Abstract:
BACKGROUND:There are a number of poor birth outcomes with advancing maternal age. Although there is some evidence of a higher risk of trauma to obstetric anal sphincter and the levator ani muscle with advancing age, findings to date are inconclusive. OBJECTIVE:The aim of this study was to assess the risk of pelvic floor injury using translabial 3- and 4-dimensional ultrasound relative to advancing maternal age in primiparous women after a singleton vaginal delivery at term and to determine any association between maternal age and obstetric trauma, including obstetric anal sphincter injuries, levator avulsion, and irreversible overdistension of the levator hiatus. STUDY DESIGN:This is a subanalysis of a perinatal intervention trial conducted in a specialist urogynecology referral unit at 2 tertiary units. All primiparous women with singleton birth at term underwent 3- and 4-dimensional translabial pelvic floor ultrasound both ante- and postnatally for the assessment of the obstetric trauma including levator ani muscle avulsion, hiatal overdistension to 25 cm(2) or more, and obstetric anal sphincter injuries. A multivariate logistic regression analysis was performed to examine the association between maternal age and obstetric trauma diagnosed on 3- and 4-dimensional translabial ultrasound. Multiple confounders were included, and the most significant (forceps and vacuum delivery) were used for probability modeling. RESULTS:Of 660 women recruited for the original study, a total of 375 women who had a vaginal delivery with complete data sets were analyzed. A total of 174 women (46.4%) showed evidence of at least 1 form of major pelvic floor trauma. Advancing maternal age at first delivery carries with it a significant incremental risk of major pelvic floor trauma with an odds ratio of 1.064 for overall risk of injury for each increasing year of age past age 18 years (P = .003). The probability of any type of trauma appears to be substantially higher for forceps delivery. Vacuum delivery appears to increase the risk of obstetric anal sphincter injuries but not of levator avulsion. CONCLUSION:There is a significant association between the risk of major pelvic floor injury and increasing maternal age at first delivery.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Rahmanou P,Caudwell-Hall J,Kamisan Atan I,Dietz HPdoi
10.1016/j.ajog.2016.04.032subject
Has Abstractpub_date
2016-10-01 00:00:00pages
451.e1-7issue
4eissn
0002-9378issn
1097-6868pii
S0002-9378(16)30117-Xjournal_volume
215pub_type
杂志文章abstract:OBJECTIVE:The purpose of this study was to evaluate the effectiveness of a human immunodeficiency virus (HIV) rapid testing (RT) program. STUDY DESIGN:From April 13, 2004, to April 13, 2005, pregnant women at 2 high-risk maternity hospitals with no or incomplete HIV testing results (negative tests at <34 weeks, none t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2007.09.005
更新日期:2008-02-01 00:00:00
abstract::Five nonstress tests were interpreted by a national sample of obstetricians blinded to specific patient clinical data. The 169 questionnaires suitable for analysis showed that the reliability of the test interpretation, as measured by the kappa statistic, decreased with increasing number of categories of interpretatio...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90459-4
更新日期:1985-11-01 00:00:00
abstract::Diurnal profiles have been constructed for glucose, free fatty acids (FFA), triglycerides, cholesterol, and ten neutral amino acids in subjects with normal carbohydrate metabolism during late pregnancy and in age- and weight-matched nongravid women. Samples of blood were secured during a 24 hour period while the subje...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-08-01 00:00:00
abstract::One of the factors determining the prognosis of choriocarcinoma is the stromal reaction of the host. We have been interested in the histologic findings of this reaction, and we studied the relationship between the CPV classification, which had been used in our department, and our clinical stage. There was no relation ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90740-7
更新日期:1981-08-01 00:00:00
abstract::We report a case of placenta accreta that was managed conservatively by uterine arterial embolization and subsequently was complicated by hematuria. Ultrasound revealed a calcified mass at the posterior bladder wall. A careful resection under cystoscopy was carried out without hemorrhagic complication. Pathologic exam...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.08.040
