. She required daily hemodialysis, intermittent plasmapheresis, and immunosu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000161061.35611.98
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:To test the primary hypothesis that extremely preterm children antenatally exposed to both magnesium sulfate and antenatal corticosteroids have a lower rate of severe neurodevelopmental impairment or death compared with those exposed to antenatal corticosteroids alone. METHODS:This was a prospective observat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/AOG.0000000000003882
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Congenital cervical spinal cord injury usually is attributed to intrapartum mechanical trauma. CASE:A fetal cervical spinal cord hemorrhage presented as congenital isolated upper extremity ("cruciate") paralysis and muscle atrophy after an atraumatic delivery. Timely neonatal diagnosis and surgery resulted ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00487-0
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVE:To determine how long fetal nucleated cells can be detected in maternal peripheral blood after delivery in cases of fetomaternal hemorrhage, using fluorescence in situ hybridization or polymerase chain reaction. METHODS:Nucleated cells with Y chromosomes were analyzed in 90 blood samples using fluorescence i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(94)00414-9
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:There are various causes of shortness of breath in a young, pregnant woman. The importance of entertaining a broad differential diagnosis is highlighted in this case. CASE:A young, pregnant African-American woman presented in her third trimester with acute onset of shortness of breath. A team approach by di...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000267318.56856.2a
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:To study the use of middle cerebral arterial Doppler findings in a group of high-risk fetuses as a predictor of adverse perinatal outcome, including subsequent neurologic handicap. METHODS:A group of very high-risk fetuses was recruited over a 2-year period for study. Weekly fetal biometries and Doppler stud...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00062-2
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the pregnancy characteristics, methods of delivery, and neonatal outcomes of fetuses affected by osteogenesis imperfecta. METHODS:We reviewed medical records of 1016 individuals whose cells were sent to the University of Washington Collagen Diagnostic Laboratory between 1987 and 1994 for confirma...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)01100-5
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:To compare outpatient to inpatient management of acute pyelonephritis in pregnancy beyond 24 weeks' gestation. METHODS:Ninety-two gravidas past 24 weeks' gestation, randomized to outpatient or inpatient therapy, received two 1-g doses of intramuscular ceftriaxone at 24-hour intervals while hospitalized, then...
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)00386-5
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of clinical trials registries in published obstetrics and gynecologic systematic reviews and meta-analyses. METHODS:We performed a metaepidemiologic study of systematic reviews between January 1, 2007, and December 31, 2015, from six obstetric and gynecologic journals (Obstetrics & Gyneco...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001204
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:To quantitatively and qualitatively describe the patient experience for clinically stable patients presenting with miscarriage to the emergency department (ED) or ambulatory clinics. METHODS:We present a subanalysis of a mixed-methods study from 2016 on factors that influence miscarriage treatment decision-m...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003571
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:To determine whether serum vascular endothelial growth factor is an independent prognostic factor in ovarian cancer patients. METHODS:We measured vascular endothelial growth factor in pretreatment serum samples of 60 women with International Federation of Gynecology and Obstetrics stages I to IV epithelial o...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00190-2
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:To assess the association of education, performance feedback, and the Hawthorne effect with a reduction in the episiotomy rate in a large academic institution. METHODS:We describe a prospective observational study of a project conducted between March 2012 and February 2017 to assist clinicians in meeting the...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002060
更新日期:2017-07-01 00:00:00
abstract::We previously reported surgical correction of vaginal agenesis and partial cervical atresia in an 11-year-old girl with amenorrhea and a pelvic mass. This patient, the subject of this report, conceived 7 years later and delivered at term. An abdominal cerclage was placed at 12 weeks' gestation to protect the cervix, a...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199011001-00001
更新日期:1990-11-01 00:00:00
