Abstract:
OBJECTIVE:To evaluate whether hysteroscopic morcellation or bipolar electrosurgical resection is more favorable for removing endometrial polyps in an office setting in terms of feasibility, speed, pain, and acceptability. METHODS:A multicenter, single-blind, randomized, controlled trial of office hysteroscopic morcellation compared with electrosurgical resection was conducted. A total of 121 women were randomly allocated to polyp removal by one of the two methods in an office setting. The outcomes assessed were time taken to complete the endometrial polypectomy, defined as the time from insertion to removal of vaginal instrumentation, completeness of polyp removal, acceptability, and pain measured on a 100-mm visual analog scale. RESULTS:The median time taken to complete the procedure was 5 minutes and 28 seconds for morcellation compared with 10 minutes and 12 seconds for electrosurgical resection (P<.001). The polyps were completely removed in 61 out of 62 (98%) women assigned to morcellation compared with 49 out of 59 (83%) women treated with electrosurgical resection (odds ratio 12.5; 95% confidence interval [CI] 1.5-100.6; P=.02). The mean pain scores during the procedure favored morcellation by 16.1 points on average (35.9 compared with 52.0; 95% CI for difference, -24.7 to -7.6; P<.001). Overall, 99% of women found office polypectomy to be acceptable, with only one woman in the electrosurgical resection group considering the procedure unacceptable. CONCLUSION:In comparison to electrosurgical resection during hysteroscopic polypectomy, morcellation was significantly quicker, less painful, more acceptable to women, and more likely to completely remove endometrial polyps compared with electrosurgical resection. CLINICAL TRIAL REGISTRATION:ClinicalTrials.gov, www.clinicaltrials.gov, NCT01509313.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Smith PP,Middleton LJ,Connor M,Clark TJdoi
10.1097/AOG.0000000000000187subject
Has Abstractpub_date
2014-04-01 00:00:00pages
745-51issue
4eissn
0029-7844issn
1873-233Xpii
00006250-201404000-00004journal_volume
123pub_type
杂志文章,多中心研究,随机对照试验abstract::Over a 3-year period at the Long Beach Women's Hospital, where electronic FHR (fetal heart rate) monitoring was routine, there were 8622 live births, including 41 infants born with major congenital malformations. The neonatal death rate in these malformed infants was 44%; 17 were delivered by cesarean section, 11 of w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-06-01 00:00:00
abstract::A 21-year-old white woman presented with virilization, hirsutism, and acne of 1.5 years' duration. Endocrine testing demonstrated complete suppression of serum testosterone, from 5.3 to 0.6 ng/mL, and serum androstenedione, from 4.7 to 1.7 ng/mL, after oral administration of 50 micrograms of mestranol and 1 mg of nore...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1989-05-01 00:00:00
abstract::A retrospective study of 343 women who lacked prenatal care was conducted to ascertain the effect of recent cocaine abuse on birth weight and gestational age. All pregnant women admitted in labor to a large urban teaching hospital between January 1 and December 31, 1986 who had not received prenatal care were included...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVE:To estimate the occurrence of synchronous epithelial ovarian and endometrial cancers among ovarian cancer patients and to assess survival of women with synchronous cancers. METHODS:Synchronous ovarian and endometrial cases were identified using data from the Surveillance, Epidemiology, and End Results Progra...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31819c7bdf
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the response rate and toxicity of alternating weekly therapy with etoposide-methotrexate-dactinomycin/cyclophosphamide-vincristine for women with high-risk gestational trophoblastic disease. METHODS:Twenty-two women with gestational trophoblastic disease received 126 cycles of the study regimen. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:To quantify the numbers of leukocytes in the normal cervix and relate these numbers to the diagnosis of cervicitis. METHODS:Isolated cell suspensions were prepared from cervical tissue recovered at hysterectomy from 37 women who had no obvious cervical disease. The percentages of CD45+ cells (leukocytes) in ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00086-6
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:The diagnosis of uterine rupture is aided by the identification of risk factors, such as oxytocin administration. In several experiments, cocaine has been shown to stimulate uterine contractility. Complications from cocaine abuse during pregnancy have increased dramatically in the United States, and cocaine ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:To establish the indications for surgical intervention, at the appropriate gestational duration, for brain tumors in pregnant women, and to evaluate any association pregnancy hormones may have with the rate of growth or development of complications of brain tumors. METHODS:We observed seven women with brain ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(96)00381-x
更新日期:1997-01-01 00:00:00
abstract::A Clostridium perfringens infection is described in an 18-year-old primigravida following cesarean section at 43 weeks' gestation. Despite the ubiquitous distribution of these organisms, such infections are rarely encountered in obstetrics. Characteristics of these bacteria and appropriate diagnostic and therapeutic p...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-10-01 00:00:00
abstract:OBJECTIVE:Many serum markers have been proposed to aid in the identification of an ectopic pregnancy, but few have been validated. Most studies have been limited by sample size and design. The goal of this study was to assess putative markers to identify which can be optimally combined. METHODS:We conducted a case-con...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1097/AOG.0b013e31820b3c61
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:To determine if using the endocervical brush after curetting the endocervix will increase the yield of endocervical tissue retrieved for an endocervical curettage (ECC) specimen. METHODS:Between March 1, 1995, and June 30, 1996, we recruited for participation patients with abnormal Papanicolaou smears referr...
