Abstract:
:The cesarean delivery rate has quadrupled during the past two decades, resulting in considerable attention focused on alternatives to cesarean birth. One option, vaginal birth after one previous cesarean, has come to be recognized as an acceptable alternative to routine elective repeat cesarean delivery. The purpose of this report was to evaluate whether women with two previous cesareans can safely undergo a trial of labor. Between July 1, 1982 and June 30, 1986, data were collected prospectively on all women with previous cesareans. Those with a known classical incision or a medical or obstetric contraindication to a trial of labor were excluded from an attempted vaginal delivery. During this period, 67,784 patients were delivered, of whom 6250 (9.2%) had had a previous cesarean. Of the 6250 previous-cesarean patients, 1088 (17.4%) had had two previous cesareans; of these, 501 (46%) underwent a trial of labor and 346 (69%) delivered vaginally. Whereas the overall rate of uterine dehiscence was 3%, the rate in those women who attempted a vaginal delivery was 1.8%, versus 4.6% in those who did not. Overall, oxytocin was used in 284 (57%) and was associated with a dehiscence rate of 2.1%, versus 1.4% in the no-oxytocin group. Successful vaginal delivery was related significantly to the use of oxytocin and to a previous vaginal delivery. Trial of labor in patients with two previous cesareans appears to be a reasonable consideration.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Phelan JP,Ahn MO,Diaz F,Brar HS,Rodriguez MHsubject
Has Abstractpub_date
1989-02-01 00:00:00pages
161-5issue
2eissn
0029-7844issn
1873-233Xjournal_volume
73pub_type
杂志文章abstract:OBJECTIVE:To evaluate the effectiveness of hysteroscopic sterilization reversal by assessing pregnancy rates and identifying surgical complications. METHODS:All patients at a single center undergoing elective reversal of hysteroscopic sterilization for fertility were followed from January 2009 to May 2014. Eligible pa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000543
更新日期:2014-12-01 00:00:00
abstract::Vaginal hysterectomy for sterilization was performed on 115 patients. The Heaney technique was used by nine gynecologists, using lidocaine and adrenaline. The average age of patients was 32.2 years and average parity 3.2. Significant unsuspected pathology was found after surgery in 21 patients. One postoperative d...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1972-05-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility of using cytologic examination of ovarian cyst fluid for distinguishing between benign and malignant tumors. METHODS:Cyst fluid was aspirated at surgery in 83 women with benign and 35 women with malignant (25 invasive and ten borderline) ovarian tumors and submitted for routine cyto...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract::Characteristics of the fetal heart rate (FHR) were studied longitudinally throughout the second and third trimesters in 43 low-risk singleton fetuses. The second trimester was characterized by an FHR pattern showing minimal differences between quiet and active intervals of fetal behavior. Few movements were accompanie...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199011000-00017
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:To assess total time for evaluation of women with first-trimester pregnancy concerns in an early pregnancy unit compared with an emergency department (ED) within a single safety net hospital system. METHODS:We performed a retrospective cohort study at Denver Health Medical Center from May 1, 2017, to April 3...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004080
更新日期:2020-11-01 00:00:00
abstract::This study covers 20 years' experience in the treatment of carcinoma of the cervix. Improved results and a decreased rate of major complications are seen as a result of a cooperative approach in treatment planning and careful dosimetry. Comparisons are made with large treatment centers as well as with national surviva...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-10-01 00:00:00
abstract::In 1992, the Executive Council of the Association of American Medical Colleges recommended that a computerized application system be investigated. Under this system, the application package would include: 1) a standardized application form, 2) a personal statement, 3) a dean's letter, 4) transcripts, 5) a chairman's l...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(94)00388-T
更新日期:1995-02-01 00:00:00
abstract::To determine whether planned anterior vaginotomy is a logical and safe means of avoiding a uterine scar with term abdominal delivery. I recorded the complications of the technique and whether vaginal birth after anterior vaginotomy occurred. Thirteen anterior vaginotomies were done when the vagina had advanced during ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00209-8
更新日期:1996-09-01 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::A case of pseudosarcoma botryoides of the vagina diagnosed in advanced pregnancy is described. The cellular characteristics (atypical cells and abnormal mitoses) suggested malignancy, but ultrastructural studies demonstrated the fibroblastic nature of the cells, thus confirming the diagnosis of pseudosarcoma. Local ex...
