Abstract:
OBJECTIVE:To examine the association of body mass index (BMI) and operative time and perioperative morbidity after hysterectomy and determine whether the association varies among abdominal, laparoscopic, and vaginal approaches. METHODS:Data abstracted from the American College of Surgeons National Safety and Quality Improvement Project registry included 55,409 women who underwent hysterectomy for benign conditions between January 2005 and December 2012. The relationships among BMI, operative time, and morbidity were examined, adjusting for age, race, ethnicity, year of surgery, smoking, diabetes, and American Society for Anesthesiologists physical classification. Adjusted means, incidence rate ratios, or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using linear, Poisson, or logistic regression, respectively. RESULTS:Body mass index was positively correlated with risk of wound complications and infection in women undergoing abdominal hysterectomy. Compared with those of normal BMI, women with BMIs 40 or higher had five times the odds of wound dehiscence (2.1% compared with 0.3%, crude OR 7.35, CI 3.78-14.30; adjusted OR 5.33, CI 2.63-10.8), five times the odds of wound infection (8.9% compared with 1.4%, crude OR 6.81, CI 5.00-9.27; adjusted OR 5.34, CI 3.85-7.41), and 89% higher odds of sepsis (1.3% compared with 0.6%, crude OR 2.39, CI 1.35-4.24; adjusted OR 1.89, CI 1.01-3.52). The magnitude of the association between wound infection and BMI was smaller after vaginal hysterectomy, and no increased odds of wound complications or sepsis were noted with a laparoscopic approach despite longer operative times. Operative time increased with BMI regardless of surgical approach. No associations were noted between BMI and hospital stay or thromboembolism. CONCLUSION:Obesity is associated with increased wound complications and infection in women undergoing abdominal hysterectomy and with longer operative times regardless of surgical approach. Vaginal or laparoscopic hysterectomy should be performed whenever feasible. LEVEL OF EVIDENCE:II.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Shah DK,Vitonis AF,Missmer SAdoi
10.1097/AOG.0000000000000698subject
Has Abstractpub_date
2015-03-01 00:00:00pages
589-598issue
3eissn
0029-7844issn
1873-233Xpii
00006250-201503000-00010journal_volume
125pub_type
杂志文章abstract::One hundred fifty-two women who received cefazolin prophylaxis and subsequently developed postpartum endometritis were randomized to treatment with either ticarcillin/clavulanic acid (75) or clindamycin-gentamicin (77). Bacteria isolated from the endometrium were predominantly facultative anaerobic bacteria. The ratio...
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:1989-05-01 00:00:00
abstract:OBJECTIVE:To determine the percentage of patients in whom carpal tunnel syndrome was induced by pregnancy, the presence of any risk factors causing persistent symptoms after delivery, and the outcome of surgical decompression in these patients. METHODS:We reviewed retrospectively the records of 100 consecutive women t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract::The influence of weight gain during pregnancy on duration of gestation and infant size at birth was examined among women beginning pregnancy underweight and at normal weight. Results of the review of 654 prenatal and delivery records revealed that 1) Prepregnancy weight status was not associated with the amount of wei...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::The effect of norethisterone on bone mineral metabolism was examined in 43 postmenopausal women. A significant decline in serum calcium, phosphate, and alkaline phosphatase in urinary calcium/creatinine ratio and in tubular maximum reabsorption of phosphate was demonstrated. There was no alteration in urinary hydroxyp...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVE:To estimate the effect of prolonged vaginal distention and anal sphincter transection on contractile properties of the external anal sphincter. METHODS:Young female virgin rats were randomly assigned to four treatment groups (sham, vaginal distention, transection of anal sphincter plus repair, or combined di...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318162f6a7
更新日期:2008-02-01 00:00:00
abstract::For direct laparoscopic entry using a sharp and dull trocar technique, the sharp trocar is inserted with a twisting motion under constant pressure, then replaced with a dull trocar when a slight loss of resistance is felt. A slow, gradual entry into the peritoneal cavity is accomplished by twisting the dull trocar und...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00215-3
更新日期:1996-10-01 00:00:00
abstract::Surgical correction of large pulsion enterocele is a contentious subject and until a technique is founded upon proper anatomic facts, the arguments will continue. Pulsion enterocele follows changes in the pelvic cellular tissues and levator ani complex; both defects must be corrected. Synchronous abdominoperineal repa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract::Individual prenatal care is intended to prevent poor perinatal outcomes and provide education to women throughout pregnancy, childbirth, and the postpartum period through a series of one-on-one encounters between a woman and her obstetrician or other obstetric care provider. Concerns regarding increasing health care c...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000002526
更新日期:2018-03-01 00:00:00
abstract::Two hundred sixty-four consecutive patients with clinical stage I endometrial adenocarcinoma who underwent primary surgical therapy between July 1979 and August 1988 were followed prospectively and evaluated for disease recurrence for 8-112 months (mean 51.5). Thirty-three patients (12.5%) developed recurrence or died...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-07-01 00:00:00
abstract:OBJECTIVE:To determine if oncogene overexpression in patients with advanced epithelial ovarian cancer correlates with survival. METHODS:Twenty-two women with stage III ovarian cancer, observed for a median of 66 (range 48-204) months were compared with 30 with a median survival of 18 (range 2-28) months. Using immunoc...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00121-5
更新日期:1998-07-01 00:00:00
abstract:OBJECTIVE:To evaluate whether cesarean delivery is a risk factor for emergent postpartum hysterectomy. METHODS:We performed a case-control study of patients who delivered at Women & Infants Hospital between January 1989 and February 2000. Fifty cases of emergent postpartum hysterectomy performed within 14 days of deli...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(03)00404-6
更新日期:2003-07-01 00:00:00
abstract::This study was planned to determine the effects of estrogen and progestogen on female sexual behavior. Forty-nine women who had undergone hysterectomy and bilateral salpingo-oophorectomy took part in a double-blind placebo-controlled cross-over study. Over a 12-month period each woman received 3 months each of ethinyl...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-09-01 00:00:00
