Abstract：
:There is a general consensus that the cesarean delivery rate in the United States is too high, and that practice patterns of obstetricians are largely to blame for this situation. In reality, the US cesarean delivery rate is the result of 3 forces largely beyond the control of the practicing clinician: patient expectations and misconceptions regarding the safety of labor, the medical-legal system, and limitations in technology. Efforts to "do something" about the cesarean delivery rate by promulgating practice directives that are marginally evidence-based or influenced by social pressures are both ineffective and potentially harmful. We examine both the recent American Congress of Obstetricians and Gynecologists (ACOG)/Society for Maternal-Fetal Medicine Care Consensus Statement "Safe Prevention of Primary Cesarean Delivery" document and the various iterations of the ACOG guidelines for vaginal birth after cesarean delivery in this context. Adherence to arbitrary time limits for active phase or second-stage arrest without incorporating other clinical factors into the decision-making process is unwise. In a similar manner, ever-changing practice standards for vaginal birth after cesarean driven by factors other than changing data are unlikely to be effective in lowering the cesarean delivery rate. Whether too high or too low, the current US cesarean delivery rate is the expected result of the unique demographic, geographic, and social forces driving it and is unlikely to change significantly given the limitations of current technology to otherwise satisfy the demands of these forces.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Clark SL,Garite TJ,Hamilton EF,Belfort MA,Hankins GDdoi
10.1016/j.ajog.2018.04.044subject
Has Abstractpub_date
2018-09-01 00:00:00pages
267-271issue
3eissn
0002-9378issn
1097-6868pii
S0002-9378(18)30375-2journal_volume
219pub_type
杂志文章abstract：UNLABELLED:Placentas obtained from women with preeclampsia produce more thromboxane and less prostacyclin than normal. They also produce more progesterone than normal. This study tested whether a progesterone concentration equivalent to that in the medium after in vitro incubation of placentas from women with preeclamp...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(89)90931-9
更新日期：1989-12-01 00:00:00
abstract：OBJECTIVE:Maternal floor infarction of the placenta is characterized by gross placental abnormalities and histologic evidence of X-cell proliferation. Previously, pregnancy-associated major basic protein has been localized to the placental X cell and identified at elevated levels in serum and amniotic fluid in all norm...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(11)91716-5
更新日期：1992-11-01 00:00:00
abstract：:A brief review of the evidence for and against the 12-week gestational age limit for abortion by curettage is reported. Existing data suggest that second trimester evacuation abortion is associated with higher morbidity and mortality rates than first trimester suction curettage, but with lower rates than second trime...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(78)90925-0
更新日期：1978-09-15 00:00:00
abstract：:The effect of Danazol, a new gonadotropin inhibitor, was examined in four categories of patients. (1) Ten normal women medicated orally with Danazol, 800 mg. daily for 91 days, showed no depression of serum LH, estrone, estradiol, or progesterone below control, second-day levels. The serum FSH was slightly depressed; ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1975-03-15 00:00:00
abstract：:Placental-related fetal growth restriction arises primarily due to deficient remodeling of the uterine spiral arteries supplying the placenta during early pregnancy. The resultant malperfusion induces cell stress within the placental tissues, leading to selective suppression of protein synthesis and reduced cell proli...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2017.11.577
更新日期：2018-02-01 00:00:00
abstract：:Cervical cancer screening is an essential component of prenatal care. The diagnosis and management of cervical intraepithelial neoplasia (CIN) during pregnancy are challenging, and sufficient information does not exist to allow for a definitive evidence-based approach. The American Society for Colposcopy and Cervical ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2008.04.010
更新日期：2008-07-01 00:00:00
abstract：:Because of the potential of dihydropyridine calcium channel blockers in the management of premature labor, we have studied the direct effects of nitrendipine on actomyosin in the pregnant and nonpregnant uterus and in the term human placenta. Actomyosin adenosinetriphosphatase in the three tissues and another model of...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(86)90679-4
更新日期：1986-02-01 00:00:00
abstract：BACKGROUND:Worldwide, tuberculosis remains a major health concern, with an estimated 9.6 million people infected in the year 2014, of which one-third were women. Tuberculosis is estimated to be even more prevalent in pregnant women than the general population. To date there has been conflicting evidence on the maternal...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2016.08.009
更新日期：2016-12-01 00:00:00
abstract：:Despite advances in diagnostic techniques, endometriosis remains an enigmatic condition. Clinical symptoms and signs often do not correlate with the anatomic stage of the disease, and morphologic characteristics very widely. A definitive diagnosis can be established only by direct visualization, usually by laparoscopy...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(90)90431-6
更新日期：1990-02-01 00:00:00
abstract：OBJECTIVES:The purpose of our study was to investigate the combined interactive effects of maternal age, parity, and smoking on pregnancy outcome. STUDY DESIGN:This was a population-based Swedish study (n = 538,829). RESULTS:Multiple logistic regression analysis showed that the smoking-related effect on the relative ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(12)90878-9
更新日期：1993-01-01 00:00:00
abstract：OBJECTIVE:The objective of the study was to examine risk factors for postterm (gestational age >or= 42 weeks) or prolonged (gestational age >or= 41 weeks) pregnancy. STUDY DESIGN:We conducted a retrospective cohort study of all term, singleton pregnancies delivered at a mature, managed care organization. The primary o...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2009.02.034
更新日期：2009-06-01 00:00:00
abstract：:This study examines some potential factors that are associated with occasional readmission soon after discharge for laparoscopic sterilization--a generally innocuous outpatient procedure. Thirty-six early readmissions among 22,000 cases of laparoscopic sterilization (an incidence rate of 1.6 per 1,000 procedures) in a...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(84)80077-0
更新日期：1984-02-01 00:00:00
abstract：:Prospective pregnancy evaluation through the combined use of a radioimmunoassay (RIA) for the beta-subunit of human chorionic gonadotropin (beta-hCG) and ultrasound during the first 42 days of gestation after ovulation was performed on a population asymptomatic for first-trimester spontaneous abortion. One hundred for...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(83)90977-8
更新日期：1983-08-15 00:00:00
abstract：OBJECTIVE:Determine whether depression screen results are consistent across successive pregnancies. STUDY DESIGN:The Edinburgh Postnatal Depression Scale was administered in 2 successive pregnancies to 2116 women. A woman was "screen-positive" if she scored ≥ 12 at 24-28 weeks' or 6-weeks' postpartum. Screen-positive ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2011.12.005
更新日期：2012-03-01 00:00:00
abstract：BACKGROUND:The process of childbirth is one of the most crucial events in the future health and development of the offspring. The vulnerability of parturients and fetuses during the delivery process led to the development of intrapartum monitoring methods and to the emergence of alternative methods of delivery. However...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2020.05.025
更新日期：2020-09-01 00:00:00
abstract：OBJECTIVES:We prospectively evaluated the accuracy of a gestational age-independent method of detecting abnormal growth, the transverse cerebellar diameter/abdominal circumference ratio, and compared this with standard ultrasonographic methods of growth assessment. STUDY DESIGN:We prospectively studied 825 low-risk ob...