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 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:BACKGROUND:Erythrasma is an uncommon vulvar infection, best diagnosed by its fluorescence under the Wood lamp. This report shows that despite a negative Wood lamp examination, the diagnosis can be made histologically. CASE:A 42-year-old woman was referred to our clinic with a persistent candidal infection. Evaluation ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::This study supports the thesis that the physical findings of pelvic relaxation, such as cystourethrocele, are the results of isolated defects in the pelvic fascia rather than the results of generalized stretching or attenuation of the supporting structures. The most frequently encountered defect resulting in cystouret...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-03-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between the symptom of mixed urinary incontinence and incontinence severity, urodynamic findings, and treatment response. METHODS:This is a secondary analysis of data from 553 women randomized into a double-blind, placebo-controlled study evaluating duloxetine (serotonin-norep...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0029-7844(03)00376-4
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:To compare adverse childhood experiences (ACEs) in women with chronic pelvic pain with a control group, and describe occurrence of specific ACEs in women with chronic pelvic pain. METHODS:This case-control study examined the relationship between history of ACEs, traumatic events occurring during childhood as...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003533
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To examine differences in clinical and pathologic characteristics between women undergoing hysterectomy who had had prior tubal sterilization and those who had not. METHODS:One thousand eight hundred fifty-one women undergoing hysterectomy were enrolled as part of a multicenter, prospective cohort study. We ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/0029-7844(96)00149-4
更新日期:1996-08-01 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:BACKGROUND:There are few data regarding safety of pregnancy after uterine artery embolization. However, numerous women desire future fertility after this procedure. Uterine rupture without a history of cesarean delivery or uterine scarring is an exceedingly rare complication in pregnancy. CASE:We report a case of uter...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182a46df9
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To determine the accuracy of the Q-tip test to measure urethrovesical junction mobility. METHODS:One hundred fourteen women with urinary incontinence or genital prolapse were evaluated with a Q-tip test and perineal ultrasound scanning to measure urethrovesical junction mobility with strain. The sensitivity,...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract::Eighty-eight cases of Stage I and Stage II carcinoma of the cervix treated with radiotherapy at the University of North Carolina Memorial Hospital between April 1969 and July 1971 are reviewed. The question of whether the radiation time-dose-fraction relationship can be applied to the combination of external beam and ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1975-10-01 00:00:00
abstract::The circulating level of ACTH (by radioimmunoassay) and cortisol (by competitive protein binding) were determined at 1- to 2-hour intervals during spontaneous labor (N=8) and induced labor (N=28) and after delivery. There were no differences in ACTH levels between primiparous and multiparous women. The primiparous wom...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1975-09-01 00:00:00
abstract::The relationship of three different fetal ponderal indexes was studied in 116 normal pregnancies between 20 and 41 weeks. All three fetal ponderal indexes were found to be independent of gestational age. Throughout normal gestation, the femur length to abdominal circumference ratio X 100 was found to be 22.3 +/- 2.4 (...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the rate of live birth and the duration of survival after termination of pregnancy without feticide. METHODS:We conducted a retrospective analysis of 241 terminations of pregnancy without feticide for fetal anomalies or genetic abnormalities between 20 0/7 and 24 0/7 weeks of gestation at a singl...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002503
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of an outcomes-management program designed to provide high-quality patient care, generate data for outcomes research, and decrease costs in a managed-care environment. METHODS:An outcomes-management program was launched in June 1994, based on the elimination of wasteful or ineff...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/S0029-7844(97)00008-2
更新日期:1997-04-01 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::Pain management should be provided whenever medically indicated. The American Society of Anesthesiologists (ASA) and the American College of Obstetricians and Gynecologists (ACOG) believe that women requesting epidural analgesia during labor should not be deprived of this service based on their insurance or inadequate...
journal_title:Obstetrics and gynecology
pub_type: 指南,杂志文章,实务指引
doi:
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:To estimate whether antenatal dietary interventions restrict maternal weight gain in obese pregnant women without compromising newborn birth weight. DATA SOURCES:PubMed and Cochrane Controlled Trials Register were searched using free-text search terms: pregnancy, obesity, overweight, dietary intervention, li...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/AOG.0b013e3182396bc6
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:To study the localization of blood vessels within a tumor and the shape of the flow curve as a method of assessing ovarian neoplasms. METHODS:We studied 39 patients with malignant tumors and 63 patients with benign ovarian tumors by means of vaginal color Doppler ultrasound, noting the localization of blood ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(94)00293-m
更新日期:1995-01-01 00:00:00
abstract::This study was carried out to determine whether some of the lowest doses of natural estrogens currently prescribed for postmenopausal women result in significant changes in plasma lipids, urinary calcium, urinary free cortisol, or level of androgens. Twenty-four postmenopausal women were studied and the estrogens inge...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the accuracy of the diagnosis of presumed ectopic pregnancy. METHODS:This was a retrospective cohort analysis at a tertiary care medical center. The patient population was composed of 1) clinically stable pregnant women with human chorionic gonadotropin (hCG) above 2000 mIU/mL and no evidence of ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)02142-7
更新日期:2002-09-01 00:00:00