Abstract:
OBJECTIVE:To evaluate use (both appropriate and inappropriate) of rescue corticosteroids before and after the implementation of a guideline for their use. METHODS:We conducted a retrospective cohort study using a pharmacy log to identify women who received an initial course of antenatal corticosteroids in the year before (2008) and in the 4 years (2009-2012) after implementation of the guideline. The charts were then reviewed to determine eligibility and assess receipt of rescue corticosteroids according to the guideline. Our primary study outcome was a temporal change in the percentage of appropriate rescue corticosteroid administration. RESULTS:Of 2,528 women who received a first course of corticosteroids, 142 (5.6%) were eligible for a rescue course, of whom 103 (73%) received it. The rate of appropriate administration increased from 18.2% (95% confidence interval [CI] 5-40%) in 2008 to 65.4% (95% CI 44-83%) in 2009, 93.5% (95% CI 79-99%) in 2010, 96.1% (95% CI 80-99%) in 2011, and 75.7% (95% CI 59-88%) in 2012 (P for test of trend <.001). Only 25 of these 103 eligible women (24.3%) delivered within 2-7 days of receipt of the rescue course. The rate of inappropriate administration among women who were not eligible for a rescue course (n=2,381) also rose from 0.4% (95% CI 0.04-1.4%) in 2008 to 1.9% (95% CI 0.9-3.5%) in 2009, 1.8% (95% CI 0.8-3.6%) in 2010, 2.4% (95% CI 1.2-4.3%) in 2011, and 2.2% (95% CI 1.1-4.0%) in 2012 (P for test of trend=.03). Among all recipients of rescue corticosteroids, 28% (41/144) were ineligible according to the guideline. CONCLUSION:Implementation of an institutional guideline for rescue corticosteroids was associated with a high rate of use among eligible women.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Datkhaeva I,Dray D,Has P,Stifani B,Hughes BL,Rouse DJdoi
10.1097/AOG.0000000000001934subject
Has Abstractpub_date
2017-04-01 00:00:00pages
720-726issue
4eissn
0029-7844issn
1873-233Xjournal_volume
129pub_type
杂志文章abstract:OBJECTIVE:To use magnetic resonance images of living women and 3-dimensional modeling software to identify the component parts and characteristic features of the external anal sphincter (EAS) that have visible separation or varying origins and insertions. METHODS:Detailed structural analysis of anal sphincter anatomy ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000189084.82449.fc
更新日期:2005-12-01 00:00:00
abstract::The value of the contraction stress test (CST), although well documented in late pregnancy, has been questioned earlier in gestation. We have evaluated the reliability of the CST in 102 patients tested before 33 weeks' gestation. Eighteen patients with a positive CST had a significantly higher incidence of abnormal ur...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-12-01 00:00:00
abstract:OBJECTIVE:To survey the interest of obstetrician-gynecologists in serving as primary care physicians and their perceived preparedness for that role from the view points of managed care plans and obstetrician-gynecologists. METHODS:A sample of obstetrician-gynecologists was asked to describe their preferred physician r...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/S0029-7844(97)00224-X
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To determine the correlation between the maximal urethral closure pressure and the stress leak-point pressure in patients with genuine stress incontinence, and to define a critical stress leak-point pressure value to detect patients with a low-pressure urethra, as defined by a maximal urethral closure pressur...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00014-i
更新日期:1995-05-01 00:00:00
abstract::One hundred ten consecutive patients with invasive gynecologic cancers, treated by radical hysterectomy at The University of California, Irvine Medical Center, underwent early postoperative intravenous pyelogram (IVP). An abnormal early postoperative IVP did not predict subsequent urinary tract dysfunction (anatomical...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:Umbilical vascular coiling may function as a rudimentary pump that facilitates venous return from the placenta. CASES:Three consecutive twin gestations with twin-twin transfusion syndrome were evaluated prospectively at delivery. The birth weights and umbilical coiling indices of donor and recipient twins w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00057-4
更新日期:1997-05-01 00:00:00
abstract::Arteriovenous fistulae of the ovarian artery may develop after gynecologic surgery. A case that occurred 9 years after hysterectomy with bilateral oophorectomy is presented and discussed. It illustrates an unusual cause of left lower quadrant abdominal pain. Surgical removal of the ovarian arteriovenous fistula result...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVE:To investigate the value of the combined use of vaginal ultrasonography and endometrial sampling in the office for the diagnosis of endometrial disease in postmenopausal women. METHODS:One hundred forty consecutive postmenopausal women presenting with uterine bleeding or endometrial cells on cervical cytolog...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0029-7844(94)00421-9
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:To describe the outcomes of intended home birth in the practices of certified nurse-midwives. METHODS:Twenty-nine US nurse-midwifery practices were recruited for the study in 1994. Women presenting for intended home birth in these practices were enrolled in the study from late 1994 to late 1995. Outcomes for...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0029-7844(98)00182-3
更新日期:1998-09-01 00:00:00
abstract::A patient with non-mosaic Turner syndrome and normal fertility had four documented pregnancies, two of which were carried to term. Although her fertility history can be considered normal, she did not have spontaneous sexual maturation or menarche, and bilateral streak gonads were identified on laparotomy for tubal lig...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract:BACKGROUND:The importance of a broad differential diagnosis is highlighted by a complex patient case. CASE:A young woman returned from her honeymoon complaining of activity-limiting pain. The evaluation revealed multiple constitutional symptoms, a breast mass, a large pelvic mass, pulmonary abnormalities, an external ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000244102.38691.d3
更新日期:2006-11-01 00:00:00
abstract::Delayed umbilical cord clamping appears to be beneficial for term and preterm infants. In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. There is a small increa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004167
