Abstract:
BACKGROUND:Induction of labor occurs in >20% of pregnancies, which equates to approximately 1 million women undergoing an induction in the United States annually. Regardless of how common inductions are, our ability to predict induction success is limited. Although multiple risk factors for a failed induction have been identified, risk factors alone are not enough to quantify an actual risk of cesarean for an individual woman undergoing a cesarean. OBJECTIVE:The objective of this study was to derive and validate a prediction model for cesarean after induction with an unfavorable cervix and to create a Web-based calculator to assist in patient counseling. STUDY DESIGN:Derivation and validation of a prediction model for cesarean delivery after induction was performed as part of a planned secondary analysis of a large randomized trial. A predictive model for cesarean delivery was derived using multivariable logistic regression from a large randomized trial on induction methods (n = 491) that took place from 2013 through 2015 at an academic institution. Full-term (≥37 weeks) women carrying a singleton gestation with intact membranes and an unfavorable cervix (Bishop score ≤6 and dilation ≤2 cm) undergoing an induction were included in this trial. Both nulliparous and multiparous women were included. Women with a prior cesarean were excluded. Refinement of the prediction model was performed using an observational cohort of women from the same institution who underwent an induction (n = 364) during the trial period. An external validation was performed utilizing a publicly available database (Consortium for Safe Labor) that includes information for >200,000 deliveries from 19 hospitals across the United States from 2002 through 2008. After applying the same inclusion and exclusion criteria utilized in the derivation cohort, a total of 8466 women remained for analysis. The discriminative power of each model was assessed using a bootstrap, bias-corrected area under the curve. RESULTS:The cesarean delivery rates in the derivation and external validation groups were: 27.7% (n = 136/491) and 26.4% (n = 2235/8466). In multivariable modeling, nulliparity, gestation age ≥40 weeks, body mass index at delivery, modified Bishop score, and height were significantly associated with cesarean. A nomogram and calculator were created and found to have an area under the curve in the external validation cohort of 0.73 (95% confidence interval, 0.72-0.74). CONCLUSION:A nomogram and user-friendly Web-based calculator that incorporates 5 variables known at the start of induction has been developed and validated. It can be found at: http://www.uphs.upenn.edu/obgyn/labor-induction-calculator/. This calculator can be used to augment patient counseling for women undergoing an induction with an unfavorable cervix.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Levine LD,Downes KL,Parry S,Elovitz MA,Sammel MD,Srinivas SKdoi
10.1016/j.ajog.2017.11.603subject
Has Abstractpub_date
2018-02-01 00:00:00pages
254.e1-254.e7issue
2eissn
0002-9378issn
1097-6868pii
S0002-9378(17)32474-2journal_volume
218pub_type
杂志文章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::In the conservative management of premature rupture of the membranes, most patients have oligohydramnios caused by continuous leakage of amniotic fluid. To avoid unfavorable effects of oligohydramnios on fetal development and well-being, we infused physiologic saline solution continuously into the amniotic cavity at a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90243-3
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:There is a marked increase in the use of selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors in the last decade. Many newborns are likely to be exposed during pregnancy and labor. OBJECTIVE:We aimed to evaluate the association between exposure to selective serotonin reup...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ajog.2018.08.030
更新日期:2019-01-01 00:00:00
abstract::Antimicrobial overutilization accelerates the development of bacterial resistance. A prospective, randomized, blinded clinical trial of vaginal hysterectomy prophylaxis was designed to compare the efficacy, safety, and costs of cefazolin with those of cefoxitin and cefotaxime. Sixteen women (7.5%) developed febrile mo...
