Abstract:
BACKGROUND:The current recommendation regarding the management of a term newborn delivered of a mother with an intrapartum fever or a diagnosis of clinical chorioamnionitis is that the neonate should have baseline laboratory work drawn along with blood cultures and be universally treated with antibiotics until culture results return. These guidelines report that the rate of intrapartum fever is about 3%; however, a few large studies suggest that the rate is higher at about 7%. OBJECTIVE:We sought to prospectively evaluate the rate of fever during labor in a large number of deliveries and determine the rate of early-onset neonatal sepsis in newborns delivered from mothers with an intrapartum fever compared with newborns delivered from mothers without intrapartum fever. STUDY DESIGN:This was a prospective cohort study of all temperatures obtained in women in labor from Jan. 1, 2011, through June 30, 2014. Every patient with a fever of ≥38°C at ≥36 weeks' gestation was evaluated for gestational age, parity, spontaneous or induced labor, group B streptococcus status, regional anesthesia, mode of delivery, treatment with intrapartum antibiotics, and whether a clinical diagnosis of chorioamnionitis was made by the managing physician. Neonates were assessed for blood culture results, neonatal intensive care unit admission, length of stay, and any major newborn complications. Statistical analysis involved χ2, Fisher exact, and Student t test. RESULTS:A total of 412 patients (6.8%; 95% confidence interval, 6.2-7.5%) developed a fever in 6057 deliveries at ≥36 weeks' gestation. No cases of maternal sepsis occurred. Of the 417 newborns (5 sets of twins), only 1 (0.24%; 95% confidence interval, 0.01-1.3%) developed early-onset neonatal sepsis with a positive blood culture for Escherichia coli. There were 4 cases (0.07%; 95% confidence interval, 0.02-0.18%) of early-onset neonatal sepsis in the 5697 newborns (52 sets of twins) delivered from mothers who were not febrile and this difference was not significant (P = .3). The positive blood cultures in these 4 neonates were 3 group B streptococcus and 1 Enterococcus. The overall rate of early-onset neonatal sepsis in this population of newborns delivered at ≥36 weeks' gestation was 0.82/1000 deliveries. CONCLUSION:The incidence of an intrapartum fever of ≥38°C in pregnancies at ≥36 weeks' gestation is common at 6.8% and this is consistent with the findings of a few other large retrospective studies. The rate of an intrapartum fever occurs in approximately 1 in 15 women in labor. The risk of neonatal sepsis in newborns delivered of mothers with intrapartum fever or a diagnosis of clinical chorioamnionitis is low at 0.24%, a rate that is <1 in 400. The recommendation for universal laboratory work, cultures, and antibiotic treatment pending culture results for this newborn population needs further examination.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Towers CV,Yates A,Zite N,Smith C,Chernicky L,Howard Bdoi
10.1016/j.ajog.2017.02.022subject
Has Abstractpub_date
2017-06-01 00:00:00pages
596.e1-596.e5issue
6eissn
0002-9378issn
1097-6868pii
S0002-9378(17)30291-0journal_volume
216pub_type
杂志文章abstract::The results of predictive fertilization bioassays (hemizona assay, hamster ova-human sperm penetration assay), in vitro fertilization treatment, fertile donor cross-match tests with either sperm or oocytes, and oocyte micromanipulation for assisted fertilization were used to establish a pathophysiologic diagnosis in c...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90684-j
更新日期:1991-05-01 00:00:00
abstract::In order to evaluate the ovarian and adrenal contribution to peripheral plasma concentrations of total testosterone (TTe), indixes of the plasma concentrations of free testosterone (FTeI), free 17 beta-hydroxysteroid androgens (FHSI), and testosterone-binding globulin (TeBG) during the menstrual cycle, women were exam...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90688-8
更新日期:1976-12-15 00:00:00
abstract::We conducted this metaanalysis to summarize the available epidemiologic evidence on the relationship between maternal overweight and obesity and the risk of stillbirth. We identified studies from 3 sources: (1) a PubMed search of relevant articles that were published between January 1980 and September 2005, (2) refere...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ajog.2007.03.027
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:We sought to define the prevalence, trends, and outcomes of primary and secondary chronic hypertension in a population-based sample of deliveries. STUDY DESIGN:An estimated 56,494,634 deliveries were identified from the 1995 through 2008 Nationwide Inpatient Sample. The association of primary and secondary c...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.10.878
更新日期:2012-02-01 00:00:00
abstract::Outpatient endometrial aspiration was offered to patients who suspected that they were pregnant, but were within 5 to 21 days after failure of expected menstruation and had a uterus of normal size on pelvic examination. This is a report of 500 consecutive cases treated between September, 1973, and April, 1975. Histolo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90567-6
