Abstract:
OBJECTIVE:To estimate the incidence of occult uterine sarcoma and leiomyosarcoma in hysterectomies for leiomyomas and the risk associated with their morcellation. METHODS:We conducted a population-based cohort study. All uterine sarcomas from 2006-2013 in an integrated health care system were identified. Age- and race-specific incidences of occult uterine sarcoma were calculated. Kaplan-Meier survival analysis was performed. Crude and adjusted risk ratios of recurrence and death associated with morcellation at 1, 2, and 3 years were estimated using Poisson regression with inverse probability weighting. RESULTS:There were 125 hysterectomies with occult uterine sarcomas identified among 34,728 hysterectomies performed for leiomyomas. The incidence of occult uterine sarcoma and leiomyosarcoma was 1 of 278 or 3.60 (95% confidence interval [CI] 2.97-4.23) and 1 of 429 or 2.33 (95% CI 1.83-2.84) per 1,000 hysterectomies. For stage I leiomyosarcoma (n=111), eight (7.2%) were power and 27 (24.3%) nonpower-morcellated. The unadjusted 3-year probability of disease-free survival for no morcellation, power and nonpower morcellation was 0.54, 0.19, and 0.51, respectively (P=.15); overall survival was 0.64, 0.75, and 0.68, respectively (P=.97). None of the adjusted risk ratios for recurrence or death were significant except for death at 1 year for power and nonpower morcellation groups combined (6/33) compared with no morcellation (4/76) (5.12, 95% CI 1.33-19.76, P=.02). We had inadequate power to infer differences for all other comparisons including 3-year survival and power morcellation. CONCLUSION:Morcellation is associated with decreased early survival of women with occult leiomyosarcomas. We could not accurately assess associations between power morcellation and 3-year survival as a result of small numbers.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Raine-Bennett T,Tucker LY,Zaritsky E,Littell RD,Palen T,Neugebauer R,Axtell A,Schultze PM,Kronbach DW,Embry-Schubert J,Sundang A,Bischoff K,Compton-Phillips AL,Lentz SEdoi
10.1097/AOG.0000000000001187subject
Has Abstractpub_date
2016-01-01 00:00:00pages
29-39issue
1eissn
0029-7844issn
1873-233Xpii
00006250-201601000-00007journal_volume
127pub_type
杂志文章abstract::In 21 pregnant women (seven in the first trimester and 14 in the second trimester), laminaria tents inserted for induction of elective abortion were removed after dilatation had been achieved, but upon the patient's request, the abortion was not carried out. Four patients again changed their minds and had uncomplicate...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract::Adverse outcomes, preventable or otherwise, are a reality of medical care. Most importantly, adverse events affect patients, but they also affect health care practitioners. Disclosing information about adverse events has benefits for the patient and the physician and, ideally, strengthens the patient-physician relatio...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001813
更新日期:2016-12-01 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::A case-control study of 209 vulvar cancer patients and 348 community controls allowed assessment of risk factors for this rare tumor. As with cervical cancer, risk increased with the number of reported lifetime sexual partners, with five or more partners associated with two- to threefold increases in risk compared wit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-05-01 00:00:00
abstract::Serum measurements of beta-human chorionic gonadotropin (beta-hCG) for pregnancy tests are now positive at very low levels (25 mIU/mL). Sonography is the diagnostic method of choice for patients with the possibility of intrauterine trophoblastic disease. A case is reported in which ultrasound confused an ovarian neopl...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198603001-00027
更新日期:1986-03-01 00:00:00
abstract::A 22-month-old child with a large cyst of Gartner's duct suffered from recurrent episodes of urinary retention. Excision of such large symptomatic cysts has been recommended in the past. Marsupialization is discussed as an alternative to extensive excision. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:Cortical blindness is characterized by loss of vision in the presence of intact anterior visual pathways. Anton syndrome, a form of anosognosia, is a rare complication of cortical blindness involving compromise of the visual association centers, with resulting patient denial of blindness. Both syndromes have...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00718-7
更新日期:1998-05-01 00:00:00
abstract::The cesarean delivery rate has quadrupled during the past two decades, resulting in considerable attention focused on alternatives to cesarean birth. One option, vaginal birth after one previous cesarean, has come to be recognized as an acceptable alternative to routine elective repeat cesarean delivery. The purpose o...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-02-01 00:00:00
abstract:OBJECTIVE:To investigate neonatal morbidity and maternal complication rates with delivery body mass index (BMI) 60 or greater. METHODS:This retrospective, multicenter cohort study included singleton pregnancies between 23 and 42 weeks of gestation from January 2005 to April 2016. Women with BMI 60 or greater were comp...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/AOG.0000000000002316
更新日期:2017-11-01 00:00:00
abstract::The management of a patient with an ovarian cyst weighing 71.1 kg is described. Preoperative paracentesis did not improve the condition of the patient and should be avoided. Supine hypotension from vena caval occlusion, technically difficult surgery, massive blood replacement, prolonged postoperative ventilatory failu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-08-01 00:00:00
abstract::Delayed umbilical cord clamping appears to be beneficial for term and preterm infants. In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. There is a small increa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000001860
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the sexual and reproductive health characteristics of women in treatment for opioid use disorder in Michigan and explore services provided and desired. METHODS:We conducted a cross-sectional study of female patients aged 18-50 years who accessed opioid use disorder treatment at 22 randomly select...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003666
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:A pregnancy with Gorham disease (massive osteolysis syndrome) is described. To our knowledge, this is the first reported case of a pregnancy associated with this disease. CASE:A 25-year-old woman was seen for pre-conception counseling with the diagnosis of Gorham disease. Before pregnancy, magnetic resonanc...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:To test the primary hypothesis that extremely preterm children antenatally exposed to both magnesium sulfate and antenatal corticosteroids have a lower rate of severe neurodevelopmental impairment or death compared with those exposed to antenatal corticosteroids alone. METHODS:This was a prospective observat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/AOG.0000000000003882
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:To assess whether primary and secondary vestibulodynia represent different pathologic pathways. METHODS:This was an analysis of archived vestibulectomy specimens from 88 premenopausal women with vestibulodynia (2002-2008). Patient records were reviewed to classify the type of vestibulodynia, duration of symp...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31821c33dc
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Small cell carcinoma of the ovary is an aggressive tumor primarily affecting young women. Despite adjuvant therapy, the majority of patients described in the literature have fared poorly, even when the disease is diagnosed at an early stage. CASE:A 19-year-old nulligravida with small cell carcinoma of the l...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000124996.56880.d9
更新日期:2004-05-01 00:00:00
abstract::A prospective randomized study was undertaken in 100 patients undergoing cesarean section to evaluate the efficacy of cefotaxime when given as a single-dose versus the more traditional triple-dose regimen for prophylaxis. Analysis of the results demonstrated no significant differences in febrile morbidity (14 versus 2...
