Abstract:
:The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine recently published consensus guidelines on periviable birth recommending that obstetric interventions (antenatal corticosteroids, tocolysis, magnesium sulfate, antibiotics for preterm premature rupture of membranes or group B streptococcus prophylaxis, and cesarean delivery for fetal indications) may be considered at 23 0/7 weeks of gestation and neonatal resuscitation at 22 0/7 weeks of gestation. Cervical cerclage significantly decreases preterm delivery and improves perinatal outcomes in women with a singleton pregnancy, prior spontaneous preterm birth, and transvaginal cervical length less than 25 mm before 24 0/7 weeks of gestation or in women who experience painless cervix dilation in the second trimester. Randomized trials assessing ultrasonogram-indicated and physical examination-indicated cerclage report a procedure-related complication rate of 0.3% and 0.9%, respectively. If previability is a requisite for receiving a cerclage, an increasing subset of women may not be afforded an intervention that has known benefit, because obstetric and neonatal interventions are likely to occur at earlier gestational ages. Given the low procedure-related complication rate demonstrated in randomized trials, appropriately selected women should continue to be offered the procedure up to 24 0/7 weeks of gestation. Based on current evidence, cerclage placed after 24 0/7 weeks of gestation cannot be recommended, and future inquiry in the form of a well-designed randomized trial after this gestational age should be considered. The goal of this commentary is to review the history of cerclage and discuss the indications, risks, benefits, and implications on future research of this procedure as it relates to gestational age during periviability.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Dahlke JD,Sperling JD,Chauhan SP,Berghella Vdoi
10.1097/AOG.0000000000001391subject
Has Abstractpub_date
2016-05-01 00:00:00pages
934-940issue
5eissn
0029-7844issn
1873-233Xpii
00006250-201605000-00018journal_volume
127pub_type
杂志文章abstract:OBJECTIVE:To quantify the current perinatal consequences associated with intrapartum detection of meconium in the amniotic fluid (AF). METHODS:We compared retrospectively the outcomes in 8136 term singleton cephalic pregnancies with meconium and 34,573 similar pregnancies with clear AF. RESULTS:Virtually all measures...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::Accurately defining a patient's risk of developing breast cancer is a challenging endeavor. Many factors have been implicated in the causation of breast cancer and quantifying them is difficult. Risk stratification is performed using population models, such as the Gail model, as well as the patient's personal and fami...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000295638.83285.97
更新日期:2007-12-01 00:00:00
abstract::Amniotic fluid alpha-fetoprotein (AFP) assays and detailed ultrasound examinations were performed in 376 prenatal patients at risk for a neural tube defect (high-risk group). In addition, 2436 patients who underwent amniocentesis for other indications underwent preamniocentesis ultrasound screening and amniotic fluid ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1982-08-01 00:00:00
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:OBJECTIVE:To compare the representation of women in obstetrics and gynecology department-based leadership to other clinical specialties while accounting for proportions of women in historical residency cohorts. METHODS:This was a cross-sectional observational study. The gender of department-based leaders (chair, vice ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001290
更新日期:2016-03-01 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:OBJECTIVE:To examine racial differences in hormone replacement therapy (HRT) use by analyzing the relative risks and rates of HRT prescriptions for black and white women. METHODS:Data on visits to hospital outpatient departments and office-based physicians by black and white women aged 45-64 years were obtained from 2...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00540-7
更新日期:1999-06-01 00:00:00
abstract::Sixty-two cases of oligohydramnios diagnosed by ultrasound between 13-28 weeks' gestation were reviewed. Three experienced ultrasonographers used a subjective scale to rate the oligohydramnios as mild, moderate, severe, or anhydramniotic. Interobserver reliability was excellent (intraclass correlation coefficient 0.81...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-05-01 00:00:00
abstract::The effect of noncreatinine chromogens on the endogenous creatinine clearance (ECC) during pregnancy was investigated. It was found that these chromogens measured as plasma "creatinine" cause a significant reduction in the ECC value. This fact should be considered when the ECC value is used to evaluate renal function ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND:To reorganize reusable laparoscopic instrumentation to promote instrument accessibility, minimize instrument breakage, eliminate infrequently used instruments on permanent trays, and help control maintenance costs. TECHNIQUE:The Robert Wood Johnson University Hospital Gynecologic Steering Committee evaluate...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:Diphallia poses several surgical, psychological, and esthetic issues. Currently, diphallia is only diagnosed after birth. CASE:We present a true diphallia in one fetus of dichorionic twins noted at 23 weeks of gestation. In this fetus, two phallus-like protrusions and a bifid scrotum, as well as a duplicate...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000327
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Endocardial fibroelastosis is a congenital heart disease known to cause congestive heart failure in early infancy. We report a case using new modalities for early prenatal diagnosis of endocardial fibroelastosis causing fetal heart failure. CASE:A multipara with two children, who died of endocardial fibroel...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01505-8
更新日期:2001-11-01 00:00:00
abstract::Two U.S. Food and Drug Administration public health warnings regarding the use of mesh in stress incontinence and prolapse repairs have had far-reaching clinical and legal consequences. In this commentary, we explore the drastically distinct results from these mesh-based procedures, which revealed systemic flaws with ...
