Abstract:
OBJECTIVE:To assess treatment outcomes associated with an obstetric hypertensive emergency quality improvement intervention instituted in a tertiary care women's emergency department. METHODS:We conducted a cohort study of pregnant (20 weeks of gestation or greater) and postpartum (6 weeks of gestation or less) women treated for hypertensive emergency (systolic blood pressure [BP] 160 mm Hg or greater, diastolic 110 mm Hg or greater, or both) before and after a quality improvement intervention. A multidisciplinary task force revised clinical guidelines and nursing policy, updated electronic order sets, and provided staff education and clinical management aids. Data were collected by electronic chart review. The primary outcome was achieving goal BP (systolic 150 mm Hg or less and diastolic 100 mm Hg or less) within an hour of initial therapy. Secondary outcomes included time from first severe BP to 1) first antihypertensive treatment and 2) goal BP. RESULTS:There were no significant differences in baseline characteristics in the preintervention (n=173; September 2014 to September 2015) and postintervention (n=173; December 2015 to November 2016) groups, including gestational age, days postpartum, maternal age, race-ethnicity, or comorbidities. We found no significant difference in primary outcome frequency: 41% achieved goal BP within 60 minutes preintervention vs 47% postintervention (P=.28). Median time from first severe BP to first treatment was unchanged (30 minutes preintervention vs 29 minutes postintervention, P=.058); however, median time from first severe BP to goal BP decreased significantly (122 vs 95 minutes, P=.04). Confirmation of hypertensive emergency within 15 minutes (recommended) was only achieved in approximately 20% of women in either group. More women initially received intravenous antihypertensive treatment after the intervention (52% preintervention vs 80% postintervention, P<.001). CONCLUSION:A quality improvement initiative was not associated with more women achieving BP control within an hour of obstetric hypertensive emergency treatment, but was associated with decreased time to achieve control. This suggests improved clinical practice after the intervention.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Froehlich RJ,Maggio L,Has P,Vrees R,Hughes BLdoi
10.1097/AOG.0000000000002809subject
Has Abstractpub_date
2018-10-01 00:00:00pages
850-858issue
4eissn
0029-7844issn
1873-233Xpii
00006250-201810000-00008journal_volume
132pub_type
杂志文章abstract::A 27-year-old woman died from pneumococcal meningitis associated with pneumococcal endometritis two days after being delivered of a .1.75-kg infant. The infant also had pneumococcal septicemia and died six days after birth. The pneumococcus isolated from the mother and the baby was type 8. The membranes had ruptured 2...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::A successful pregnancy occurred in the first year after liver transplantation. The patient was treated with prednisolone, azathioprine, and low-dose cyclosporine A. A healthy girl of 2260 g (fifth to tenth percentile) was born at 38 weeks. ...
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 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...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003747
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To compare umbilical cord and maternal serum peak gentamicin concentration, gentamicin elimination, and clinical outcomes between women who received once-daily compared with standard, thrice-daily dosing for clinical chorioamnionitis. METHODS:We randomly assigned 38 laboring women, at least 34 weeks gestatio...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.AOG.0000151106.87930.1a
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the usefulness of routine screening for other associated autoimmune endocrine disorders in patients with karyotypically normal spontaneous premature ovarian failure. METHODS:One hundred nineteen women with karyotypically normal spontaneous premature ovarian failure (FSH exceeding 40 mIU/mL) who d...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00077-x
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:The 4-S modification of the Roeder knot may be tied laparoscopically as a single-throw knot. TECHNIQUE:It is tied by adding a fourth wrap around the suture loop and securing the loop in place with a square knot rather than a single half-hitch. EXPERIENCE:We have used this knot in laparoscopic surgeries for...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00492-4
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of delaying colposcopy in women with negative Papanicolaou smears and positive speculoscopy results. METHODS:This was a prospective study of asymptomatic women ages 13-60 years, regularly scheduled for pelvic examinations. All women had Papanicolaou smears and magnified visual examinat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00515-3
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To determine whether peak expiratory flow rate changes with pregnancy and advancing gestation. METHODS:We measured the peak expiratory flow rate in 57 women during each trimester of pregnancy and postpartum. During four visits, all subjects exhaled forcefully three times into a peak flow meter. For each visi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/S0029-7844(96)00512-1
更新日期:1997-03-01 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::A 19-year-old primigravida at term presented with bilateral, spontaneous pneumothorax. The maternal and infant outcomes were successful. The impact on pregnancy is discussed, and suggestions are made for obstetric management. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-09-01 00:00:00
abstract::The prognostic significance of residual endometrial carcinoma in the hysterectomy specimen after preoperative radiotherapy is controversial. Sixty-two patients with stage II endometrial carcinoma were treated with a standardized program of preoperative radiotherapy, followed in six weeks by an extrafascial hysterectom...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-12-01 00:00:00
abstract::Serum human chorionic somatomammotropin (hCS) was measured in 35 patients with intact unaborted hydatidiform mole by a rapid radioimmunoassay using 70% dioxane in water to separate the bound from unbound fraction. Serum hCG was measured by a hemagglutination inhibition method. Serum hCS ranged from 250 to 5900 ng/ml, ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-02-01 00:00:00
abstract:OBJECTIVE:To show that meconium causes fetal morbidity and death at earlier gestations than reported previously. METHODS:We searched for specimens from 1997 and 1998 with pathologic diagnosis of meconium-induced umbilical vascular necrosis in placentas of nonmalformed fetuses and newborns. Because intra-amniotic infec...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00307-5
