Abstract:
OBJECTIVE:To estimate the prevalence of filled opioid prescriptions after vaginal delivery. METHODS:We conducted a retrospective cohort study of 164,720 Medicaid-enrolled women in Pennsylvania who delivered a liveborn neonate vaginally from 2008 to 2013, excluding women who used opioids during pregnancy or who had an opioid use disorder. We assessed overall filled prescriptions as well as filled prescriptions in the presence or absence of the following pain-inducing conditions: bilateral tubal ligation, perineal laceration, or episiotomy. Outcomes included a binary measure of whether a woman had any opioid prescription fill 5 days or less after delivery and, among those women, a second opioid prescription fill 6-60 days after delivery. Among women with no coded pain-inducing conditions at delivery, we used multivariable logistic regression with standard errors clustered to account for within-hospital correlation to assess the association between patient characteristics and odds of a filled opioid prescription. RESULTS:Twelve percent of women (n=18,131) filled an outpatient opioid prescription 5 days or less after vaginal delivery; among those women, 14% (n=2,592, or 1.6% of the total) filled a second opioid prescription 6-60 days after delivery. Of the former, 5,110 (28.2%) had one or more pain-inducing conditions. Predictors of filled opioid prescriptions with no observed pain-inducing condition at delivery included tobacco use (adjusted odds ratio [OR] 1.3, 95% confidence interval [CI] 1.2-1.4) and a mental health condition (adjusted OR 1.3, 95% CI 1.2-1.4). Having a diagnosis of substance use disorder other than opioid use disorder was not associated with filling an opioid prescription 5 days or less after delivery, but was associated with having a second opioid prescription 6-60 days after delivery (adjusted OR 1.4, 95% CI 1.2-1.6). CONCLUSION:More than 1 in 10 Medicaid-enrolled women fill an outpatient opioid prescription after vaginal delivery. National opioid-prescribing recommendations for common obstetrics procedures such as vaginal delivery are warranted.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Jarlenski M,Bodnar LM,Kim JY,Donohue J,Krans EE,Bogen DLdoi
10.1097/AOG.0000000000001868subject
Has Abstractpub_date
2017-03-01 00:00:00pages
431-437issue
3eissn
0029-7844issn
1873-233Xpii
00006250-201703000-00005journal_volume
129pub_type
杂志文章abstract:BACKGROUND:We report the possible association between in vitro fertilization (IVF) and recurrent acute pancreatitis. CASE:A patient developed acute pancreatitis during each of two cycles of IVF. On a spontaneous cycle, serum triglycerides were as follows: early follicular phase 2.34 mmol/L, mid-follicular phase 4.17 m...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::Sixty-four cases of stage I vulvar squamous cell carcinoma were analyzed histologically to define a patient subset at minimum risk for recurrence or nodal metastases. Three patterns of invasion were predefined: carcinoma in situ with early stromal invasion (33%), pushing (8%), and infiltrative (59%). Infiltrative patt...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVE:To determine whether calcium supplementation prevents progression to severe disease in preterm nulliparous women with mild preeclampsia. METHODS:Seventy-five women hospitalized at 24-36 weeks' gestation because of mild preeclampsia were randomized to receive either 2 g/day of elemental calcium (36 women) or ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0029-7844(95)00052-s
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE:To evaluate weekly stripping of membranes at term to determine its safety and effectiveness in reducing the incidence of prolonged and postterm pregnancies. METHODS:One hundred forty-two pregnant women with certain gestational dates were randomly selected to receive, starting at 38 weeks, either weekly strip...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0029-7844(96)00046-4
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Neuroleptic malignant syndrome (NMS) is characterized by a tetrad of mental status changes, extrapyramidal symptoms, hyperpyrexia, and autonomic instability and can develop after the use of antipsychotics. CASE:A young, multiparous woman presented at 26 weeks of gestation with acute psychosis and was treate...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31822864af
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To examine possible changes in cardiac function in fetuses of pregestational diabetic mothers. METHODS:We conducted a prospective longitudinal study of 31 women whose pregnancies were between 22 weeks' gestation and term, and who had pregestational diabetes. All diabetic women included in the study had glyco...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00003-4
更新日期:1999-06-01 00:00:00
abstract::The group A streptococcus is capable of producing exotoxins that have been linked to a toxic shock-like syndrome. Streptococcal toxic shock is a rapidly progressive disease associated with injury to multiple organ systems and a 30-60% mortality rate. We present a case of a 40-year-old woman who developed group A strep...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-09-01 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 estimate the incidence and identify the risk factors for pelvic organ prolapse repair after hysterectomy. METHODS:We conducted a case-control study. We identified 6,214 women who underwent hysterectomy in our gynecology department from 1982 to 2002. Cases (n=114) were women who required pelvic organ prola...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000278567.37925.4e
更新日期:2007-09-01 00:00:00
abstract::Cloacal dysgenesis is a rare anomaly. Fifty cases have been reported in the literature. This condition differs from the usual imperforate anus. The diagnosis, evaluation, and therapeutic management require an understanding of the embryogenesis of the cloaca. The presence at birth of a single interlabial orifice or an ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-07-01 00:00:00
abstract:OBJECTIVE:To analyze contemporary U.S. use of minimally invasive surgery for the treatment of endometrial cancer and associated inpatient complications and costs. METHODS:In this retrospective cohort study, the National Inpatient Sample database was analyzed in patients with nonmetastatic endometrial cancer who underw...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001567
更新日期:2016-09-01 00:00:00
abstract::Two applications of amniocentesis for the evaluation of the patient in idiopathic premature labor, fetal lung maturity testing, and detection of occult intraamniotic infection were evaluated in a review of 59 cases. Seven patients (12%) had positive amniotic fluid cultures despite the absence of clinical signs of infe...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:In nondiabetic women, pregnancy alone rarely causes clinical hypoglycemia. Non-islet cell tumors have recently been shown to be associated with the production of insulin-like growth factor II (IGF-II) and a paraneoplastic syndrome resulting in hypoglycemia. A case report and review of pathophysiologic mechan...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(94)00313-3
