Abstract:
BACKGROUND:Mid-trimester transvaginal cervical length assessment can identify women who are at risk of preterm birth and afford opportunities for preterm birth prevention. However, the incidence of a short cervix is low, and some physicians have questioned whether a universal screening program among women without a previous preterm birth would be beneficial. OBJECTIVE:The purpose of this study was to examine whether the introduction of a universal transvaginal cervical length screening program is associated with a reduction in the preterm birth rate. STUDY DESIGN:This is a cohort study of women with singleton gestations and without any previous preterm births who underwent an obstetric sonogram at 18-24 weeks of gestation and who had their delivery at a single tertiary institution from January 2007 to January 2014. In July 2011, a program was implemented in which all pregnant women who had a sonogram at 18-24 weeks of gestation were to receive a transvaginal cervical length measurement. The preterm birth rates were compared before and after the implementation of the universal cervical length screening program. Multivariable analysis was used to identify whether the universal cervical length screening program was associated independently with the frequency of preterm birth. The Breslow-Day test for homogeneity was used to assess whether any interaction existed in the association based on parity. RESULTS:Of 64,207 eligible women, 46,598 underwent their mid-trimester sonogram before the universal cervical length screening program, and 17,609 underwent a sonogram after implementation of the program. Of the 17,590 women (99.9%) who agreed to cervical length measurement, 157 (0.89%) had a measurement of ≤25 mm. The introduction of the cervical length program was associated with a significant decrease in the frequency of preterm birth at <37 weeks of gestation (6.7% vs 6.0%; adjusted odds ratio, 0.82 [95% confidence interval, 0.76-0.88]), <34 weeks of gestation (1.9% vs 1.7%; adjusted odds ratio, 0.74 [95% confidence interval, 0.64-0.85]), and <32 weeks of gestation (1.1% vs 1.0%; adjusted odds ratio, 0.74 (95% confidence interval, 0.62-0.90]). This reduction in frequency of preterm birth primarily was due to a change in spontaneous (and not medically indicated) preterm births. The effect size for the reduction in preterm birth was similar in nulliparous and multiparous women with previous term births. CONCLUSION:The introduction of a universal transvaginal cervical length screening program in women without a history of preterm birth is associated with a reduction in the frequency of preterm birth.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Son M,Grobman WA,Ayala NK,Miller ESdoi
10.1016/j.ajog.2015.12.020subject
Has Abstractpub_date
2016-03-01 00:00:00pages
365.e1-5issue
3eissn
0002-9378issn
1097-6868pii
S0002-9378(15)02541-7journal_volume
214pub_type
杂志文章abstract::To investigate the merits of using psychometric testing as a predictive adjunct to counseling patients in the choice of a contraceptive method, 134 family-planning patients using an oral contraceptive for one year or longer completed the Neuroticism Scale Questionnaire. Clinic records of these patients were examined t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90016-8
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVE:Pertussis causes significant morbidity among adults, children, and especially infants. Since 2006, pertussis vaccination has been recommended for women after delivery. We conducted a prospective, controlled evaluation of in-hospital postpartum pertussis vaccination of birth mothers from October 2009 through J...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.09.043
更新日期:2014-03-01 00:00:00
abstract::Relaxin is a peptide hormone produced by the corpus luteum during pregnancy in human beings. There are no extraluteal sites of production of relaxin in women. By means of a heterologous porcine radioimmunoassay, serial serum relaxin concentrations were determined in three women throughout pregnancy and into labor. All...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract:OBJECTIVE:When unopposed estrogen replacement treatment is used, what is the pattern of endometrial growth? Does endometrial growth differ for various dosages and formulations? STUDY DESIGN:A total of 87 postmenopausal women, median age 57 years (mean 56.7 +/- 5.6 years, range 45 to 69 years), were studied in a prospe...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-9378(97)80022-1
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to show and discuss an association between fetal inflammatory response syndrome (FIRS) and an adverse neonatal outcome defined as combined severe neonatal morbidity and mortality in preterm neonates hospitalized in our neonatal intensive care unit. STUDY DESIGN:This was an observati...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.08.030
