Abstract:
BACKGROUND:It is not well-characterized whether attempting operative vaginal delivery is a safe and effective alternative among women who undergo a trial of labor after cesarean delivery who are unable to complete second-stage labor with a spontaneous vaginal delivery. OBJECTIVE:The purpose of this study was to compare maternal and neonatal outcomes that are associated with attempted operative vaginal delivery with those that are associated with second-stage repeat cesarean delivery without an operative vaginal delivery attempt among women who undergo a trial of labor after cesarean delivery. STUDY DESIGN:This is a retrospective secondary analysis of data from Cesarean Registry of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Women who underwent a trial of labor after cesarean delivery who were at least 36 weeks gestation were eligible for analysis if they had a live, singleton, nonanomalous gestation in cephalic presentation and reached second-stage labor (defined as complete cervical dilation) with a fetal station of at least +2. The data for women who had an attempted operative vaginal delivery with either forceps or vacuum were compared with those of women who underwent second stage repeat cesarean delivery without operative vaginal delivery attempt. Outcomes of maternal and neonatal complications were compared between groups with bivariable and multivariable analyses. RESULTS:Of 1230 women whose cases were eligible for analysis, 945 women (76.8%) had an attempted operative vaginal delivery. Of those who underwent attempted operative vaginal delivery, 914 women (96.7%) achieved a vaginal delivery. Women who attempted operative vaginal delivery had a lower mean body mass index (30.4±6.0 vs 31.8±5.9 kg/m2; P=.001) and gestational age (39.5±1.3 vs 39.8±1.2 weeks; P=.012) at delivery and were more likely to be of non-Hispanic black race (30.0% vs 22.1%; P=.002), to have had a previous vaginal delivery (34.9% vs 20.4%; P<.001), and to have fetal descent greater than +2 station at complete dilation (55.6% vs 16.8%; P<.001) and were less likely to have chorioamnionitis (6.8% vs 19.3%; P<.001). The frequency of endometritis was significantly lower among women who had an attempted operative vaginal delivery compared with those who had repeat cesarean delivery (2.5% vs 9.1%; P<.001). However, other serious maternal or neonatal adverse outcomes were not statistically different between the groups. These findings persisted after adjustment for potential confounders. CONCLUSION:In the setting of a trial of labor after cesarean delivery in the second stage with a fetal station of at least +2, attempted operative vaginal delivery resulted in a vaginal birth after cesarean delivery in most women and was not associated with increased adverse maternal and neonatal outcomes but was associated with a reduced frequency of endometritis compared with repeat cesarean delivery without operative vaginal delivery attempt.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Son M,Roy A,Grobman WAdoi
10.1016/j.ajog.2017.01.013subject
Has Abstractpub_date
2017-04-01 00:00:00pages
407.e1-407.e5issue
4eissn
0002-9378issn
1097-6868pii
S0002-9378(17)30120-5journal_volume
216pub_type
杂志文章abstract::Herein is the first reported case of bartholinitis complicated by toxic shock-like syndrome. Streptococcal exotoxin is implicated in this case of nonmenstrual toxic shock-like syndrome, which is an increasingly recognized manifestation of streptococcal infection. Further surveillance, investigation, and reporting of s...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90163-4
更新日期:1989-05-01 00:00:00
abstract:OBJECTIVE:Our purpose was to compare the estimated maternal cerebral perfusion pressure and an index of vascular resistance, the resistance area product, in nonpregnant women with hypertensive pregnant women. STUDY DESIGN:The maternal middle cerebral artery was evaluated by transcranial Doppler ultrasonography in 17 n...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70131-0
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVE:Our purpose was to study the effects of postmenopausal hormone replacement therapy on the uterus and uterine circulation. STUDY DESIGN:The study population consisted of 432 women, 58 to 59 years of age. Color Doppler ultrasonography with a transvaginal probe was used to measure the size of the uterus and the...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90506-e
更新日期:1993-02-01 00:00:00
abstract::Relationships among prepregnancy weight status, prenatal weight gain, and the outcome of 922 twin gestations delivered at term were retrospectively investigated with the use of data provided by linked birth-death certificates in Kansas, 1980 to 1986. Infant birth weights were found to increase linearly with prenatal w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90845-x
更新日期:1990-01-01 00:00:00
abstract::Ovaries from six women with normal menstrual cycles, a follicle wall biopsy specimen from a gonadotropin-stimulated preovulatory ovary, and a corpus luteum of pregnancy were examined by immunohistochemistry for the presence of immunoreactive renin and angiotensin II. Both antisera densely stained thecal and stromal ce...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90077-x