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:10.1016/0002-9378(87)90144-x
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:Only 64% of obstetrics and gynecology program directors report routine, scheduled training in abortion, despite the Accreditation Council for Graduate Medical Education's requirements for routine training. Most report that exposure to training is limited to specific clinical circumstances. OBJECTIVE:We soug...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2019.04.026
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:Amino acid substitutions in platelet membrane glycoproteins result in alloantigens implicated in neonatal alloimmune thrombocytopenia. We report the use of the reverse dot blot technique to genotype the five major fetal platelet alloantigens from amniotic fluid cells. STUDY DESIGN:We evaluated a patient with...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)91353-x
更新日期:1995-10-01 00:00:00
abstract::Cholecystosonography was performed on 338 obstetric patients, and the gallbladder was successfully visualized in 93% of them. Gallbladder volume increased with duration of pregnancy. Three and one-half percent of the patients had obvious cholelithiasis, and a total of 4.2% had abnormalities. These findings suggest tha...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(82)90434-3
更新日期:1982-11-15 00:00:00
abstract:BACKGROUND:The relative impact of age, pregnancy, and vaginal delivery on symptomatic pelvic organ prolapse is still an unresolved issue that involves the controversial question about the protective effect of cesarean section. OBJECTIVE:The purpose of this study was to compare the age-related prevalence of symptomatic...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2019.10.007
更新日期:2020-04-01 00:00:00
abstract::Brachial artery Doppler flow velocity waveforms were recorded from 10 nonpregnant women and 19 women with uncomplicated pregnancies. The pregnant group showed higher peak systolic frequencies (3.24 compared with 2.26, p = 0.01), higher maximum end-diastolic frequencies (0.62 compared with 0.25, p = 0.01), and lower pu...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90026-n
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVE:Our objective was to explore the association between maternal ethnicity and maternal antepartum complications of pregnancy, maternal sociodemographic factors, and newborn characteristics with the incidence of hyaline membrane disease. STUDY DESIGN:By using a retrospective cohort analysis the incidence of hya...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90496-6
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:Our objective was to evaluate women with clinical signs or chemical evidence of androgen excess by corticotropin stimulation testing. STUDY DESIGN:Seventy-six women with evidence of androgen excess were evaluated by corticotropin stimulation testing. Results were examined by plasma levels of dehydroepiandros...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91406-9
更新日期:1992-08-01 00:00:00
abstract::A review of 80 cases of planned or anticipated cesarean hysterectomies done at major centers in the greater Los Angeles area is presented. There were no deaths and five cases of morbidity. Nineteen percent, or one of five cases, required blood transfusions. According to the recommendation of the American Association o...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90287-4
更新日期:1984-05-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine the proportion of pregnancy loss after genetic amniocentesis that is related to preexisting subclinical intrauterine inflammation. STUDY DESIGN:We accessed our bank of stored second-trimester amniotic fluid and maternal serum samples obtained from women undergoing genetic amnioce...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)80007-x
更新日期:1996-10-01 00:00:00
abstract::The levels of unconjugated estriol in maternal vein serum during labor, cord artery serum, and cord vein serum were measured in normal pregnancy and in pregnancy complicated by intrauterine growth retardation. The mean level of unconjugated estriol in maternal vein serum was significantly lower in the intrauterine gro...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:Our purpose was to review the findings of a Gynecologic Endoscopic Review Committee established to monitor and review operative endoscopic procedures performed by the staff at a large private hospital, Swedish Hospital Medical Center, in Seattle. STUDY DESIGN:Hospital charts of patients undergoing the endosc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract::An analysis of United States birth certificate records for the calendar year 1977 indicated that women who failed to seek prenatal care were at increased risk of delivery of a low-birth weight infant, even after social factors were considered. However, the strength of association, as well as the population impact, bet...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)90681-6
更新日期:1983-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine surgical outcomes for the correction of clitoral phimosis caused by lichen sclerosus. STUDY DESIGN:Eight women with lichen sclerosus underwent surgical repair of clitoral phimosis. They were assessed 12-36 months postoperatively by an independent research assistant. A...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.08.023
