Abstract:
BACKGROUND:Myofascial pain is characterized by the presence of trigger points, tenderness to palpation, and local or referred pain, and commonly involves the pelvic floor muscles in men and women. Pelvic floor myofascial pain in the absence of local or referred pain has also been observed in patients with lower urinary tract symptoms, and we have found that many patients report an improvement in these symptoms after receiving myofascial-targeted pelvic floor physical therapy. OBJECTIVE:We sought to systematically review the literature for examination techniques used to assess pelvic floor myofascial pain in women. STUDY DESIGN:We performed a systematic literature search using strategies for the concepts of pelvic floor disorders, myofascial pain, and diagnosis in Ovid MEDLINE 1946-, Embase 1947-, Scopus 1960-, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and Cochrane Database of Systematic Reviews. Articles were screened by 3 authors and included if they contained a description of a pelvic myofascial physical examination. RESULTS:In all, 55 studies met our inclusion criteria. Overall, examination components varied significantly among the included studies and were frequently undefined. A consensus examination guideline was developed based on the available data and includes use of a single digit (62%, 34/55) to perform transvaginal palpation (75%, 41/55) of the levator ani (87%, 48/55) and obturator internus (45%, 25/55) muscles with a patient-reported scale to assess the level of pain to palpation (51%, 28/55). CONCLUSION:Physical examination methods to evaluate pelvic musculature for presence of myofascial pain varied significantly and were often undefined. Given the known role of pelvic floor myofascial pain in chronic pelvic pain and link between pelvic floor myofascial pain and lower urinary tract symptoms, physicians should be trained to evaluate for pelvic floor myofascial pain as part of their physical examination in patients presenting with these symptoms. Therefore, the development and standardization of a reliable and reproducible examination is needed.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Meister MR,Shivakumar N,Sutcliffe S,Spitznagle T,Lowder JLdoi
10.1016/j.ajog.2018.06.014subject
Has Abstractpub_date
2018-11-01 00:00:00pages
497.e1-497.e13issue
5eissn
0002-9378issn
1097-6868pii
S0002-9378(18)30530-1journal_volume
219pub_type
杂志文章abstract::Amniotic fluid testosterone was assayed by radioimmunoassay in 812 samples taken at 16 weeks' gestation at the time of genetic amniocentesis. In each of 361 samples (45% of total), correct assignment of fetal sex was made where the testosterone level was above 33.8 ng/ml for male fetuses and below 16.2 ng/ml for femal...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(80)90854-6
更新日期:1980-02-01 00:00:00
abstract::Two infants, who presented at birth with isoimmune thrombocytopenic purpura, are the basis for this report. The problems confronting the physician in treating an affected infant, as well as in the management of subsequent pregnancies after an infant with isoimmunization has been delivered, are discussed. In view of th...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90008-9
更新日期:1976-01-01 00:00:00
abstract::Samples of cervical tissue were obtained from women immediately following term delivery from spontaneous labor or oral PGE2-induced labor and from a small nunber of nonpregnant women in the reproductive years undergoing hysterectomy for benign gynecologic disease. The measured strips were placed in a well-oxygenated b...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90278-7
更新日期:1976-09-15 00:00:00
abstract::Maternal urinary 6 beta-hydroxycortisol (6 beta-OHF) and creatinine levels were measured in 28 patients with singleton pregnancies admitted in apparent premature labor and in 17 women with singleton pregnancies delivered at term. Urine specimens were collected immediately after admission but prior to the initiation of...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90003-x
更新日期:1981-02-01 00:00:00
abstract::Vasomotor symptoms after menopause are multifactorial in origin but result primarily from the loss of estrogen as ovarian function ceases. Although hot flushes typically last for 0.5 to 5.0 years after natural menopause, they may persist for as long as 15 years in a small percentage of postmenopausal women. In contras...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0002-9378(99)70725-8
更新日期:1999-03-01 00:00:00
abstract::A 15-year-old girl with papillary serous carcinoma of the peritoneum was seen with abdominal distention, ascites, and elevated CA 125 tumor marker. After other therapy failed, she achieved complete and continuing remission with paclitaxel. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90046-2
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine whether amniotic fluid levels of glial acidic fibrillary protein (GFAP) would reflect myelomeningocele-related neurodegeneration in the rat model of retinoic acid-induced myelomeningocele, which is a model that is very similar to human myelomeningocele and develops...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.09.032
更新日期:2011-02-01 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::Our subjects were 32 patients whose old complete perineal lacerations were repaired in the 10 hospitals in the South Hampton Roads Metropolitan area over a 20-year period. The layer technique of repair (26 patients) and the Warren flap procedure (6 patients) were used. Function improved in 24 of 26 patients (92%) with...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(88)80053-x
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVE:This study was designed to develop formulas using the chest circumference instead of the abdominal circumference for estimating fetal weight. STUDY DESIGN:Ultrasonographic measurements of the chest circumference, biparietal diameter, abdominal circumference, humeral length, and femoral length were obtained i...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91427-6
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVE:Postmenopausal women who receive sequential hormone replacement therapy with estrogen combined with progestogen for 10 to 24 d/mo for a prolonged period may have an elevated endometrial cancer risk relative to those who have never received hormone replacement therapy. We investigated whether daily use of estr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.108081
更新日期:2000-12-01 00:00:00
abstract::Vaginitis is one of the most common causes of patient visits to gynecologists, primary care providers, and urgent care centers. However, many women leave without a clear diagnosis or experience recurrent symptoms despite treatment. The 3 most common etiologies of vaginitis are trichomonas, bacterial vaginosis, and vul...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2019.09.001