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:1985-02-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy and safety of an oral formulation of tranexamic acid for the treatment of heavy menstrual bleeding. METHODS:Adult women with heavy menstrual bleeding (mean menstrual blood loss 80 mL or more per cycle) were enrolled in a double-blind, placebo-controlled study. After two pretreatment me...
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.0b013e3181f20177
更新日期:2010-10-01 00:00:00
abstract::Laparoscopic radiofrequency ablation of uterine leiomyomas with a new Federal Drug Administration (FDA)-approved device, a device that delivers radiofrequency energy, is a novel procedure that aims to meet patient and physician demand for effective, minimally invasive leiomyoma treatment. However, as a new procedure, ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000914
更新日期:2015-08-01 00:00:00
abstract::Recommendations for activity after obstetric and gynecologic procedures remain based on tradition and anecdote. After reviewing the current evidence base, guidelines, and practice for postdischarge instructions related to physical activity after the most common obstetric and gynecologic surgical procedures, we conclud...
journal_title:Obstetrics and gynecology
pub_type: 社论
doi:10.1097/AOG.0b013e3181b6f50d
更新日期:2009-10-01 00:00:00
abstract::The role of Neisseria gonorrhoeae in the etiology and pathogenesis of acute salpingitis and its relationship to nongonococcal salpingitis were investigated. To accomplish this goal, isolated microorganisms obtained from the fallopian tubes and cul-de-sac via laparoscopy were evaluated in relation to the number of epis...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-07-01 00:00:00
abstract:OBJECTIVE:The objective was to describe timely refills of hormonal contraceptive products among a large, geographically diverse population of U.S. women as an estimate of method continuation over time. METHODS:Longitudinal prescription refills from the Verispan database were collected from 99% of retail pharmacies in ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181875ec5
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To examine the availability of trial of labor after cesarean delivery (TOLAC) in New Mexico from 1998 to 2012 and maternity care providers' perception of barriers to TOLAC. METHODS:Hospital maternity unit directors were surveyed regarding TOLAC availability from 1998 to 2012. Maternity care providers (obstet...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31829bd0a0
更新日期:2013-08-01 00:00:00
abstract::The effect of an 8-hour, 3-dose perioperative regimen of cefazolin or placebo was evaluated in 97 patients. Postoperative morbidity occurred in 13 patients (27.1%) in the cefazolin group and in 17 patients (34.7%) who received placebo. The clinical sites of infection were similar in both groups except that wound infec...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1978-09-01 00:00:00
abstract::Cystadenofibromas are benign ovarian neoplasms containing both epithelial and stromal components. The epithelial component is usually of simple serous type resembling fallopian tube epithelium. Occasionally, tumors with unusual epithelial pattenrs are encountered. In this study, 16 cystadenofibromas with unusual epith...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-12-01 00:00:00
abstract:BACKGROUND:Opportunistic salpingectomy at the time of hysterectomy is currently recommended to reduce the lifetime risk of ovarian cancer. The vaginal route is least invasive, but surgeons sometimes may choose to perform this procedure laparoscopically or robotically when anticipating adnexal surgery as a result of lim...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002746
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To estimate the association between state Medicaid coverage of medically necessary abortion and severe maternal morbidity and in-hospital maternal mortality in the United States. METHODS:We used data on pregnancy-related hospitalizations from the Nationwide Inpatient Sample from 2000 to 2011 (weighted n=38,0...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001982
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To evaluate absorption of estradiol (E2) and compare two low doses of 17 beta-E2 (25 microgram and 10 microgram) in postmenopausal women with atrophic vaginitis. METHODS:In a double-masked, randomized, parallel-group study, 58 postmenopausal women were treated with 25 microgram or 10 microgram of 17 beta-E2 ...
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(01)01385-0
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Warfarin-induced skin necrosis is a rare and dangerous complication affecting 0.01-0.1% of patients on warfarin. Deficiencies in protein C or protein S in association with other factors have been implicated in its etiology. No report has described this disorder in the immediate postpartum period in patients ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00393-1
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost-effectiveness of human papillomavirus (HPV) DNA testing as a primary screening test in combination with cervical cytology in women aged 30 years or more. METHODS:A state-transition mathematical model was used to simulate the natural history of HPV and cervical cancer in a cohort of U.S. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000120143.50098.c7
更新日期:2004-04-01 00:00:00