更新日期:1976-06-01 00:00:00
abstract:OBJECTIVE:Optimal management of acardiac twin pregnancies is controversial. Data suggest a 50% mortality rate in the "pump" twin when the pregnancy is managed expectantly. Because of increased antenatal diagnosis, outcomes in expectantly managed cases may be better than reported. Our objective was to determine the outc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/s0002-9378(03)00597-0
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:Fetal plasma angiotensin II levels are 10 times the levels found in adults. Despite these high levels, central injection of angiotensin II may stimulate fetal swallowing and increase fetal arterial blood pressure. We postulated that the high rate of spontaneous fetal swallowing and normal fetal pressor regula...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.117310
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the long-term impact of anal sphincter laceration on anal incontinence. STUDY DESIGN:Five to 10 years after first delivery, anal incontinence and other bowel symptoms were measured with the Epidemiology of Prolapse and Incontinence Questionnaire and the short form...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.06.055
更新日期:2012-11-01 00:00:00
abstract::Pre-eclampsia is characterized by uteroplacental ischemia. Prostaglandins can alter systemic blood pressure as well as regulate blood flow to the fetoplacental unit. In the present study, levels of prostaglandin E were significantly decreased in placental tissue from pre-eclamptic patients. Prostaglandin F, a potent v...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90478-6
更新日期:1976-09-01 00:00:00
abstract:OBJECTIVE:We sought to determine whether midpregnancy antioxidant levels are associated with preeclampsia, overall and by timing of onset. STUDY DESIGN:We carried out a case-control study, nested within a cohort of 5337 pregnant women in Montreal, Quebec, Canada. Blood samples obtained at 24-26 weeks were assayed for ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2015.07.027
更新日期:2015-11-01 00:00:00
abstract::A study was conducted to evaluate the sensitivity of the five commercially available home pregnancy testing kits. Known amounts of human chorionic gonadotropin (hCG) were diluted in pooled, sterile male urine. Varying concentrations of hCG were randomly assigned to 100 kits of each of the five brands. The test results...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(82)90351-9
更新日期:1982-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the effects of raloxifene on endothelial function in healthy, postmenopausal women. STUDY DESIGN:This was a randomized, double-blind, placebo-controlled crossover trial. Subjects (n = 19; mean age, 61 years) underwent endothelial function testing at baseline and aft...
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:10.1067/mob.2003.28
更新日期:2003-02-01 00:00:00
abstract::Endocervical Chlamydia trachomatis infection was found in 13 of 162 volunteer female university students (8%). Infection was correlated with younger age (p less than 0.05), less than or equal to 4 years of intercourse (p less than 0.05), a history of gonorrhea (p less than 0.01), and exposure to a partner with urethri...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(85)80105-8
更新日期:1985-10-01 00:00:00
abstract::Revamping the delivery of women's health care to meet future demands will require a number of changes. In the first 2 articles of this series, we introduced the reasons for change, suggested the use of the 'Triple Aim' concept to (1) improve the health of a population, (2) enhance the patient experience, and (3) contr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.08.022
更新日期:2015-01-01 00:00:00
abstract::A previous study reported frequent resistance of the cervix at 9 mm during dilation and interpreted the resistance as the beginning of a tear of the internal os. A more recent identical study did not indicate such tears. Measurement of the dilators revealed that the set used in the previous study had uneven increments...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(88)80157-1
更新日期:1988-10-01 00:00:00
abstract::In order to examine the relationship between circadian rhythms in different steroids, cortisol (F), estrone E1), estradiol (E2), and estriol (E3) were measured by radioimmunoassay in maternal venous plasma taken at 30 to 60-minute intervals over 24 hours from 11 healthy women at 34 to 35 weeks' gestation. Maternal F w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90393-4
更新日期:1979-11-15 00:00:00
abstract:OBJECTIVES:The current study was designed to elucidate risk factors associated with the development of cervical cancer during the course of routine Papanicolaou smear screening (rapid-onset cervical cancer). STUDY DESIGN:Four hundred eighty-three women diagnosed with invasive cervical cancer, representing 73% of all s...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70256-5