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:With no single regimen recognized as the standard for the treatment of first trimester cervical pregnancy, this report offers a successful treatment option with suction curettage and balloon tamponade. STUDY DESIGN:This is a retrospective review, with institutional review board approval, of 13 consecutive fi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.03.057
更新日期:2014-06-01 00:00:00
abstract::The serum vitamin B12 level falls progressively during pregnancy, when measured either by microbiologic assay or by a radioisotope dilution technique. The concentration of the vitamin assayed by radioisotope dilution was consistently higher than the value obtained by microbiologic assay. This discrepancy was greatest ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90609-2
更新日期:1975-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine whether fetal carriage of specific alleles of the polymorphic interleukin-1 receptor antagonist gene is associated with variations in intra-amniotic cytokine levels and previous pregnancy outcomes. STUDY DESIGN:Fetal cells in midtrimester amniotic fluid from 189 wom...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.05.071
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:Our purpose was to study the effects of long-term treatment with magnesium sulfate on hypoxic-ischemic brain damage in newborn rats. STUDY DESIGN:Seven-day-old rat pups (n = 120) were exposed to unilateral carotid artery ligation and 2 hours of hypoxia (8% oxygen in 92% nitrogen). Neuronal loss was evaluated...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.108343
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:This retrospective study was conducted to determine whether predischarge survival and morbidity of very-low-birth weight infants varied according to the principal pregnancy complication that led to preterm delivery. STUDY DESIGN:The hospital records of 535 consecutive live-born singleton infants who weighed ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90288-t
更新日期:1993-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate perinatal outcome after thoracoamniotic shunting for fetal pleural effusions with hydrops. STUDY DESIGN:This was a retrospective study. RESULTS:Shunting was performed immediately after diagnosis and was successful in all 54 of the cases that were attempted. There we...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.05.016
更新日期:2004-12-01 00:00:00
abstract::The Amniostat-FLM rapid slide test (Hana Biologics, Inc., Alameda, Calif.) for detection of phosphatidylglycerol has previously been evaluated and has shown good correlation with the more sophisticated two-dimensional thin-layer chromatographic method. A new, ultrasensitive kit has now been released with a lower level...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90429-8
更新日期:1989-02-01 00:00:00
abstract::Transferrin receptors have been identified on the villous trophoblast of normal chorionic villi by immunohistochemical techniques. The current study investigated the expression of transferrin receptors on molar chorionic villi by using a monoclonal antibody in immunofluorescence assays. The villous trophoblast of mola...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90438-7
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:The Apgar score is universally used for fetal assessment at the time of birth, whereas, the collection of fetal cord blood gases is performed commonly in high-risk situations or in the setting of Apgar scores of <7, which is a less standardized approach. It has been well-established that neonatal acidemia at...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.05.035
更新日期:2016-10-01 00:00:00
abstract::A prospective study of carbohydrate metabolism was done with 56 "normal" women who were 4 to 11 weeks post partum. Each had a 3 hour oral glucose tolerance test performed before and after 6 months of using an intrauterine contraceptive device (IUCD). The results showed only slight changes in blood glucose and plasma ...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(75)90850-9
更新日期:1975-12-15 00:00:00
abstract:OBJECTIVE:This study investigates the association of allelic variation in angiogenic pathway genes and preeclampsia. STUDY DESIGN:Data for cases with preeclampsia and term control subjects were collected prospectively. Maternal DNA was extracted, and 124 tagging single nucleotide polymorphisms in 6 genes (vascular end...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.01.040
更新日期:2010-05-01 00:00:00
abstract::Cellular transplantation is an attractive alternative to whole-organ transplantation when only a discrete function of the organ is deficient. Early fetal donor cells have an advantage because they engraft readily and do not cause graft-versus-host disease. Similarly, the fetus is an ideal recipient of allogeneic fetal...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(91)90656-c
更新日期:1991-01-01 00:00:00
abstract::Seventeen pregnant rabbits were studied under conscious, unstressed conditions after catheterization of the right ventricle (RV), a femoral artery (A), and a uterine vein (UV). Respiratory gas tensions, pH, and oxygen saturations and contents were determined serially throughout the latter half of gestation. The uterin...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(85)80054-5
