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：:Luteal phase deficiency is thought to be a cause of female infertility. Nevertheless, little agreement exists concerning either its diagnosis or its treatment. To address the latter question, we reviewed the English literature and examined the effect of treatment on pregnancy rates. One randomized controlled trial fou...
journal_title：American journal of obstetrics and gynecology
pub_type： 临床试验,杂志文章,随机对照试验,评审
doi：10.1016/s0002-9378(11)91724-4
更新日期：1992-11-01 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：:A rapid and accurate technique for assessment of spermatozoa motility has been developed. With the use of tricolor photography with sequential exposures in green, red, and blue light, spermatozoa were photographed in Makler chambers with a depth of 10 mu. Exposure in green light had a 1-second duration and was immedia...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(83)90497-0
更新日期：1983-01-15 00:00:00
abstract：OBJECTIVE:The objective of this study was to test the hypothesis that fetuses destined to deliver preterm do not reach their individual growth potential. STUDY DESIGN:In a case control design, data on 44 preterm deliveries at < or =34 weeks were compared with data on a control group of next consecutive term deliveries...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2001.115865
更新日期：2001-08-01 00:00:00
abstract：:Studies on mouse sperm-egg binding and fertilization have been suggested to involve the interaction of sperm-associated beta 1-4 galactosyltransferase with egg zona pellucida glycoproteins. A population of human males, whose sperm demonstrated an inability to penetrate ovulated zona pellucida-free hamster eggs in vitr...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(89)90180-4
更新日期：1989-05-01 00:00:00
abstract：:Attempts were made to produce inferior vena cava (IVC) compression in 14 pregnant and 12 nonpregnant bitches. Ligation of the iliac veins, the IVC below the renal veins, or the left renal vein separately produced minimal hemodynamic disturbances. Only ligation of the two renal veins or of the IVC above the renal veins...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(78)90365-4
更新日期：1978-01-15 00:00:00
abstract：OBJECTIVE:This study was undertaken to determine (1) the methadone serum trough level adequate to prevent withdrawal symptoms in heroin-addicted pregnant women and (2) whether the methadone serum trough level in symptomatic women with withdrawal symptoms differs from that of asymptomatic women. STUDY DESIGN:Pregnant w...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2002.127132
更新日期：2002-11-01 00:00:00
abstract：:Seventeen pregnant rabbits were studied under conscious, unstressed conditions after catheterization of the right ventricle (RV), a femoral artery (A), and a uterine vein (UV). Respiratory gas tensions, pH, and oxygen saturations and contents were determined serially throughout the latter half of gestation. The uterin...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(85)80054-5
更新日期：1985-07-15 00:00:00
abstract：:Coronavirus disease 2019 is an emerging disease with a rapid increase in cases and deaths since its first identification in Wuhan, China, in December 2019. Limited data are available about coronavirus disease 2019 during pregnancy; however, information on illnesses associated with other highly pathogenic coronaviruses...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2020.02.017
更新日期：2020-05-01 00:00:00
abstract：OBJECTIVE:Our objective was to ascertain long-term tolerability and effects of a novel, low-dosage continuous progestin-cyclic estrogen regimen on vasomotor flushing, vaginal bleeding patterns, bone density, and plasma lipoprotein lipids. STUDY DESIGN:Eighteen postmenopausal women with climacteric symptoms received lo...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(92)91842-x
更新日期：1992-01-01 00:00:00
abstract：OBJECTIVE:Recently the Accreditation Council for Graduate Medical Education placed restrictions on all residency programs that limited work hours to 80 hours per week. The objective of this study was to determine the work hours for practicing obstetrician-gynecologists in an urban center. STUDY DESIGN:A questionnaire ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/s0002-9378(03)00888-3
更新日期：2003-09-01 00:00:00
abstract：OBJECTIVE:Before the availability of modern imaging studies the diagnosis of septic pelvic thrombophlebitis causing prolonged puerperal fever was difficult to confirm without surgical exploration. With the use of computed tomography infection-related pelvic phlebitis can now be confirmed, and this study was designed to...
