Abstract：
OBJECTIVE:To estimate the cost-effectiveness of universal group B streptococci (GBS) screening in women with a singleton pregnancy planning a repeat cesarean delivery. METHODS:We conducted a decision analysis from a health care perspective to compare the cost-effectiveness of GBS screening for women planning a repeat cesarean delivery. With universal screening, all GBS-positive women who labored before a scheduled cesarean delivery received antibiotic prophylaxis. With no screening, women who presented in labor received antibiotics based on risk-based criteria. Neonates born to women colonized with GBS were at risk for early-onset GBS disease, disability, and death. We assumed a GBS prevalence of 25%, that 26.6% of women labored between 35 weeks of gestation and their scheduled time for cesarean delivery, and that 3.3% who planned a repeat cesarean delivery instead delivered vaginally. The primary outcome was cost per neonatal quality-adjusted life-year gained, with a cost-effectiveness threshold of $100,000 per quality-adjusted life-year. Neonatal quality of life was assessed using five health states (healthy, mild, moderate, or severe disability, and death) with a life expectancy of 79 years for healthy neonates. One-way sensitivity and Monte Carlo analyses were used to evaluate the results. RESULTS:In the base case, universal GBS screening in women planning a repeat cesarean delivery was not cost-effective compared with no screening, costing $114,445 per neonatal quality-adjusted life-year gained. The cost to prevent an adverse outcome from GBS exceeded $400,000. If greater than 28% of women were GBS-positive, greater than 29% labored before their scheduled delivery, or greater than 10% delivered vaginally, universal screening became cost effective. CONCLUSION:Universal GBS screening in women with a singleton pregnancy planning a repeat cesarean delivery may not be cost-effective in all populations. However, in populations with a high GBS prevalence, women at high risk of laboring before their scheduled cesarean delivery, or women who may ultimately opt for a vaginal delivery, GBS screening may be cost effective.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Albright CM,MacGregor C,Sutton D,Theva M,Hughes BL,Werner EFdoi
10.1097/AOG.0000000000001800subject
Has Abstractpub_date
2017-01-01 00:00:00pages
111-119issue
1eissn
0029-7844issn
1873-233Xjournal_volume
129pub_type
杂志文章abstract：:Obstetrician-gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that require minimal interventions and have high rates of patient satisfaction. Many common obstetric practices are of limited or un...
journal_title：Obstetrics and gynecology
pub_type： 社论
doi：10.1097/AOG.0000000000003081
更新日期：2019-02-01 00:00:00
abstract：OBJECTIVE:Reducing tobacco use in pregnancy is a public health priority. Brief smoking counseling during prenatal care is effective but generates modest cessation rates. Telephone counseling is an effective smoking cessation method that could offer pregnant women convenient access to more intensive smoking cessation co...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,随机对照试验
doi：10.1097/01.AOG.0000218100.05601.f8
更新日期：2006-07-01 00:00:00
abstract：:A case of endometrioid carcinoma arising in endometriosis of the fallopian tube is described. One case of tubal endometrioid carcinoma has been reported previously, but the entity has not hitherto been recognized among primary fallopian tube tumors. The clinical presentations, histopathology, and pathogenesis of this ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1978-07-01 00:00:00
abstract：OBJECTIVE:To evaluate the efficacy of device-guided slow-paced respiration for reducing the frequency and severity of menopausal hot flushes. METHODS:Perimenopausal or postmenopausal women reporting four or more hot flushes per day were recruited into a parallel-group, randomized trial of slow-paced respiration using ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,随机对照试验
doi：10.1097/AOG.0000000000000821
更新日期：2015-05-01 00:00:00
abstract：OBJECTIVE:To evaluate the degree to which prenatal knowledge of fetal anomalies and sociodemographic characteristics determined outcome of 53,000 pregnancies. METHODS:Pregnancies were consecutively evaluated at a university hospital between 1984 and 1997. The severity of anomalies was graded by using an ordinal scale,...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(01)01673-8
更新日期：2002-02-01 00:00:00
abstract：OBJECTIVE:To evaluate an evidence-based collaborative depression care intervention adapted to obstetrics and gynecology clinics compared with usual care. METHODS:A two-site, randomized controlled trial included screen-positive women (Patient Health Questionnaire-9 score of at least 10) who met criteria for major depre...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1097/AOG.0000000000000231