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the long-term outcome of patients with severe cervical intraepithelial neoplasia or squamous cell carcinoma in situ (CIN III) after cold-knife conization with clear margins. METHODS:A total of 4417 women (mean age 36, range 18-72 years) with histologically confirmed CIN III had cold-knife conizat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)01174-1
更新日期:2001-03-01 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:Despite a change of fetal physiologic and biochemical functions with gestational age, stationary umbilical cord acid-base reference values are used as measures of obstetric care quality. The aim of this study was to assess the risk of low Apgar score relative to low pH when using stationary versus gestational...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(03)00512-x
更新日期:2003-08-01 00:00:00
abstract:INTRODUCTION:The first transdermal drug delivery system was introduced in the United States over 20 years ago. Created as an alternative route of administration to improve patient compliance as well as to reduce side effects, the transdermal delivery of drugs now represents a $1.5 to $2 billion market and is growing ra...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000161958.70059.db
更新日期:2005-05-01 00:00:00
abstract::Excised tubal segments from 42 women with uterotubal junction obstruction were studied histologically to evaluate the pathologic spectrum of disease and correlate this with clinical data. The most frequent lesion encountered was obliterative fibrosis (38.1%), confirmed by connective tissue stains, which was not associ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Cytologic diagnosis of adenocarcinoma metastatic to the peritoneal surface is often hampered by the difficulty of differentiating between reactive mesothelial cells and macrophages from malignant epithelial cells by light microscopy. With in vitro tissue culture technics, the fibroblastic dedifferentiation of mesothel...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-197507000-00015
更新日期:1975-07-01 00:00:00
abstract::We previously reported surgical correction of vaginal agenesis and partial cervical atresia in an 11-year-old girl with amenorrhea and a pelvic mass. This patient, the subject of this report, conceived 7 years later and delivered at term. An abdominal cerclage was placed at 12 weeks' gestation to protect the cervix, a...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199011001-00001
更新日期:1990-11-01 00:00:00
abstract::During a five-year period, 2815 patients undergoing 5685 fetal heart rate (FHR) tests produced 147 positive contraction stress tests. Baseline FHR patterns were considered reactive if three or more accelerations occurred during 30 minutes of the contraction stress test and nonreactive if fewer or no accelerations were...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract:OBJECTIVE:To assess outcomes and costs associated with around-the-clock point-of-care intrapartum group B streptococcus (GBS) polymerase chain reaction (PCR) screening. METHODS:Intrapartum PCR screening was implemented in 2010. Intrapartum PCR was compared with antenatal culture screening in an uncontrolled, single in...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1097/AOG.0000000000003057
更新日期:2019-02-01 00:00:00
abstract::Granulosa and theca cell tumors are rather common gonadal stromal tumors. A postmenopausal patient with a granulosa cell tumor, who complained chiefly of breast tenderness and enlarging, abdomen, is presented. Preoperative and postoperative studies including serum estrone, estradiol, prolactin, FSH, and LH,as well as ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-07-01 00:00:00
abstract:BACKGROUND:Hepatocellular carcinoma associated with pregnancy is unusual. CASE:A 33-year-old woman presented at 25 weeks' gestation with sudden, severe epigastric pain for 6 hours. Abdominal ultrasonography and magnetic resonance imaging showed multiple liver tumors with a small amount of ascites. Exploratory laparoto...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0029-7844(01)01357-6
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVE:To identify the effects of percutaneous estradiol (E2) implants on bone histology and bone mass of postmenopausal women with low bone mineral density. METHODS:Sixteen postmenopausal women with low bone mineral density were treated with 75-mg E2 implants. Each had iliac crest bone biopsies performed, followin...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:Adult females with menorrhagia may have unrecognized mild von Willebrand's disease. Most females with known von Willebrand's disease report menorrhagia. CASE:A 38-year-old healthy female desired contraception. She described heavy menses lasting 8 days since menarche. History included uncomplicated vaginal d...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000157758.94890.59
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:To describe the relations between body mass index (BMI; kg/m(2)), weight gain, and incident urinary incontinence in middle-aged women. METHODS:This was a prospective study in the Nurses' Health Study II. Participants reported their weight at age 18 years, and current weight and height in 1989; weight was upd...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000270121.15510.57
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Refeeding syndrome is a rare constellation of electrolyte abnormalities after reintroduction of glucose during an adaptive state of starvation and malnutrition, resulting in fluid shifts, end-organ damage, and, potentially, death. We present a case of fetal death in a patient with hyperemesis gravidarum comp...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003276
更新日期:2019-06-01 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:BACKGROUND:Opportunistic salpingectomy at the time of hysterectomy is currently recommended to reduce the lifetime risk of ovarian cancer. The vaginal route is least invasive, but surgeons sometimes may choose to perform this procedure laparoscopically or robotically when anticipating adnexal surgery as a result of lim...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002746
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To assess whether obesity is an independent predictor of mortality in women with cervical cancer. METHODS:This retrospective cohort study of patients with stages IB1-IVA cervical cancer treated with curative intent at MD Anderson Cancer Center from 1980 through 2007 categorized these women as underweight, no...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000558
更新日期:2014-12-01 00:00:00