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:This study compared birth parameters and the longitudinal course in physical and neurologic development between children with 2 and 3 vessel umbilical cords. STUDY DESIGN:Our study of the Collaborative Perinatal Project included singletons of at least 24 weeks' gestation with single umbilical artery at birth...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.06.031
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the efficacy of osteopathic manipulative treatment (OMT) to reduce low back pain and improve functioning during the third trimester in pregnancy and to improve selected outcomes of labor and delivery. STUDY DESIGN:Pregnancy research on osteopathic manipulation optimi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ajog.2014.07.043
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Mortality associated with cervical cancer is a public health concern for women, particularly in HIV-seropositive women in resource-limited countries. HIV-seropositive women are at a higher risk of high-grade cervical precancer, which can eventually progress to invasive carcinoma as compared to HIV-seronegati...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ajog.2017.03.022
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Developmental exposure to dioxin-like compounds has been associated with cognitive and motor impairments in children. These toxicants have been shown to be thyroid toxicants in animal studies. Therefore, the objective of this study was to quantify the overall dioxin-like activity in maternal serum and determi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.08.013
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVE:We performed a systematic review to evaluate endovaginal cervical ultrasonography as a predictor of preterm delivery. STUDY DESIGN:Selection criteria were original published English-language reports of prospective studies including women at <37 weeks' gestation with intact amniotic membranes. Parameters and ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0002-9378(99)70407-2
更新日期:1999-12-01 00:00:00
abstract::A case of herpes gestationis recurring in each pregnancy, with a postpartum flare-up in the last pregnancy, is described. The diagnosis was confirmed by skin biopsy. The first pregnancy ended in a term stillbirth, but there were favorable outcomes in four subsequent pregnancies. Histopathologic examination of the plac...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90514-r
更新日期:1991-03-01 00:00:00
abstract::Pregnancy-specific beta 1-glycoprotein (SP-1) was measured by radioimmunoassay in patients admitted to the hospital with a clinical diagnosis of hemorrhage in early pregnancy. The results were compared with a normal range and were analyzed for their predictive value in determining prognosis. Six of the total study gou...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(80)90243-4
更新日期:1980-10-01 00:00:00
abstract:OBJECTIVE:Pregnancy induces rapid, progressive, and substantial changes to the cardiovascular system. The low recurrence risk of preeclampsia, despite familial predisposition, suggests an adaptation associated with pregnancy that attenuates the risk for subsequent preeclampsia. We aimed to evaluate the persistent effec...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2015.01.005
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:The study was undertaken to explore the antiproliferative mechanism of action of 2-[piperidinoethoxyphenyl]-3-[4-hydroxyphenyl]-2H-benzo(b)pyran (K-1) in estradiol-induced rat uterine hyperplasia. STUDY DESIGN:Adult ovariectomized rats received vehicle or estradiol alone (20 μg/kg) or estradiol along with K-...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.05.024
更新日期:2011-10-01 00:00:00
abstract::To assess the effect of endogenous human atrial natriuretic peptide on the vascular system in preeclampsia, the circadian variations of plasma human atrial natriuretic peptide, cyclic guanosine 3'5'-monophosphate, cyclic adenosine 3'5'-monophosphate, and blood pressure were measured. In severe preeclamptic women, the ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90110-5
更新日期:1989-01-01 00:00:00
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:OBJECTIVE:The arcus tendineous fasciae pelvis (ATFP) provides support to the anterior vagina. The objective of this study was to determine the impact of menopause on the structural components of the ATFP. STUDY DESIGN:Biopsy specimens of the ATFP were obtained from 10 premenopausal, 5 postmenopausal, and 12 postmenopa...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2003.08.040
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to examine the contribution of electronic fetal heart rate monitoring in the prediction and prevention of intrapartum fetal asphyxia in the preterm pregnancy. STUDY DESIGN:The outcome of 40 pregnancies with biochemically confirmed intrapartum fetal asphyxia (ie, an umbilical artery ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.119642
更新日期:2002-02-01 00:00:00