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:We investigated whether maternal plasma levels of the placental hormone corticotropin-releasing hormone are elevated in pregnancies complicated by preterm labor. STUDY DESIGN:Mean maternal corticotropin-releasing hormone levels were studied in women who met specific criteria for preterm labor and in women w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)90606-1
更新日期:1992-04-01 00:00:00
abstract::In 1970 Morgan described an operation designed to meet the problem created by scarring and fibrosis resulting from previous operative procedures to the urethra and bladder neck. In the method, a 2 cm wide polypropylene (Marlex) mesh is placed as a broad hammock to elevate and support the urethrovesical junction with l...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90681-1
更新日期:1979-02-01 00:00:00
abstract::The effect of menstrual cycle phases on the indexes of magnesium and zinc status was assessed in five normally menstruating women. Plasma concentrations of magnesium and zinc and the magnesium and zinc content of red blood cells and peripheral blood mononuclear cells were measured for 3 or 5 days per week during three...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80096-0
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVE:Our purpose was to assess the effects of the adjunctive use of cardiovascular dynamics monitoring in the ambulatory management of 199 pregnant patients with severe hypertension. STUDY DESIGN:A prospective, observational study was performed. Determinants of mean arterial pressure were computed by using the Ho...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.123744
更新日期:2002-06-01 00:00:00
abstract::Since 1955 standardized treatment applied uniformly to all cases of eclampsia at Parkland Memorial Hospital has consisted of (1) magnesium sulfate intravenously and intramuscularly to control convulsions, (2) intravenous hydralazine intermittently to lower diastolic blood pressure when it exceeded 110 mm. Hg, and (3) ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90042-3
更新日期:1975-11-01 00:00:00
abstract:OBJECTIVE:Our purpose was to investigate perfusion pressure changes ex vivo induced by angiotensin II on fetoplacental vasculature pretreated with low-dose acetylsalicylic acid. STUDY DESIGN:Two cotyledons from each of 12 placentas were perfused. The intervillous space of one cotyledon was infused with acetylsalicylic...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)70021-8
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:A growing literature suggests that minority races, particularly Black women, have a lower probability of live birth and higher risk of perinatal complications after autologous assisted reproductive technology. However, questions still remain as to whether these racial disparities have arisen because of assoc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2020.09.013
更新日期:2020-09-12 00:00:00
abstract::To test the hypothesis that intrauterine insemination with washed spermatozoa induces antisperm antibody formation, we measured serum antisperm antibody levels by the Immunobead technique in a population of women receiving exogenous gonadotropins. Antibody levels were measured before therapy (baseline) and then serial...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(89)80045-6
更新日期:1989-03-01 00:00:00
abstract::Paired maternal and fetal atrial natriuretic peptide concentrations were measured in 62 percutaneous umbilical blood samplings performed principally for the assessment and treatment of rhesus isoimmunization. Pretransfusion fetal atrial natriuretic peptide levels were significantly higher than maternal atrial natriure...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90419-r
更新日期:1991-10-01 00:00:00
abstract:OBJECTIVE:We hypothesized that diagnostic approaches to lower genital tract infections are inaccurate and proposed this study to evaluate typical approaches. STUDY DESIGN:Clinical diagnoses were made with symptoms, direct observation, wet mount, vaginal pH, and amines in 598 women with genital complaints. Laboratory 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.2004.02.015
更新日期:2004-04-01 00:00:00
abstract::Autosomal recessive polycystic kidney disease is frequently diagnosed in utero by obstetric ultrasonography. We report a case in which there were varying outcomes of this disorder in three affected fetuses in a family. Recognition of variable expression within one family is important when parents are considering termi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91672-w
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to evaluate the differences in vaginal culture, microscopy, and Gram stain between postmenopausal women who wear pessaries and those who do not to explain pessary-related, bothersome vaginal discharge. STUDY DESIGN:Postmenopausal women not using exogenous estrogen who had eithe...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.07.024
更新日期:2015-01-01 00:00:00