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:We sought to determine the proportion of evidence-based (EB), vs non-EB (NEB) iatrogenic late preterm birth, and to compare corresponding rates of neonatal intensive care unit (NICU) admission. STUDY DESIGN:We performed a retrospective cohort study. Cases were categorized as EB or NEB. NICU admission was com...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.08.007
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:This study evaluated the role of nitric oxide in the maintenance of uterine quiescence in nonpregnant and pregnant ewes. STUDY DESIGN:Sixteen ovariectomized nonpregnant and 10 pregnant (115 days' gestation) chronically instrumented ewes were studied. Uterine contractility was assessed by electromyography and...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.105428
更新日期:2000-07-01 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:BACKGROUND:Patients with ovarian cancer tend to receive the highest quality of care at high-volume cancer centers with gynecological oncologists. However, the care that they receive prior to gynecological oncology consult has not been examined. We investigated the quantity and quality of care given to patients with ova...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2018.01.015
更新日期:2018-04-01 00:00:00
abstract::Twelve pregnant women at term with unfavorable cervices (less than or equal to 5 points according to Bishop score) were given prostaglandin E2 for cervical priming and labor induction. Prostaglandin E2 was given in the following manner: 0.5 mg in gel strictly intracervically (n = 4), extraamniotically (n = 4), or pros...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90986-h
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVES:Smoking is associated with a reduced risk of preeclampsia, but what is the outcome of pregnancy when preeclampsia develops in women who smoke? STUDY DESIGN:Single births in Sweden from 1987 through 1993 to nulliparous women aged 15 to 34 years (N = 317,652) were included. Poisson regression analyses were us...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)70455-1
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:Several articles have implied that progestogen supplementation during pregnancy to reduce the risk of preterm birth may increase the risk for developing gestational diabetes mellitus. OBJECTIVE:The purpose of the present meta-analysis was to accumulate existing evidence concerning this correlation. DATA SO...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ajog.2019.05.033
更新日期:2019-11-01 00:00:00
abstract::Radical trachelectomy is an effective fertility-sparing treatment for women with early-stage cervical cancer. We describe the first reported ovarian recurrence after radical trachelectomy for stage IB1 adenocarcinoma cervical cancer. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.03.071
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate whether maternal febrile illnesses in early pregnancy are associated with increased risk for congenital heart defects in the offspring and whether such risk is mitigated by multivitamin supplement use. STUDY DESIGN:From a multistate population-based case-control stud...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.10.880
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to calculate the prospective risk of fetal death in monochorionic-diamniotic twins. STUDY DESIGN:We evaluated 193 monochorionic diamniotic twin pregnancies that were followed and delivered after 24 weeks. Surveillance included cardiotocography and sonography performed at least o...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.01.099
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate endometrial biopsy and curettage in detecting small nerve fibers in eutopic endometrium for diagnosis of endometriosis. STUDY DESIGN:Endometrial biopsies with precise, consistent technique and curettings were taken from 37 women (20 with endometriosis and 17 without ...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/j.ajog.2007.04.032
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:We sought to determine if increased placental vascular impedance to flow is associated with changes in fetal cardiac function using spatiotemporal image correlation and virtual organ computer-aided analysis. STUDY DESIGN:A cross-sectional study was performed in fetuses with umbilical artery pulsatility index...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.11.043
更新日期:2013-02-01 00:00:00
abstract::The object of this randomized study was to compare the safety and efficacy of oral ofloxacin, 400 mg twice daily for 10 days, versus intramuscular cefoxitin, 2 gm, plus oral probenecid, 1 gm, followed by oral doxycycline, 100 mg twice daily for 10 days, in the outpatient treatment of uncomplicated acute salpingitis. T...