journal_title:Obstetrics and gynecology
pub_type: 社论
doi:10.1097/AOG.0000000000002776
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:To estimate the diagnostic accuracy of electronic fetal heart rate abnormalities in the identification of neonates with encephalopathy treated with whole-body hypothermia. METHODS:Between January 1, 2007, and July 1, 2013, there were 39 neonates born at two hospitals within our system treated with whole-body...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000424
更新日期:2014-09-01 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::The second case is reported of renal failure in association with XY gonadal dysgenesis. The random association of these conditions appears unlikely. Recognition of a possible association is important because of potential fatality due to renal failure or gonadoblastoma in unrecognized cases. In groups at risk, follicle...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVE:To determine risk factors for hysterectomy, pelvic pain, and continued menorrhagia after rollerball endometrial ablation. METHODS:All women having rollerball endometrial ablations between 1990 and 2000 were sent standardized questionnaires on pre- and postablation symptoms, satisfaction with the ablation, an...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)02185-3
更新日期:2002-10-01 00:00:00
abstract::All cases of dermatomyositis-polymyositis in women seen between 1970 and 1977 at Baylor Affiliated Hospitals were reviewed. Twenty-five patients were identified with this diagnosis. Of these women, 5 were found to have a malignant tumor: 3 ovarian carcinomas, 1 cervical intraepithelial carcinoma, and 1 colon carcinoma...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-10-01 00:00:00
abstract::All 119 medical schools in the United States provided information for a study of academic manpower conducted by the Association of Professors of Gynecology and Obstetrics (APGO). The average number of full-time faculty members per medical school is 13.2, with 2 positions vacant per school. Subspecialists are concentra...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-05-01 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 assess the effect of prenatal vitamin K1 on the coagulation status of newborns. METHODS:We measured noncarboxylated prothrombin and performed the Normotest in two groups of 5-day-old infants whose mothers were given oral vitamin K1, 10 mg/day for 2 weeks at least 10 days before delivery, or were untreated...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:To assess whether lack of patient preparation for common physical and emotional postpartum symptoms is associated with patient satisfaction with obstetric clinicians. METHODS:We conducted a telephone survey of 724 postpartum women. Women were interviewed 2 weeks postpartum to assess self-perceived preparatio...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181c8b39b
更新日期:2010-02-01 00:00:00
abstract::A simple, rapid, economical, and accurate test to assess fetal pulmonary maturity on a 24-hour basis, 7 days a week, is urgently needed. A 15-minute test has been developed that correlates well with fetal pulmonary maturity. Optical density (OD) readings at 650 nm of greater than or equal to 0.15 in pigment-free, cent...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract::In an effort to improve maternal and fetal outcome in patients laboring with thick meconium, 85 patients presenting with thick meconium were randomized to receive either amnioinfusion with 1000 mL normal saline initially and every 6 hours until delivery, or routine care. Meconium was discovered on initial examination ...
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:1989-04-01 00:00:00
abstract:OBJECTIVES:To define the profile of 24-hour uterine activity in normal pregnancy and to correlate contraction frequency with physical activity and emotional stress diaries. METHODS:One hundred nine low-risk pregnant women who delivered at term recorded uterine contractions for 24 hours twice weekly from 20-40 weeks' g...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199404000-00006
更新日期:1994-04-01 00:00:00
abstract::The phenomenon of adolescent childbearing is complex and far reaching, affecting not only the adolescents but also their children and their community. The prevalence and public health effect of adolescent pregnancy reflect complex structural social problems and an unmet need for acceptable and effective contraceptive ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002632
更新日期:2018-05-01 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 method of reanastomosis of the uterine tube after Pomeroy tubal ligation is presented. The pregnancy rate was 69%. The viable birth rate was 38%, with 1 ectopic pregnancy, 2 patients pregnant, and 1 patient lost to followup at the time of this report. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-05-01 00:00:00
abstract::Five hundred twelve patients who presented with initial atypical cervical cytology between February 1982 and February 1983 at Naval Hospital, San Diego were randomized with respect to antibiotic treatment and interval before repeat cytologic examination. Treatment before repeat cytology did not improve the rate of rev...
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:1986-08-01 00:00:00
abstract:OBJECTIVE:To determine whether glucagon has relaxant effects on the spontaneous contractions of term pregnant human uterine smooth muscle in an isolated preparation. METHODS:Myometrial specimens were excised from the upper incisional surface of the lower uterine segment in seven women during elective cesarean delivery...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00283-9
更新日期:1996-11-01 00:00:00