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Precocious cervical ripening, as defined by cervical shortening on transvaginal sonography, has prompted a broad evaluation of secondary strategies (such as cerclage, vaginal progesterone, or a cervical pessary) to prevent preterm delivery. However, there is still a lack of direct comparisons between individ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2015.12.007
更新日期:2016-06-01 00:00:00
abstract::Most pharmacokinetic studies of antibodies in pregnancy have been carried out at the time of abortion or delivery. Whether such data represent pregnancy as such is not known. The present study compares the pharmacokinetic properties of cefuroxime in seven women during pregnancy, at delivery, and after delivery. After ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32526-1
更新日期:1982-04-01 00:00:00
abstract::X-ray evaluation of the pelvis plays a pivotal role in selecting term breech presentation for a possible trial of labor. Even minimal degrees of disproportion may have disastrous consequences for the aftercoming head. Our evaluation of x-ray pelvimetry by computerized tomography scanning suggests it is probably more a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90695-7
更新日期:1985-12-15 00:00:00
abstract:OBJECTIVE:Our purpose was to document noninvasively the effect of sickle cell disease on left ventricular systolic and diastolic function during the third trimester of pregnancy. STUDY DESIGN:Fifteen patients with sickle cell disease underwent a two-dimensional M-mode echocardiography obtained using the long axis with...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70393-0
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to assess the utility of the Advanced Life Support in Obstetrics Course for obstetrics/gynecology first-year residents by triangulating pretest and posttest scores on written test of knowledge by interns, with qualitative surveys by residents, and faculty. STUDY DESIGN:Obstetrics/gy...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.10.912
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate endometrial biopsy and curettage in detecting small nerve fibers in eutopic endometrium for diagnosis of endometriosis. STUDY DESIGN:Endometrial biopsies with precise, consistent technique and curettings were taken from 37 women (20 with endometriosis and 17 without ...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/j.ajog.2007.04.032
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Maternal mortality ratios (MMR) appear to have increased in the United States over the last decade. Three potential contributing factors are (1) a shifting maternal age distribution, (2) changes in age-specific MMR, and (3) the addition of a checkbox indicating recent pregnancy on the death certificate. OBJ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2017.04.042
更新日期:2017-09-01 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:OBJECTIVE:Thrombin is a potent uterotonic agent that may play an important role in human parturition. FGL2 is a prothrombinase that cleaves prothrombin to thrombin. The purpose of this study was to determine FGL2 messenger RNA expression in human myometrium and to assess its relationship to the expression of EP3-6 pros...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.248
更新日期:2003-04-01 00:00:00
abstract::Amniotic fluid embolism is a leading cause of maternal mortality in developed countries. Our understanding of risk factors, diagnosis, treatment, and prognosis is hampered by a lack of uniform clinical case definition; neither histologic nor laboratory findings have been identified unique to this condition. Amniotic f...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.06.037
更新日期:2016-10-01 00:00:00
abstract::A randomized, comparative study of two low-dose oral contraceptives was carried out in 60 nonpregnant women for 12 cycles. Twenty-eight women took a preparation containing 150 micrograms of desogestrel and 30 micrograms of ethinyl estradiol; 32 took 75 micrograms of gestodene and 30 micrograms of ethinyl estradiol. Ba...
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(90)91357-i
更新日期:1990-10-01 00:00:00
abstract::A total of 1,755 fetal heart rate (FHR) tracings of the second stage of labor was analyzed. The FHR patterns were classified according to the behavior of the baseline FHR and are listed in decreasing order of benignity: normocardia, transitory bradycardia, tachycardia, persistent bradycardia, and progressive bradycard...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90041-7
更新日期:1981-06-15 00:00:00
abstract::All pregnant women, regardless of age, should be offered screening or invasive testing for chromosomal abnormalities at <20 weeks' gestation. Noninvasive prenatal screening for fetal aneuploidy with the use of cell-free DNA (cfDNA) is a screening method that offers high sensitivity and specificity in validation studie...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2015.05.004
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to evaluate the presence or absence of neurotrophins and their respective receptors within adult human preovulatory follicles. STUDY DESIGN:Prospective study of neurotrophins and their receptors in follicular cells and unfertilized oocytes from women undergoing aspiration for in vit...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.12.022
更新日期:2006-04-01 00:00:00
abstract::Imaging currently plays a limited role in the investigation of pelvic floor disorders. It is obvious that magnetic resonance imaging has limitations in urogynecology and female urology at present due to cost and access limitations and due to the fact that it is generally a static, not a dynamic, method. However, none ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2009.08.018
更新日期:2010-04-01 00:00:00
abstract::Removal of fallopian tubes and ovaries through the laparoscope is a safe and efficient alternative to laparotomy. Seventeen patients undergoing this procedure are described. This approach should be considered for those patients requiring adnexal surgery provided that the operator is skilled in multiple puncture laparo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90825-r
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:An abnormal umbilical artery Doppler waveform is a risk factor for adverse perinatal outcome. However, it has not been established whether this is related to the earlier gestational age at delivery of fetuses with abnormal Doppler findings or whether Doppler findings are an independent predictor of perinatal ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90087-6
更新日期:1994-09-01 00:00:00
abstract::One of the largest nationally reported cases of carcinoma in situ in the teenage population of the United States is based on 1 year's computerized data from Cancer Screening Services. In 1981, 796,337 women were screened with an average age of 25.9. Of these, 18,589 (2.33%) had abnormal cytology. In 194,069 (24.3%) of...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90555-6
更新日期:1984-03-15 00:00:00