更新日期：2014-06-01 00:00:00
abstract：:Antepartum pituitary infarction occurs only in insulin-dependent diabetic patients. It is manifested by severe headache, followed by decreasing insulin requirements. Delivery is frequently premature, with high fetal wastage and increased maternal mortality. During the puerperium, the first manifestation of pituitary d...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1979-03-01 00:00:00
abstract：:Nonsteroidal antiinflammatory compounds that act by inhibiting synthesis of prostaglandins from arachidonic acid have been shown to have various and sometimes profound effects on fetal and neonatal circulation. Agents such as acetylsalicylic acid, indomethacin, and naproxen pass readily across the placenta and have be...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1981-11-01 00:00:00
abstract：BACKGROUND:The combination of severe uterovaginal prolapse and stress urinary incontinence in medically compromised patients in whom surgery is contraindicated is a difficult treatment dilemma. CASE:A 75-year-old woman with severe cardiac compromise and a history of pulmonary embolus presented with severe uterovaginal...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(97)00260-3
更新日期：1997-10-01 00:00:00
abstract：OBJECTIVE:To examine the relationships between clinical or histological chorioamnionitis and cerebral palsy using a meta-analysis approach. DATA SOURCES:A systematic review of the literature appeared in PubMed between 2000 and 2009 was conducted using the search terms "cerebral palsy" and "infection," with broad-scope...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,meta分析,评审
doi：10.1097/AOG.0b013e3181e90046
更新日期：2010-08-01 00:00:00
abstract：BACKGROUND:Intravenous leiomyomatosis is a rare tumor originating from the uterus that spreads through vessels. This tumor, while histologically benign, can cause fatal cardiovascular symptoms resulting from growth within the heart cavity. CASE:A 51-year-old woman with chronic hypertension was found to have a murmur. ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1097/01.AOG.0000127947.14387.01
更新日期：2004-05-01 00:00:00
abstract：:Four white women who developed osteosarcoma during pregnancy were referred for treatment, 2 prior to delivery and development of metastases, and 2 after delivery and development of metastases. After amputation, these patients received combination chemotherapy with either vincristine-cyclophosphamide or adriamycin-cycl...
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 hypothesize that higher intake of docosahexaenoic acid, an n-3 long chain polyunsaturated fatty acid, would increase duration of gestation and birth weight in US women. METHODS:This was a randomized, double-blind, controlled, clinical trial. Subjects were enrolled in an ambulatory clinic where they receiv...
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(02)02585-1
更新日期：2003-03-01 00:00:00
abstract：OBJECTIVE:To determine the factors that influence the survival of patients with endometrial carcinoma histologically confined to the uterus. METHODS:Retrospective analysis was conducted of 262 surgically staged cases using multiple regression (Cox proportional hazards model). RESULTS:After excluding patients with cle...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1992-10-01 00:00:00
abstract：OBJECTIVE:To ascertain whether the TDx-FLM assay is a better predictor of neonatal respiratory distress syndrome (RDS) than the lecithin-sphingomyelin ratio (L/S) and phosphatidylglycerol (PG). METHODS:Amniotic fluid samples of 140 women requiring assessment of fetal lung maturity and delivering within 72 hours of amn...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1993-12-01 00:00:00
abstract：OBJECTIVE:To evaluate the long-term effect of tubal sterilization on menstrual indices and pelvic pain. METHODS:Five hundred women undergoing sterilization were interviewed before sterilization, 6-10 months after surgery, and 3-4.5 years later. Four hundred sixty-six non-sterilized comparison women were interviewed in...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1993-07-01 00:00:00
abstract：:Cervical smears taken by the wooden Ayre spatula (widely used in the United Kingdom) and by a plastic spatula (Armovical) were compared for their ability to detect dysplastic cervical epithelium and endocervical cells. At the same time, the value of taking duplicate smears was assessed. Paired cervical smears were obt...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1982-07-01 00:00:00