更新日期:1995-05-01 00:00:00
abstract::To assess the problem of continuing atenolol in a breast-feeding mother with hypertension associated with thyrotoxicosis, studies were performed to determine simultaneous plasma and breast milk concentrations of atenolol after a single dose of 50 mg and on continuous therapy of varying weekly dosages. Peak atenolol co...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract::Uncontrolled lipid peroxidation may play an important role in the pathophysiology of preeclampsia by causing vascular endothelial cell dysfunction. Sera contain antioxidant mechanisms that serve to control lipid peroxidation. We tested the hypothesis that the sera antioxidant protective mechanisms are diminished in wo...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-06-01 00:00:00
abstract::A total of 410 colposcopic examinations were performed on 188 female cebus monkeys that were under study to determine the oncogenic potential of herpes simplex virus type 2 in this genus. A split-cone vaginal speculum was developed that permitted good observation of the vaginal cervix in the cebus monkey. The cervical...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-11-01 00:00:00
abstract:OBJECTIVE:The experience of physical and sexual violence (victimization) is common among U.S. women and is associated with adverse health consequences. The study objectives were to estimate the prevalence of victimization in women with cancer and to examine associations with demographics, cancer screening, and cancer s...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000217694.18062.91
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To estimate the incidence of gestational diabetes mellitus (GDM) according to The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria and the pregnancy complications in women fulfilling these criteria but who are not considered diabetic according to the Canadian Diabetes Ass...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31826994ec
更新日期:2012-10-01 00:00:00
abstract::Estrogen treatment of postmenopausal women has been suggested to improve mood and psychological function. However, this remains controversial because previous studies involved heterogeneous groups, were not double blind, and included women who were also experiencing somatic symptoms that were relieved by estrogen. A r...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1991-12-01 00:00:00
abstract::Pelvic organ prolapse (POP) is a common, benign condition in women. For many women it can cause vaginal bulge and pressure, voiding dysfunction, defecatory dysfunction, and sexual dysfunction, which may adversely affect quality of life. Women in the United States have a 13% lifetime risk of undergoing surgery for POP ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000002008
更新日期:2017-04-01 00:00:00
abstract::Endometriotic ureteral obstruction is a serious event commonly diagnosed late and therefore associated with a major risk of hydronephrotic renal atrophy. The standard therapy is surgical. However, medical treatment has been reported using danazol, progestins, and estrogen-progestin combinations, although solid documen...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::A woman in her 34th week of gestation required emergency appendectomy for perforation, with postoperative wound dehiscence secondary to fasciitis and tension on the suture line. Polypropylene mesh was used to repair the abdominal wall. Fetal distress necessitated a cesarean section. The mother and child both survived ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVE:To describe our initial experience with a computerized telecommunication system, termed the interactive voice-response system, to record resident performance of laparoscopic surgery. METHODS:After completing a laparoscopic procedure, the surgeon and resident telephone a toll-free number independently and res...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/S0029-7844(97)00137-3
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:To determine if corticosteroid administration causes increased contractions or labor in high-order multiple gestations. METHODS:Medical records of all triplet and quadruplet pregnancies cared for by Phoenix Perinatal Associates from August 1988 to January 1992 were reviewed retrospectively. Twenty-one women ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(94)00355-H
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVE:Postcesarean endometritis and wound infection remain significant morbidities, despite use of strategies to prevent these complications. We investigated the effect of preoperative vaginal preparation with povidone-iodine as a preventive intervention against postcesarean endometritis and wound infection. METHO...
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.0000164032.16599.7e
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:To compare lamellar body counts with the lecithin/sphingomyelin ratio and phosphatidylglycerol analysis in terms of assessment of risk of respiratory distress syndrome (RDS). METHODS:Lamellar body counts, lecithin-sphingomyelin ratios (L/Ss), and phosphatidylglycerol levels were assessed in 1611 amniotic flu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/s0029-7844(00)01133-9
更新日期:2001-02-01 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:ABSTRACT:Meeting the ethical obligations of informed consent requires that an obstetrician-gynecologist gives the patient adequate, accurate, and understandable information and requires that the patient has the ability to understand and reason through this information and is free to ask questions and to make an intenti...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004247
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVE:To estimate the association of maternal plasma concentrations of tryptophan and six kynurenine pathway metabolites with the risk of preeclampsia. METHODS:The study was based on a subsample of 2,936 pregnant women who delivered singleton neonates in the Norwegian Mother and Child Cohort Study in 2002-2003. Ma...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318255004e
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To determine if the signs and symptoms of genital herpes in pregnancy accurately identify primary genital herpes infections using serologic testing for final classification. METHODS:Twenty-three women with clinical signs and symptoms suggestive of primary genital herpes infections in the second and third tri...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00121-x
更新日期:1997-06-01 00:00:00