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVE:To compare the prevalence of abnormal anal cytology and high-risk human papillomavirus (HPV) among women with a history of HPV-related genital neoplasia with women without a history of HPV-related genital neoplasia. METHODS:A cross-sectional cohort study was performed from December 2012 to February 2014. Wom...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001135
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the relationship between the presence of microorganisms at the time of cesarean at different sites of the genital tract and the development of postpartum endometritus. METHODS:One-hundred thirty-three healthy women who delivered by cesarean were enrolled in this prospective study. Cultures were o...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/s0029-7844(99)00421-4
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:To quantify the numbers of leukocytes in the normal cervix and relate these numbers to the diagnosis of cervicitis. METHODS:Isolated cell suspensions were prepared from cervical tissue recovered at hysterectomy from 37 women who had no obvious cervical disease. The percentages of CD45+ cells (leukocytes) in ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00086-6
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:To compare the prevalence of large-for-gestational-age (LGA) newborns across categories of body mass index (BMI) in five racial and ethnic groups. METHODS:This cohort study examined 7,468 women with gestational diabetes mellitus (GDM) who delivered a live newborn between 1995 and 2006 at Kaiser Permanente No...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318291b15c
更新日期:2013-06-01 00:00:00
abstract::We compared the TDx Fetal Lung Maturity test and the fluorescence polarization method using 1-palmitoyl-2(6-[(7-nitro-2,1,3-benzoxadiazol-4- yl)amino]caproyl)phosphatidylcholine (NBD-phosphatidylcholine). Using 76 paired human amniotic fluid samples, the fluorescence polarization values of the two methods were found t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVE:To determine if bacteria are capable of producing phosphatidylglycerol in amniotic fluid (AF) and the number of colony forming units (CFU) of bacteria necessary to produce this result. METHODS:Eleven species of bacteria and one species of yeast, common to the female genital tract and implicated in chorioamni...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00032-m
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:Burkitt lymphoma during pregnancy is a rare event, and outcomes have been poor. However, few patients were treated by current standards, with nearly half receiving single-agent cyclophosphamide or no chemotherapy. CASE:A patient with Burkitt lymphoma presenting at 11 6/7 weeks' gestation was treated with su...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0029-7844(98)00282-8
更新日期:1998-10-01 00:00:00
abstract::We studied 30 control women and 131 pill users to evaluate effects of birth control pills and clinical factors on hemostasis. When control patients were matched with an equal number of pill users, none of the direct markers of activated hemostasis (fibrinopeptide A, platelet factor 4, and beta thromboglobulin) were in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract:BACKGROUND:Previous case reports have reported maternal and fetal mortality in pregnancies complicated by air emboli induced by various mechanisms. CASE:A 33-year-old multiparous woman with a known rectovaginal fistula presented with symptoms of placental abruption. She subsequently was found to have a large intrauter...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31821fcdb2
更新日期:2011-08-01 00:00:00
abstract::Fourteen patients with stage IB or IIA neuroendocrine small-cell cervical cancer were treated either by operation alone or operation in combination with postoperative radiotherapy at the University of California, Irvine Medical Center, and Memorial Medical Center of Long Beach, between January 1979 and February 1986. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To determine whether obstetric admissions to the intensive care unit (ICU) are useful quality-assurance indicators. METHODS:We analyzed retrospectively obstetric ICU admissions at two tertiary care centers from 1991 to 1997. RESULTS:The 131 obstetric admissions represented 0.3% of all deliveries. The majori...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00274-4
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Retained viable intrauterine pregnancy is an infrequent complication of vacuum aspiration. We report a case of a retained single intrauterine pregnancy after an elective vacuum aspiration of a dichorionic-diamniotic twin gestation. CASE:A patient presented to the emergency department reporting vaginal spott...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181dd1fac
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence, magnitude, and type of fetal acidemia associated with contemporary obstetric anesthetic techniques. METHODS:Umbilical artery blood gases were obtained in 1601 singleton pregnancies delivered by elective cesarean. RESULTS:General anesthesia was used in 371 (23%) women, epidural i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(94)p4401-9
更新日期:1995-01-01 00:00:00
abstract::A 10-year retrospective study of acute puerperal inversion of the uterus was undertaken at Women and Infants Hospital of Rhode Island. There were 11 inversions in 70,481 deliveries for an incidence of one in 6407. The age ranged from 19-31 years. Seventy-three percent occurred in nulliparous women. All cases were reco...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-04-01 00:00:00
abstract::Obstructed labor due to a large sacrococcygeal tumor is reported. A technique of transabdominal intrauterine reduction in the size of the tumor to allow delivery of the infant in satisfactory condition is described. The method and the successful outcome have not previously been reported. It is recommended as a combine...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract:OBJECTIVE:To investigate whether botulinum neurotoxin type A improves vaginismus and study its efficacy with repeated treatments. METHODS:Outpatients were referred because standard cognitive-behavioral and medical treatment for vaginismus and vulvar vestibular syndrome failed. From this group, we prospectively recruit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181bb0dbb
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of 3 common intrauterine resuscitation techniques used during labor. METHODS:Intrauterine resuscitation techniques were prospectively evaluated in healthy women during labor. Forty-two women were randomized to either a 500-mL or 1,000-mL intravenous (IV) fluid bolus over 20 minutes. ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.AOG.0000164474.03350.7c
更新日期:2005-06-01 00:00:00