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/s0002-9378(99)70450-3
更新日期：1999-07-01 00:00:00
abstract：:The rates of maternal morbidity and mortality in the United States demand a comprehensive approach to assessing pregnancy-related risks. Numerous medical and nonmedical factors contribute to maternal morbidity and mortality. Reducing the number of women who experience pregnancy morbidity requires identifying which wom...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2020.12.006
更新日期：2020-12-09 00:00:00
abstract：OBJECTIVE:We studied the role of smooth muscle-relaxing prostacyclin and its endogenous antagonist, thromboxane A2, in preterm labor by assessing the urinary output of the breakdown products of prostacyclin (6-keto-prostaglandin F1 alpha and 2,3-dinor-6-keto-prostaglandin F1 alpha) and those of thromboxane A2 (thrombox...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(92)91851-z
更新日期：1992-01-01 00:00:00
abstract：:Ten pregnant ewes were alternated in a study of the blocking effect of parenteral magnesium on the catecholamine response to cocaine. Indirect blood pressures were recorded at 1-minute intervals for 12 minutes before and after a bolus of 2 mg/kg of cocaine. Fetal heart rates were continuously recorded from skin electr...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(89)90693-5
更新日期：1989-11-01 00:00:00
abstract：OBJECTIVE:Our purpose was to evaluate the efficacy and consequences of sacrospinous ligament suspension and pelvic reconstruction. STUDY DESIGN:Patients who underwent sacrospinous ligament suspension between 1978 and 1991 were evaluated from follow-up visits, telephone interviews, questionnaires, and chart reviews. Be...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(96)70085-6
更新日期：1996-12-01 00:00:00
abstract：OBJECTIVE:Although a higher maternal body mass index is associated with preterm birth, it is unclear whether excess gestational weight gain (GWG) or obesity drives increased risk. We and others have shown that the placenta harbors microbiota, which is significantly different among preterm births. Our aim in this study ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2014.12.041
更新日期：2015-05-01 00:00:00
abstract：BACKGROUND:The Twin Birth Study randomized women with uncomplicated pregnancies, between 32(0/7)-38(6/7) weeks' gestation where the first twin was in cephalic presentation, to a policy of either a planned cesarean or planned vaginal delivery. The primary analysis showed that planned cesarean delivery did not increase o...
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.2015.12.051
更新日期：2016-03-01 00:00:00
abstract：OBJECTIVE:This study was undertaken to evaluate the effects on peripheric pulmonary vessel muscularization by tracheal occlusion (TO) performed at different gestational ages in fetal rabbits with surgically induced diaphragmatic hernia. STUDY DESIGN:In 23 New Zealand white does, both ovarian end fetuses underwent surg...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2004.01.006
更新日期：2004-09-01 00:00:00
abstract：:A total of 635 consecutive cesarean sections performed in private practices during the past 20 years are reviewed. In the course of this 20 year period, we have tried to alter gradually our surgical technique used for this procedure to conform to the principles of surgery developed by Halsted. The study is divided int...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(87)80006-6
更新日期：1987-09-01 00:00:00
abstract：OBJECTIVE:The objective of the study was to investigate the differences in perinatal outcomes between various Asian ethnic subgroups at a national level. STUDY DESIGN:This is a retrospective cohort study of all non-Hispanic Chinese, Japanese, Filipino, Asian Indian, Korean, Vietnamese, Samoan, Guamanian, and Hawaiian ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2008.06.073
更新日期：2008-10-01 00:00:00
abstract：:Three term neonates presented with an unusual combination of skin changes (sclerema) and joint contractures at birth. In each case a prolonged period of fetal hyporeactivity was reported by the mother. Each child demonstrated a number of clinical findings consistent with chronic fetal hypoxia. Each child recovered wit...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(86)90834-3
更新日期：1986-08-01 00:00:00
abstract：OBJECTIVE:Our purpose was to determine what factors occurring after digital separation of the chorionic membranes from the lower uterine segment (membrane stripping) are involved in observed clinical changes compared with patients not so treated. STUDY DESIGN:Thirty patients were randomly divided among a study populat...
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(93)90134-5
更新日期：1993-07-01 00:00:00
abstract：:Cervical cultures of 2013 consecutive obstetric patients with no history of genital herpes simplex virus infection were used to determine the frequency of asymptomatic herpes simplex virus shedding in labor. Four (0.20%) of these patients had positive cultures. None of the exposed neonates developed clinical evidence ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(88)90034-8
更新日期：1988-03-01 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：OBJECTIVE:Our purpose was to determine whether obese women and underweight women have an increased risk of birth defects in their offspring. STUDY DESIGN:A geographically based case-control study of women living in California and Illinois was performed. There were 499 mothers of offspring with neural tube defects, 337...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(94)70224-1
更新日期：1994-02-01 00:00:00
abstract：:This systematic review of uterosacral ligament suspension provides a metaanalysis of anatomic outcomes and a summary of subjective outcomes. A successful anatomic outcome was considered present when women had "optimal" or "satisfactory" (pelvic organ prolapse quantification system stage 0 or 1) outcomes. In the anteri...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.ajog.2009.07.052
更新日期：2010-02-01 00:00:00
abstract：:A simple modification of the technique of transabdominal chorionic villus sampling is described. This technique uses a short piece of extension tubing between the needle hub and aspirating syringe. The advantages of this technique are discussed. ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(92)91659-x
更新日期：1992-02-01 00:00:00
abstract：:Myoelectrical activity and progesterone (P) and 17 beta-estradiol (E2) concentrations were measured in 12 human oviducts with tubal pregnancy. Spikes were frequently superimposed on a single, smooth, slow wave. The region above a large conceptus (P dominance) was inactive in eight of 10 oviducts. The myoelectrical act...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(84)80166-0
更新日期：1984-01-15 00:00:00
abstract：:A successful pregnancy in a patient with a 45,X/47,XXX karyotype who had premature menopause is described. Review of the literature revealed an additional 24 cases of fertility in women with gonadal dysgenesis associated with a 45,X chromosomal line. Their reproductive history showed a total of 58 pregnancies. However...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(76)90516-0
更新日期：1976-11-15 00:00:00