abstract::Fifteen fallopian tubes in which a previous ipsilateral eccyesis was managed by conservative surgical techniques were examined. The condition of the tube relative to the previous surgical management and the resolution of the previous implantation sites were correlated with the recurrent tubal pregnancy. All previous i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::The average length of the umbilical cord at delivery is 21 +/- 1 in., but lengths vary from 10 to 50 in. When distended and carrying blood between the fetus and the placenta, the cord is longer; the distended areteries and vein are spiraled about each other. No physiologic data explain the manner by which blood flows ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-02-01 00:00:00
abstract::Antepartum pituitary infarction occurs only in insulin-dependent diabetic patients. It is manifested by severe headache, followed by decreasing insulin requirements. Delivery is frequently premature, with high fetal wastage and increased maternal mortality. During the puerperium, the first manifestation of pituitary d...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-03-01 00:00:00
abstract:OBJECTIVE:To examine the relationships between clinical or histological chorioamnionitis and cerebral palsy using a meta-analysis approach. DATA SOURCES:A systematic review of the literature appeared in PubMed between 2000 and 2009 was conducted using the search terms "cerebral palsy" and "infection," with broad-scope...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/AOG.0b013e3181e90046
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To assess the influence of several maternal and neonatal variables on the recurrence of gestational diabetes mellitus. METHODS:A retrospective review was conducted on 90 of our patients whose index pregnancy was complicated by gestational diabetes mellitus and whose subsequent pregnancy was also managed at o...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-11-01 00:00:00
abstract::Sixteen isoimmunized pregnancies at risk for erythroblastosis fetalis were managed by serial amniocenteses for bilirubin delta optical density at 450 nm (delta OD450). Before amniocentesis each fetus was evaluated ultrasonically and the fetal liver size, the abdominal circumference, and the umbilical vein diameter, in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-08-01 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:OBJECTIVE:To estimate the change in indications for scheduled deliveries during the Ohio Perinatal Quality Collaborative's initiative to decrease scheduled deliveries for nonmedical indications before 39 weeks of gestation. METHODS:Documented indications for scheduled deliveries between 36 0/7 and 38 6/7 weeks were ca...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318260d9b2
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:To describe the outcomes of intended home birth in the practices of certified nurse-midwives. METHODS:Twenty-nine US nurse-midwifery practices were recruited for the study in 1994. Women presenting for intended home birth in these practices were enrolled in the study from late 1994 to late 1995. Outcomes for...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0029-7844(98)00182-3
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Uterine malignant mixed mesodermal tumor is a rare variant of uterine cancer. Data suggest that tamoxifen is involved in the pathogenesis. We report a case of a women in whom a malignant mixed mesodermal tumor was diagnosed while she was taking raloxifene, which is also a selective estrogen receptor modulato...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000160480.55365.a8
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:To estimate the effect of the menstrual cycle and oral contraceptive pill (OCP) use on the prevalence, incidence, and persistence of human papillomavirus (HPV). METHODS:A longitudinal study was conducted among 2,065 women aged 18-29 years. The women returned a self-collected cervicovaginal sample and filled ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181e238f0
更新日期:2010-07-01 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::The use of assisted reproductive technology (ART) for treating the infertile couple is increasing in the United States. The purpose of this paper is to review the short-term outcomes after ART. Pregnancy rates after ART have shown nearly continuous improvement in the years since its inception. A number of factors affe...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000194207.06554.5b
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Cortical blindness is a complication of severe preeclampsia, but it is unclear whether it results from cerebral vasospasm and ischemic injury or vasogenic (hydrostatic) edema due to increased capillary permeability. CASE:Reversible cortical blindness in a 33-year-old gravida 2, para 1, with severe postpartu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)00878-4
更新日期:2000-06-01 00:00:00
abstract::Retrograde ejaculation is characterized by aspermia or oligospermia and results from an incompetent bladder neck, often due to a dysfunction of the internal sphincter. In almost 3 years, eight couples who suffered from infertility due to retrograde ejaculation were treated with inseminations with spermatozoa gained fr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::Human papillomavirus (HPV) is associated with cervical intraepithelial neoplasia (CIN) and carcinomas. The present study involved women who had an abnormal Papanicolaou smear and whose cervix contained acetowhite area(s) that lacked the histologic features of CIN. Sequences homologous to HPV DNA, determined by Souther...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-06-01 00:00:00