abstract:OBJECTIVE:To determine clinical characteristics of women with endometriosis-associated intraperitoneal cancers, to assess differences based on the relationship of the cancer to the endometriosis, and to assess factors associated with survival. METHODS:A search of medical records at The University of Texas M. D. Anders...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)02149-x
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:We investigated the relationship between low maternal age and neonatal survival among extremely preterm twins. METHODS:This was a retrospective cohort study on live births of extremely preterm twins delivered to teenaged mothers (aged 15-19 years) in the United States within the period 1995 through 1998. Ove...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000126724.91988.fa
更新日期:2004-06-01 00:00:00
abstract::: The initial visit for screening and the provision of reproductive preventive health care services and guidance should take place between the ages of 13 years and 15 years. The initial reproductive health visit provides an excellent opportunity for the obstetrician-gynecologist to start a patient-physician relationsh...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000446826.46833.c0
更新日期:2014-05-01 00:00:00
abstract::In a comparative trial, ethanol effectively arrested preterm labor for 48 hours for more in 32% of cases, a beta-adrenergic agent (salbutamol) in 60% of cases (not statistically significant), and a combination of ethanol and indomethacin in 70% of cases (statistically significant, P less than 0.5). Labor was delayed f...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-02-01 00:00:00
abstract:OBJECTIVE:To examine differences in clinical and pathologic characteristics between women undergoing hysterectomy who had had prior tubal sterilization and those who had not. METHODS:One thousand eight hundred fifty-one women undergoing hysterectomy were enrolled as part of a multicenter, prospective cohort study. We ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/0029-7844(96)00149-4
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:Vaginal evisceration can take place many years after vaginal surgery. CASE:An 87-year-old woman presented with evisceration of small bowel through the vagina, 15 years after she underwent a vaginal hysterectomy. On physical examination, her vital signs were normal. Forty centimeters of small bowel was visib...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)02336-0
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Approximately 24% of American adults have tattoos. Studies of humans and mice demonstrate that tattoo pigment migrates to lymph nodes and can cause lymphadenopathy. CASE:A 32-year-old woman presented with a 6-cm vulvar mass and extensive bilateral inguinofemoral lymphadenopathy. Bilateral small tattoos were...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182583be2
更新日期:2012-08-01 00:00:00
abstract::Danazol is widely used in the management of endometriosis and mammary dysplasia. However, its mechanism of action is still obscure because of the few studies done and the controversial results obtained. Antigonadotropic activity has been postulated by some investigators, whereas others have observed no effect on the g...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-04-01 00:00:00
abstract:BACKGROUND:Traditional methods of exchange of research information may not be rapid enough, especially for international multicenter studies or when discussing controversial issues such as the value of fetal monitoring. The Internet is a useful tool that provides numerous opportunities for immediate communication withi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00569-4
更新日期:2000-02-01 00:00:00
abstract::The class of uterine malformations known as communicating uteri is characterized by two separate uterocervical cavities connected by an isthmic communication. Nine types have been described. We report the second proven case of a septate communicating uterus with double cervix. Investigation of secondary infertility in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-05-01 00:00:00
abstract::Opioid use in pregnancy has escalated dramatically in recent years, paralleling the epidemic observed in the general population. To combat the opioid epidemic, all health care providers need to take an active role. Pregnancy provides an important opportunity to identify and treat women with substance use disorders. Su...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000002229
更新日期:2017-08-01 00:00:00
abstract::Pelvic organ prolapse (POP) is a common, benign condition in women. For many women it can cause vaginal bulge and pressure, voiding dysfunction, defecatory dysfunction, and sexual dysfunction, which may adversely affect quality of life. Women in the United States have a 13% lifetime risk of undergoing surgery for POP ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003520
更新日期:2019-11-01 00:00:00
abstract::The interactions of an antiestrogen (tamoxifen) and a progestin (medroxyprogesterone acetate) on endometrial 17 beta-hydroxysteroid dehydrogenase activities were studied in short-term experiments (four to 96 hours) in normally menstruating women at the follicular phase and were related to simultaneously measured conce...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-11-01 00:00:00
abstract::A case of a primary retroperitoneal mucinous cystadenocarcinoma of ovarian type found at laparotomy in the presence of two normal ovaries is described. Careful examination of the tumor showed no evidence of ovarian tissue in the wall. The appearance of this tumor could be traced from areas of benign mucinous cystadeno...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-04-01 00:00:00
abstract::We have reviewed the family histories of children with neural tube defects to determine which relatives are at sufficient risk to be offered amniocentesis for prenatal diagnosis. The recurrence risks for sibs was 6%; therefore, women with one affected child should be made aware of the availability of this test for mon...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVE:To evaluate whether there is an increased risk of cesarean delivery in women who delay childbearing into their later reproductive years, using a well-defined cohort and controlling for difference in baseline susceptibility such as complications of pregnancy and labor. METHODS:The current study included all w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract::Cord blood IgA and IgM levels were measured in newborns of mothers with prematurely ruptured membranes (PRM) who had also received prenatal glucocorticoid treatment to accelerate fetal lung maturity. Previous data show that some newborns of mothers with PRM had elevated IgA and/or IgM levels. This increase was also fo...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-04-01 00:00:00
abstract::Use of a scalp electrode facilitates and adds precision to electronic fetal monitoring. We report an instance of neonatal osteomyelitis due to infection of the electrode insertion site. Electrode-associated soft and bony tissue infections are most commonly mediated by cervicovaginal microflora and appear clinically an...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00