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(97)00470-5
更新日期:1997-11-01 00:00:00
abstract::Laparoscopy was used to evaluate 100 women who consistently reported pelvic pain in the same location for a minimum of six months. These findings were compared with those of 50 asymptomatic women who underwent laparoscopy for tubal ligation. Overall, 83% of the group with pelvic pain had abnormal pelvic organs as comp...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
abstract:OBJECTIVE:To investigate the value of the combined use of vaginal ultrasonography and endometrial sampling in the office for the diagnosis of endometrial disease in postmenopausal women. METHODS:One hundred forty consecutive postmenopausal women presenting with uterine bleeding or endometrial cells on cervical cytolog...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0029-7844(94)00421-9
更新日期:1995-03-01 00:00:00
abstract::The medical records of 330 patients treated with terbutaline infusion for the inhibition of preterm labor were reviewed over a five-year period. In patients with intact membranes the results were uniformly good, particularly when treatment was instituted before the 30th week. Half these patients had a prolonged labor ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-08-01 00:00:00
abstract::Dating of maturity of the endometrium by histologic examination was correlated with four methods of ovulation detection in 13 cycling parous women. Histologic dating was assessed independently by two pathologists and correlated with the postovulatory duration as determined by daily transvaginal ultrasound scanning, se...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To estimate the rates of early neonatal and maternal complications in a consecutive series of successful Kielland's rotational forceps deliveries. METHODS:This was a retrospective cohort study of consecutive cases of successful rotational forceps deliveries performed in singleton pregnancies at 36 weeks of g...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31828b72cb
更新日期:2013-05-01 00:00:00
abstract::The authors determined the prevalence of certain major congenital disorders among live-born infants of 6509 mothers in a prepaid health plan for the 30-month period of January 1, 1980 through June 30, 1982 who used a wide variety of drugs during the first trimester of pregnancy. The results were similar to those obtai...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-04-01 00:00:00
abstract:BACKGROUND:An existing model for fourth-degree laceration repair uses beef tongue with plastic or vinyl tubing. This modified model substitutes beef tripe for the anal mucosa and chicken leg muscles for the anal sphincter muscle analogs to create a realistic model. METHOD:Tripe is tunneled through the body of the trim...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001908
更新日期:2017-03-01 00:00:00
abstract::Obstetrician-gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that require minimal interventions and have high rates of patient satisfaction. Many common obstetric practices are of limited or un...
journal_title:Obstetrics and gynecology
pub_type: 社论
doi:10.1097/AOG.0000000000003081
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To assess the association of education, performance feedback, and the Hawthorne effect with a reduction in the episiotomy rate in a large academic institution. METHODS:We describe a prospective observational study of a project conducted between March 2012 and February 2017 to assist clinicians in meeting the...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002060
更新日期:2017-07-01 00:00:00
abstract::The recent United States Food and Drug Administration approval of a commercial kit containing the Yuzpe regimen for emergency contraception is a welcome event. Unlike emergency contraceptive pills sold in other countries, however, the United States product has a pregnancy test bundled with the pills. The test could id...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)80049-0
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVE:To describe the relations between body mass index (BMI; kg/m(2)), weight gain, and incident urinary incontinence in middle-aged women. METHODS:This was a prospective study in the Nurses' Health Study II. Participants reported their weight at age 18 years, and current weight and height in 1989; weight was upd...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000270121.15510.57
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Gestational alloimmune liver disease, a form of profound liver failure in the newborn, is the main underlying cause of the entity formerly known as neonatal hemochromatosis. Antepartum maternal intravenous immunoglobulin (IVIG) has been shown to prevent gestational alloimmune liver disease, which otherwise h...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001569
更新日期:2016-11-01 00:00:00
abstract::Short-term oral steroid therapy was used to treat a capillary hemangioma of the vagina and urethra in a young child. After 8 weeks of prednisolone therapy (40 mg every other day decreasing to 2.5 mg every other day), vaginal bleeding has not recurred. At 2 years and 8 months, the patient presented with severe hematuri...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1989-05-01 00:00:00
abstract::Fourteen cases of typhoid fever complicating pregnancy are presented. The diagnosis was confirmed by blood cultures in 13 patients and by a rising Widal titer in one. Stool cultures were positive in only two out of five patients; urine cultures in 12 patients and cervical cultures in five patients were all negative. T...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-05-01 00:00:00
abstract:OBJECTIVE:To compare clinical and sonographic estimates of birth weights with five new estimation techniques that involve measurements of soft tissue, for identifying newborns with birth weights of at least 4000 g. METHODS:Over 1 year, each woman at or after 36 weeks' gestation and suspected of having a macrosomic fet...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00606-7
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:To collect data from nine European countries for cases of obstetric hemorrhage between 2000 and 2004 in which recombinant activated factor VII (rFVIIa) was used. METHODS:The cases were identified through national surveys. Standardized case report forms included sociodemographic details, past medical and obst...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000288515.48066.99
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:To compare the accuracy of predicted birth weight by the gestation-adjusted projection method using ultrasonographic measurements obtained just before and at term. METHODS:The study group comprised patients with singleton pregnancies who underwent sonograms between 34.0 and 36.9 weeks' gestation (period 1) a...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00617-1
更新日期:2000-04-01 00:00:00
abstract::We studied 30 control women and 131 pill users to evaluate effects of birth control pills and clinical factors on hemostasis. When control patients were matched with an equal number of pill users, none of the direct markers of activated hemostasis (fibrinopeptide A, platelet factor 4, and beta thromboglobulin) were in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract::Intrauterine retention of fetal bone is a rare complication of abortion that can cause secondary infertility by an unknown mechanism. We report such a case in which menstrual fluid prostanoids were measured to elucidate the possible pathophysiology. The pattern of prostanoid increases was similar to that seen in intra...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00