journal_title：American journal of obstetrics and gynecology
pub_type： 临床试验,杂志文章
doi：10.1016/0002-9378(94)90035-3
更新日期：1994-10-01 00:00:00
abstract：OBJECTIVE:After strong evidence and major organizations recommending salpingectomy over tubal ligation, we sought to perform a systematic review and meta-analysis comparing the intraoperative attributes and complication rates associated with these 2 procedures. DATA SOURCES:We searched PubMed, the Cochrane Library, Em...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2020.09.011
更新日期：2020-09-14 00:00:00
abstract：OBJECTIVE:The purpose of this study was to assess the validity of vaginal fetal fibronectin as a screening test for spontaneous preterm birth in patients with cervical cerclage. STUDY DESIGN:A historic cohort of 117 patients who underwent cervical cerclage placement between 1996 and 2002 were identified. All patients ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/s0002-9378(03)00656-2
更新日期：2003-11-01 00:00:00
abstract：:A retrospective chart review was performed on all patients undergoing trachelectomy in the Roanoke Valley between January 1, 1975 and April 30, 1987. During this period a total of 55 trachelectomies were performed. Fifty-three of the 55 trachelectomies (96%) were performed by the vaginal approach. Forty-seven of the 5...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(88)80042-5
更新日期：1988-09-01 00:00:00
abstract：OBJECTIVE:We sought to assess changes in indications, technique, successful fluid aspiration, and pregnancy outcomes in a large cohort of genetic amniocenteses performed by a single physician. STUDY DESIGN:Records were reviewed regarding 4600 women who underwent genetic amniocentesis by a single physician between 1972...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2001.116737
更新日期：2001-08-01 00:00:00
abstract：:Universal access to contraception benefits society: unintended pregnancies, maternal mortality, preterm birth, abortions, and obesity would be reduced by increasing access to affordable contraception. Women should be able to choose when and whether to use contraception, choose which method to use, and have ready acces...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2019.09.014
更新日期：2020-02-01 00:00:00
abstract：OBJECTIVE:Our goal was to improve the accuracy of estimating fetal weights among macrosomic fetuses with the traditional measurements of abdominal circumference, femur length, and head circumference. STUDY DESIGN:We used 4831 cases without anomalies from an ultrasonography laboratory database with an estimated fetal w...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,meta分析
doi：10.1067/mob.2000.106853
更新日期：2000-06-01 00:00:00
abstract：:In responsive tissues the induction of 25-hydroxycholecalciferol 24-hydroxylase activity is a marker of 1,25-dihydroxycholecalciferol action. In this study we investigated the responsiveness of various malignant cells, which were derived from carcinomas of gynecologic origin, to 1,25-dihydroxycholecalciferol; we did s...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(86)90162-6
更新日期：1986-12-01 00:00:00
abstract：OBJECTIVE:The aim of this study was to test the hypothesis that standardization of cardiac output in pregnancy by correcting for body surface area, and thus obtaining cardiac index, is justified. STUDY DESIGN:Cardiac output was determined by thoracic electrical bioimpedance monitoring in 78 pregnant women; recordings ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(95)90367-4
更新日期：1995-09-01 00:00:00
abstract：OBJECTIVE:In adults, one of the major determinants of leukocyte telomere length (LTL), a predictor of age-related diseases and mortality, is cumulative psychosocial stress exposure. More recently we reported that exposure to maternal psychosocial stress during intrauterine life is associated with LTL in young adulthood...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2012.11.033
更新日期：2013-02-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to determine the association of maternal psychotropic medication use during pregnancy with preterm delivery and other adverse perinatal outcomes. STUDY DESIGN:A cohort of 2793 pregnant women in Washington State was interviewed, and their medical files were abstracted. Logistic r...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2009.06.061
更新日期：2009-12-01 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：OBJECTIVES:The objectives of this study were to investigate differences in diameter and vasoconstriction of premyometrial versus uteroplacental radial arteries and to evaluate the contribution of nitric oxide (NO) to myogenic tone as a function of vessel location. STUDY DESIGN:Radial arteries supplying either the myom...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/s0002-9378(03)00623-9
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 assess the risk of neonatal death and morbidity in vertex-nonvertex second twins according to the mode of delivery and birth weight. STUDY DESIGN:Data from a retrospective cohort study that was based on all twin births in the United States (1995-1997) were used. RESULTS:A to...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2004.09.132
更新日期：2005-03-01 00:00:00