abstract::After the adoption of the use of umbilical artery and middle cerebral artery peak systolic velocity in high-risk pregnancies and in pregnancies that are at risk of having an anemic fetus, the main focus of Doppler ultrasonography in obstetrics today is intrauterine growth-restricted fetuses. What is most needed at thi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.10.054
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:We sought to investigate CpG-island methylation profiling of apoptotic genes apoptotic protease activating factor 1, caspase 8, death-associated protein kinase (DAPK), tumor necrosis factor receptor superfamily member 6 (FAS), Survivin, and tumor necrosis factor-related apoptosis-inducing ligand receptor-1 an...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.11.037
更新日期:2010-03-01 00:00:00
abstract::It has recently been suggested that platelet-activating factor is involved in a number of processes associated with reproductive biology. We have demonstrated a critical role for this autacoid in the initiation and maintenance of parturition both in animals and man. In the present investigation, it has been demonstrat...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)90610-3
更新日期:1992-04-01 00:00:00
abstract:OBJECTIVE:The molecular mechanisms underlying ectopic implantation have not been well characterized. Here we investigate HOXA10 gene expression at the site of ectopic implantation as compared with the endometrium and with the normal fallopian tube. STUDY DESIGN:Northern blot analysis was used to evaluate HOXA10 gene m...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.01.066
更新日期:2004-05-01 00:00:00
abstract::The source of amniotic fluid prolactin was investigated with the use of amnion, chorion, placenta, and decidual tissue taken from term human pregnancy. Decidua alone of these tissues contained significant quantities of prolactin. The release of decidual prolactin was affected by the presence or absence of oxygen and p...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)33248-3
更新日期:1977-01-15 00:00:00
abstract:BACKGROUND:The combination of the qualitative fetal fibronectin test and cervical length measurement has a high negative predictive value for preterm birth within 7 days; however, positive prediction is poor. A new bedside quantitative fetal fibronectin test showed potential additional value over the conventional quali...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.08.012
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:We sought to describe the peripartum outcome of women weighing >300 pounds (135 kg) who were candidates for trial of labor after a prior cesarean delivery. STUDY DESIGN:All pregnant women who weighed in excess of 300 pounds and had a prior cesarean delivery were included in this prospective investigation. St...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.116729
更新日期:2001-08-01 00:00:00
abstract::Plasma triglyceride concentration and blood oxygen tension were measured in samples obtained by cordocentesis from 35 small- and 54 appropriate-for-gestational-age fetuses at 18 to 36 weeks' gestation. In the appropriate-for-gestational-age fetuses there was an exponential decrease in plasma triglycerides with gestati...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90391-j
更新日期:1990-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the prevalence of burnout in chairs of academic departments of obstetrics and gynecology, identify important stressors, and develop strategies to treat and prevent burnout. STUDY DESIGN:We performed a cross-sectional study of 131 chairs in the United States and Puer...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.122391
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Since its debut in 2011, cell-free fetal DNA screening has undergone rapid expansion with respect to both utilization and coverage. However, conclusive data regarding the clinical validity and utility of this screening tool, both for the originally included common autosomal and sex-chromosomal aneuploidies a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2017.10.005
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Umbilical cord arterial blood gas values are used to diagnose fetal acidemia; however, arterial cord blood specimens are frequently not available. OBJECTIVE:We sought to assess whether umbilical cord venous blood gas values can be used to reliably predict fetal acidemia. STUDY DESIGN:This is an observation...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2017.05.047
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the relationship between gestational age and outcomes of outborn versus inborn preterm infants. STUDY DESIGN:Multivariable logistic regression analysis was used to examine gestational age-specific, risk-adjusted outcomes of 2962 singleton infants who were born at <32 ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.139
更新日期:2003-03-01 00:00:00
abstract::Fifty-one patients with granulosa-cell tumors and nine patients with Sertoli-Leydig-cell tumors have been treated at the M. D. Anderson Hospital. The most important prognostic finding was the stage of the tumor when first seen. Conservative surgery was utilized in young patients with lesions confined to one ovary. Mor...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90577-9
更新日期:1976-06-01 00:00:00