更新日期:1985-07-15 00:00:00
abstract::The US Centers for Disease Control and Prevention is conducting an observational study of 300-500 women infected with influenza during pregnancy. Women are being recruited from members of the Kaiser Permanente health plan in 2 metropolitan areas before and during the 2010 through 2011 influenza season either following...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.01.006
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to find out whether the effects of thermal stress on plasma catecholamines and plasma renin activity are altered by pregnancy. STUDY DESIGN:Nonpregnant (n = 15) and pregnant (13 to 14 weeks, n = 23; 36 to 37 weeks, n = 23) healthy women were examined. Samples were taken before t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91590-7
更新日期:1992-09-01 00:00:00
abstract::Patients who develop polyarteritis nodosa in pregnancy generally have a grim prognosis. A young nulliparous woman developed the disease and attained remission before becoming pregnant. Although she developed a recurrence, both mother and infant did well. It appears that if a patient becomes pregnant while in remission...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0002-9378(89)80039-0
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:Fatty acids (FAs) are essential for fetal development. Cellular FA uptake is modulated by fatty acid-binding proteins (FABPs). We hypothesized that hypoxia regulates the expression of FABPs in human trophoblasts. STUDY DESIGN:Primary term human trophoblasts were cultured for 72 hours in either standard (O2 =...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.03.066
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to describe patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse symptoms and to describe predictors of preference for uterine preservation. STUDY DESIGN:This multicenter, cross-sectional study evaluated patient preferences for uterin...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2013.08.003
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:In vitro fertilization (IVF) is considered a generally safe procedure, although associated with a higher incidence of preterm birth. The literature is inconsistent about the psychological impact of IVF, and we found no reports about outcome in late preterm (LPT) children. Our objective was to study neuropsych...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.06.041
更新日期:2013-10-01 00:00:00
abstract::Gynecologic cancer records of 4,238 patients treated between 1956 and 1974 were reviewed. Sixteen patients developed noeplasia in the cervix or vagina 10 or more years following pelvic irradiation. Three patients had squamous carcinoma in situ; the other 13 patients had invasive squamous cancer involving the upper vag...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90445-8
更新日期:1977-03-01 00:00:00
abstract::Many different approaches are advocated for management of iatrogenic (operative) ureteric injury. We herein report our experience with 28 ureteral injuries in 26 patients. In six patients, seven injuries were recognized at the time of the initial operation; four end-to-end anastomoses and three ureteroneocystostomies ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90283-8
更新日期:1986-09-01 00:00:00
abstract::The first reported measurement of plasma renin and aldosterone in toxemia with an abdominal pregnancy is presented. In contrast to toxemia where plasma renin and aldosterone are either normal or low, extraordinarily high levels of both were found in this patient which returned to normal after delivery. The role of ext...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90046-0
更新日期:1975-07-01 00:00:00
abstract:OBJECTIVES:Our objectives were to document the causes of fluid absorption during continuous flow hysteroscopy and to determine under which operative conditions fluid overload may occur. STUDY DESIGN:Fifteen patients underwent operative hysteroscopy with 2% ethanol solution for uterine distention. Absorption of fluid w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91417-3
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVE:The prototype of surgical treatment for vulvar vestibulitis has been the Woodruff vulvoplasty. A simpler surgery could be less morbid, technically easier, and equally effective. STUDY DESIGN:Twelve patients underwent vestibular revision, nine with local anesthesia. They were followed up for between 6 months ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70200-4
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:Our aim was to determine the ability of pathogens commonly associated with genital tract infection and preterm labor to incorporate arachidonic acid and to metabolize it to prostaglandins or to other eicosanoids. STUDY DESIGN:Four common genital tract pathogens, Escherichia coli, Streptococcus viridans, Bact...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91631-j
更新日期:1992-05-01 00:00:00