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:The objective of the investigation was to study placental transfer and conjugation of bisphenol A (BPA) across the human placenta. STUDY DESIGN:Human placentae obtained from healthy term singleton pregnancies were utilized in a dual recirculating model of ex vivo placental perfusion. Seven placentae were per...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.01.025
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to test the adaptation of autonomic modulation of heart rate in high-risk or in vitro fertilization (IVF) pregnancies during the first trimester. STUDY DESIGN:Thirty-three pregnant women were studied between 6.0 and 12.5 weeks of gestation and were divided into three groups: no...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(03)00896-2
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVES:Preeclampsia is associated with hypertension, fetal growth retardation, and proteinuria. We hypothesized that impaired vascular nitric oxide synthesis during pregnancy may be an important causal factor in preeclampsia. STUDY DESIGN:An inhibitor of nitric oxide synthase, L-nitro-arginine methyl ester, or a n...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90299-x
更新日期:1993-11-01 00:00:00
abstract::The excess risk of nonfatal myocardial infarction among users of oral contraceptives observed in England and Wales can be explained in terms of the high proportion of smokers in the study population. Among nonsmokers, the relative risk associated with the use of oral contraceptives is estimated to be 2 to 1, which is ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90539-1
更新日期:1976-10-01 00:00:00
abstract:OBJECTIVE:We sought to evaluate an intrapartum nucleic acid amplification test (NAAT) for group B streptococcus (GBS). STUDY DESIGN:This was a prospective cohort study of 559 women comparing intrapartum GBS culture with antepartum culture and intrapartum NAAT. RESULTS:GBS prevalence was 19.5% by antepartum culture an...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.06.087
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:Postpartum infections are polymicrobial and typically include Ureaplasma, an intracellular microbe that is treated by macrolides such as azithromycin. The aim of this study was to evaluate the perinatal pharmacokinetics of azithromycin after a single preincision dose before cesarean delivery. STUDY DESIGN:Th...
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.2015.01.015
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Complex oncologic surgeries, including those for endometrial cancer, increasingly have been concentrated to greater-volume centers, owing to previous research that has demonstrated associations between greater surgical volume and improved outcomes. There is a potential for concentration of care to have unwan...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2019.07.026
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the contribution of randomization to nicotine replacement therapy (NRT), sociodemographic and psychosocial factors, and pregnancy and medical history to serious perinatal adverse events among pregnant smokers. STUDY DESIGN:We performed a retrospective review of all ...
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.2009.06.006
更新日期:2009-10-01 00:00:00
abstract::The effects of glucocorticoids on primate fetal lung function have not been clearly delineated. In this prospective study of preterm rhesus fetuses exposed in utero to betamethasone for 72 hours, the most significant alteration was a striking increase in maximum lung volumes. Functionally less significant increases in...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90267-3
更新日期:1978-04-15 00:00:00
abstract::The intervillous blood flow and other maternal hemodynamic parameters were assessed in 40 mothers with pregnancy-induced hypertension in late pregnancy before and after hypotensive treatment. Furosemide caused a significant decrease in the intervillous blood flow, whereas the effects of dihydralazine and metoprolol we...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90093-1
更新日期:1986-07-01 00:00:00
abstract::Total 24 hour urinary 17-ketosteroid and serum testosterone (T), androstenedione (delta), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DS), and cortisol levels were measured before and during four days of dexamethasone administration in 28 hirsute patients and 10 women with normal ovulatory cycles. B...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90560-9
更新日期:1977-06-15 00:00:00
abstract:OBJECTIVES:Our purpose was to determine the newborn complications after respiratory or metabolic acidosis at delivery and to demonstrate the characteristics of an asphyxial insult predictive of these complications. STUDY DESIGN:Fifty-nine term fetuses with metabolic acidosis were matched with 59 fetuses with normal bl...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70101-6
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVES:Our purpose was to determine whether systemic hypotension induced by rapid withdrawal of fetal blood would induce periventricular leukomalacia in the brain of premature fetal sheep. STUDY DESIGN:At 113 days' gestation, systemic hypotension (mean blood pressure <30 mm Hg) was induced by withdrawing approxima...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70519-3
更新日期:1999-09-01 00:00:00