Abstract:
OBJECTIVE:To characterize long-term national trends in surgical approach for hysterectomy after the U.S. Food and Drug Administration (FDA) warning against power morcellation for laparoscopic specimen removal. METHODS:This was a descriptive study using data from the American College of Surgeons National Surgical Quality Improvement Program from 2012 to 2016. We identified hysterectomies using Current Procedural Terminology codes. We used an interrupted time-series analysis to evaluate abdominal and supracervical hysterectomy trends surrounding The Wall Street Journal article first reporting morcellation safety concerns and the FDA safety communication. We compared categorical and continuous variables using χ, t, and Wilcoxon rank sum tests. RESULTS:We identified 179,950 hysterectomies; laparoscopy was the most common mode of hysterectomy in every quarter. Before The Wall Street Journal article, there was no significant change in proportion of abdominal hysterectomies (0.3% decrease/quarter, P=.14). After The Wall Street Journal article, use of abdominal hysterectomy increased 1.1% per quarter for two quarters through the FDA warning (P<.001), plateaued for three quarters until March 2015 (P=.65), then decreased by 0.8% per quarter through 2016 (P<.001). Supracervical hysterectomy volume continuously decreased after the FDA warning (1.0% decrease per quarter, P<.001) and after three quarters (0.7% decrease per quarter, P=.01), then plateaued from April 2015 through 2016 (0.05% decrease per quarter, P=.40). Mode of supracervical hysterectomy was unchanged from 2012 to 2013 (P=.43), followed by two quarters of significant increase in proportion of supracervical abdominal hysterectomies (11.7%/quarter, P<.001). This change in mode of supracervical hysterectomy then plateaued through 2016 (P=.06). CONCLUSION:Despite early studies suggesting that minimally invasive hysterectomy decreased in response to safety concerns regarding power morcellation, we found that this effect reversed 1 year after the FDA safety communication. However, there was a sustained decline in supracervical hysterectomy, and the remaining supracervical hysterectomies were more likely to be performed using laparotomy.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Jorgensen EM,Modest AM,Hur HC,Hacker MR,Awtrey CSdoi
10.1097/AOG.0000000000003181subject
Has Abstractpub_date
2019-04-01 00:00:00pages
643-649issue
4eissn
0029-7844issn
1873-233Xpii
00006250-201904000-00008journal_volume
133pub_type
杂志文章abstract:OBJECTIVE:To evaluate the counterregulatory responses to insulin-induced hypoglycemia in healthy women and in women with insulin-dependent diabetes during pregnancy and in the nonpregnant state. METHODS:Hypoglycemia was induced using the hypoglycemic clamp technique in 17 women with insulin-dependent diabetes and in t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00495-5
更新日期:1996-04-01 00:00:00
abstract::This study reviewed 20 cases of extensive squamous carcinoma in situ of the vulva and posterior perineum. Two patients had concurrent, overt invasive carcinoma of the vulva, 14 patients had concurrent extensive vulvar carcinoma in situ, three patients had previous skinning vulvectomy for carcinoma in situ, and one pat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-09-01 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:BACKGROUND:Abdominal pregnancies are rare types of ectopic pregnancies with high rates of maternal mortality and morbidity when encountered anywhere in the world. Combining such high-risk pregnancy with the limitations found in a low-resource setting can lead to increased complications, which can be more difficult to m...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000706
更新日期:2015-05-01 00:00:00
abstract::Hemostatic and platelet function studies were performed prospectively on 61 preeclamptic patients and 24 healthy pregnant control patients to delineate possible causes of thrombocytopenia in preeclampsia. Thrombocytopenia occurred in 50% of the preeclamptic patients, and was accompanied by qualitative platelet defects...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVE:To determine the influence of maternal blood contamination on amniotic fluid (AF) glucose and white blood cell count (WBC). METHODS:Amniotic fluid from 23 preterm, nondiabetic pregnant women was studied. Maternal blood was added to the AF at increasing concentrations, and glucose and WBCs were assessed. RES...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00354-1
更新日期:1996-02-01 00:00:00
abstract::Newborn screening is the largest genetic screening program in the United States, with approximately 4 million infants screened annually. Newborn screening is a mandatory state-based public health program that provides all newborns in the United States with testing and necessary follow-up health care for a variety of m...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000003246
更新日期:2019-05-01 00:00:00
abstract::Conjoined twins occur with a frequency of 1/50,000--1/100,000 deliveries. The cephalothoracopagus variety is particularly rare. This paper presents a case report of cephalothoracopagus (Janiceps) twinning, with a detailed pathologic analysis, as well as an historical review and discussion of diagnostic modalities. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract:OBJECTIVE:To assess the association between Chlamydia trachomatis antibodies, antibodies to C trachomatis heat shock proteins 60 and 10, and C-reactive protein (CRP) levels in maternal serum measured by highly sensitive CRP assay during the first trimester and spontaneous preterm delivery before 37 weeks of gestation. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000164464.11979.5d
更新日期:2005-07-01 00:00:00
abstract::The effect on labor of administering ritodrine after a premature rupture of the membranes (PROM) was studied in a double-blind trial in 30 patients. The patients were selected according to the following criteria: 28 to 36 weeks' gestation, only 1 fetus, cervix dilated 4 cm or less, and absence of pyrexia or other sign...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:To examine predictors of health care providers perceiving intrauterine devices (IUDs) as unsafe for nulliparous women and of infrequent provision of IUDs to nulliparous women. METHODS:We analyzed questionnaire data obtained during December 2009 to March 2010 from 635 office-based providers (physicians) and 1...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31824aca39
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Double aneuploidies account for 0.21-2.8% of spontaneous abortions resulting from chromosomal abnormalities. Rarely, cell-free DNA testing detects multiple aneuploidies; however, to discern among maternal, placental, and fetal origin, further evaluation is required. CASE:A 49-year-old woman, gravida 5 para ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001390