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:10.1016/0002-9378(91)91479-g
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to examine routine cervical cancer screening diagnoses and outcomes on an age-specific basis in a US population. STUDY DESIGN:We conducted an observational cohort study using 1997-2002 health plan administrative and laboratory data for women enrolled at Kaiser Permanente Northwest (...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.01.043
更新日期:2004-07-01 00:00:00
abstract::The efficacy of prostaglandin E2 (PGE2) for the induction of labor in pregnancies complicated by IUFD or missed abortion has been demonstrated. Gastrointestinal and pyrexic side effects are frequently observed. The following report describes two patients with documented IUFD who experienced a dramatic pyrexic and card...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90793-7
更新日期:1978-09-01 00:00:00
abstract::Since July 1, 1978, we have instituted the following changes in the management of severely Rh-immunized patients: (1) serial amniotic fluid optical density (delta OD450 ) values and real-time ultrasound scanning beginning at 21 weeks' gestation, (2) fetal transfusions as early as the twenty-third week, (3) ultrasound ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90234-5
更新日期:1984-06-01 00:00:00
abstract::With the "double PG impact" (DPGI) technique in 100 sedated first- and second-trimester volunteers, pregnancy was terminated successfully in 99 with a total extraovular PGF2alpha dose of 19.0 +/- 1.5 mg. in 16.9 +/- 0.9 hours. Two thirds of the patients received only the initial dose of 11.6 +/- 0.5 mg. of PG and abor...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90002-8
更新日期:1976-01-01 00:00:00
abstract::To characterize the effects of aminophylline and nifedipine on pregnant human myometrium, in vitro contractility studies were performed on myometrial strips obtained at cesarean section. The strips were stimulated with oxytocin (800 mU/L) to simulate labor and then were exposed to increasing concentrations of aminophy...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80373-3
更新日期:1987-07-01 00:00:00
abstract::Characteristics of cervical dilation produced by the new osmotic dilator, laminaria, and rigid (metal or plastic) dilators were compared. The osmotic dilator (Lamicel) is an open-porosity polyvinyl alcohol sponge loaded with magnesium sulfate and compressed into a rod. Pressures exerted by the Lamicel and laminaria te...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)90997-3
更新日期:1983-07-15 00:00:00
abstract:OBJECTIVE:We quantified the impact of chorioamnionitis on both the white and gray matter structures of the preterm ovine central nervous system (CNS). STUDY DESIGN:The CNS was studied at 125 days of gestation, either 2 or 14 days after the intraamniotic administration of 10 mg of lipopolysaccharide (LPS) (Escherichia ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.12.003
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:We performed a systematic review and meta-analysis to determine whether D-mannose reduces urinary tract infection recurrence (ie, cumulative incidence) in adult women with recurrent urinary tract infection compared with other prevention agents. Secondary outcomes included side effects and compliance with D-ma...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ajog.2020.05.048
更新日期:2020-08-01 00:00:00
abstract::Seventy-three women, primigravidas and multigravidas, received 1.0 mg PGE2 tablets hourly for 5 doses the evening prior to scheduled induction of term labor to improve cervical ripeness. The over-all response to treatment depended upon the initial cervical score. Gastrointestinal side effects occurred infrequently and...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90736-1
更新日期:1979-12-15 00:00:00
abstract:OBJECTIVE:We aimed to characterize the effect of vaginal or abdominal mesh insertion and of different collagen augmentation of polypropylene mesh in a sheep model. Outcome measures were passive and active biomechanical properties and semiquantitative morphometry. STUDY DESIGN:Forty-two Texel sheep were used: 6 were no...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.11.008
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Type 2 diabetes (T2D) in lean individuals is not well studied and up to 26% of diabetes occurs in these individuals. Although the cause is not well understood, it has been primarily attributed to nutritional issues during early development. OBJECTIVE:Our objective was to develop a lean T2D model using gesta...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.02.004
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:To summarize what is known about satisfaction with childbirth, with particular attention to the roles of pain and pain relief. STUDY DESIGN:A systematic review of 137 reports of factors influencing women's evaluations of their childbirth experiences. The reports included descriptive studies, randomized contr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1067/mob.2002.121141
更新日期:2002-05-01 00:00:00