abstract：:Worldwide, sterilization (tubal sterilization and vasectomy) is used by more people than any other method of contraception. All techniques of tubal sterilization in widespread use in the United States have low risks of surgical complications. Although tubal sterilization is highly effective, the risk of pregnancy vari...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1097/01.AOG.0000298621.98372.62
更新日期：2008-01-01 00:00:00
abstract：OBJECTIVE:To examine the effectiveness of lidocaine spray compared with conventional lidocaine submucosal injection during a loop electrosurgical excision procedure (LEEP). METHODS:Women undergoing LEEP for any degrees of cervical intraepithelial neoplasia were invited to participate. The participants were randomly as...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,随机对照试验
doi：10.1097/AOG.0b013e31829d888e
更新日期：2013-09-01 00:00:00
abstract：OBJECTIVE:Elective repeat cesarean delivery at 37 or 38 weeks compared with 39 completed weeks of gestation is associated with adverse neonatal outcomes. We assessed whether delivery before 39 weeks is justifiable on the basis of decreased adverse maternal outcomes. METHODS:We conducted a cohort study of women with li...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0b013e3182078115
更新日期：2011-02-01 00:00:00
abstract：OBJECTIVE:To compare the perinatal outcomes of normotensive women with those of women with a history of chronic hypertension with normal blood pressures before 20 weeks of gestation, stratifying the latter by whether they were receiving antihypertensive medication. METHODS:We conducted a retrospective cohort study of ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000002574
更新日期：2018-05-01 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 characterize the rate of obstetric anal sphincter injuries and identify key risk factors of obstetric anal sphincter injuries, including duration of the second stage of labor. METHODS:This retrospective cohort study included all singleton, term, cephalic vaginal deliveries within Kaiser Permanente Norther...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000002444
更新日期：2018-02-01 00:00:00
abstract：OBJECTIVE:To evaluate fetal outcome and long-term impact of very early preterm premature rupture of membranes (PROM). METHODS:In a retrospective cohort study, 78 women with singleton pregnancies who delivered at the Oulu University Central Hospital between 1990 and 1996 and who had early PROM, between the 17th and 30t...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(98)00213-0
更新日期：1998-09-01 00:00:00
abstract：:The authors attempted to relate neonatal mortality to method of delivery in a series of 345 infants, weighing 700 to 1500 g, who were born in King County, Washington, from 1977 to 1979. Overall, 38% of infants delivered vaginally died as opposed to 32% of those with cesarean births. However, after adjustment for birth...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1984-08-01 00:00:00
abstract：:Forty-eight of 100 pregnant women received a 100-g (nonfasting) glucose screening test at about 28 weeks' gestation, followed by a 100-g glucose tolerance test. Another 52 received a 100-g (nonfasting) glucose polymer screening test followed by a 100-g glucose polymer tolerance test. Mean plasma glucose one hour after...
journal_title：Obstetrics and gynecology
pub_type： 临床试验,杂志文章
doi：
更新日期：1985-10-01 00:00:00
abstract：:Findings from basic neuroscience have provided information on the effects of estrogen on brain morphology and chemistry that explain how this sex steroid may influence brain function. The clinical literature shows that estrogen enhances mood and specific aspects of cognitive functioning in postmenopausal women. There ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0029-7844(95)00431-9
更新日期：1996-02-01 00:00:00
abstract：OBJECTIVE:To evaluate the Interstitial Cystitis Symptom Index and Problem Index as a screening tool for interstitial cystitis, and to estimate the prevalence and risk factors for interstitial cystitis in women with chronic pelvic pain. METHODS:Forty-five women scheduled to undergo laparoscopy for chronic pelvic pain w...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(02)02087-2
更新日期：2002-08-01 00:00:00
abstract：:Several reports of pregnancy and sepsis associated with an intrauterine device have been reported. A case of a CU-7 in utero with sepsis due to Escherichia coli in a 10-12 week gestation is presented. ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1976-07-01 00:00:00
abstract：:The pre- and postoperative endocrine profile in a patient with an ovarian sex cord tumor with annular tubules resembles a granulosa cell tumor despite morphologic features of a Sertoli-Leydig cell tumor. Gonadotropin and prolactin levels were compatible with estrogen-progesterone synergy on hypothalamic pituitary func...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1986-09-01 00:00:00