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To determine whether women with abnormal Papanicolaou smears who received educational brochures at the initial booking for colposcopy were more likely to complete recommended treatment and follow-up after 18-24 months than were those who did not receive the brochures. METHODS:One hundred eight women particip...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00006250-199404000-00016
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:Breast pain is a common complaint among lactating women. Vasospasm of the nipple should be considered in the differential diagnosis of breast pain, particularly when no other signs of infection or trauma are encountered. This report demonstrates a case of vasospasm successfully treated with nifedipine. CASE...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000214671.19023.68
更新日期:2006-09-01 00:00:00
abstract::Patient choices and plans may sometimes carry increased risk or include alternatives that individual physicians feel uncomfortable supporting or recommending. We consider in this commentary how the ethical principles of respect for autonomy and nonmaleficence can be balanced using, among other examples, the choice by ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182167413
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:To determine whether the overall retention of weight gained during pregnancy and the factors affecting postpartum weight retention differ by race. METHODS:Data from the 1988 National Maternal and Infant Health Survey were analyzed to examine postpartum weight retention of 20 lb or more among 990 black and 11...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::The efficacy and safety of bromocriptine mesylate (5 to 7.5 mg per day for up to 24 weeks) were studied in 22 clinical trials involving 226 patients who had amenorrhea/galactorrhea associated with hyperprolactinemia and no demonstrable pituitary tumor. Of the 187 patients evaluated for efficacy, 80% experienced reinit...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1097/00006250-198003000-00002
更新日期:1980-03-01 00:00:00
abstract::A rare case of a paraganglioma (extraadrenal pheochromocytoma) that complicated both pregnancy and the puerperium is described. The patient presented a confusing clinical picture simulating pregnancy-induced hypertension, which, after delivery, masqueraded as intractable fever of unknown origin. Computed tomography pr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1982-06-01 00:00:00
abstract::Uterine leiomyomas are associated with various complications during pregnancy. During a 2-year period, pregnant women with a history of leiomyomas were referred to our antenatal testing unit for ultrasound evaluation. Eighty-five patients were found to have single or multiple leiomyomas by ultrasound examination. The ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::Checklists are used in medical and nonmedical settings as cognitive aids to ensure that users complete all the items associated with a particular task. They are ideal for tasks with many steps, for tasks performed under stressful circumstances, or for reminding people to perform tasks that they are not routinely accus...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001766
更新日期:2016-11-01 00:00:00
abstract::Postpartum hemorrhage is a common and serious complication of the third stage of labor resulting in anemia and increased morbidity in the puerperium. Administration of uterotonic drugs and suitable mechanical assistance in delivery of the placenta may significantly reduce this hazard. Ergometrine and oxytocin have bee...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-12-01 00:00:00
abstract::The midtrimester abortion program at a large community hospital was evaluated. During the 3-year study, 1839 patients aborted in the midtrimester by intraamniotic injection of hypertonic saline, prostaglandin F2alpha or a combination of saline and prostaglandin F2alpha. The method, using a combination of saline and pr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-05-01 00:00:00
abstract::Twenty-three patients with premature uterine contractions occurring between the 27th and 35th weeks of pregnancy were treated in a prospective and randomized study with intravenous ritodrine in a 0.1 wt/vol% solution of isotonic saline (N = 12) or isotonic glucose (N = 11). The aim of the study was to record the effec...
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:1981-09-01 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
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:OBJECTIVE:To evaluate the outcome of intrauterine growth restriction (IUGR) infants with abnormal pulsatility index of the umbilical artery according to the neonatal birth weight/gestational age standards and the intrauterine growth charts. METHODS:We analyzed 53 pregnancies with severe IUGR classified as group 2 (22 ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31818bdc7e
更新日期:2008-12-01 00:00:00
abstract::Infants delivered preterm often reflect accelerated maturation. The present study examines the occurrence of suboptimal intrauterine growth in infants delivered preterm by comparing their birth weights to the weights sonographically predicted for in utero fetuses at similar gestational ages but who ultimately deliver ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract::The increasing incidence of multiple gestations and the need for genetic diagnosis often pose a question as to the safety of amniocentesis in these cases. Under careful sonographic control and using indigo carmine as a marker, a technique for amniocentesis in a triplet gestation is presented. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-09-01 00:00:00
abstract:OBJECTIVE:To identify neonatal complications associated with placenta previa. METHODS:This was a population-based, retrospective cohort study involving all singleton deliveries in Nova Scotia from 1988 to 1995. The study group consisted of all completed singleton pregnancies complicated by placenta previa; all other s...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00480-3
更新日期:1999-04-01 00:00:00
abstract::Twelve patients with either severe preeclampsia (9) or eclampsia (3) were treated with intravenous diazoxide, 300-mg bolus, for the reduction of diastolic blood pressure (less than or equal 110 torr) after the usual and customary measures had been initiated to include parenteral MgSO4 and diazepam. Diazoxide precipito...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-06-01 00:00:00