Abstract：
OBJECTIVE:To define the frequency, risk factors, and outcomes of massive transfusion in obstetrics. METHODS:The State Inpatient Dataset for New York (1998-2007) was used to identify all delivery hospitalizations for hospitals that reported at least one delivery-related transfusion per year. Multivariable logistic regression analysis was performed to examine the relationship between maternal age, race, and relevant clinical variables and the risk of massive blood transfusion defined as 10 or more units of blood recorded. RESULTS:Massive blood transfusion complicated 6 of every 10,000 deliveries with cases observed even in the smallest facilities. Risk factors with the strongest independent associations with massive blood transfusion included abnormal placentation (1.6/10,000 deliveries, adjusted odds ratio [OR] 18.5, 95% confidence interval [CI] 14.7-23.3), placental abruption (1.0/10,000, adjusted OR 14.6, 95% CI 11.2-19.0), severe preeclampsia (0.8/10,000, adjusted OR 10.4, 95% CI 7.7-14.2), and intrauterine fetal demise (0.7/10,000, adjusted OR 5.5, 95% CI 3.9-7.8). The most common etiologies of massive blood transfusion were abnormal placentation (26.6% of cases), uterine atony (21.2%), placental abruption (16.7%), and postpartum hemorrhage associated with coagulopathy (15.0%). A disproportionate number of women who received a massive blood transfusion experienced severe morbidity including renal failure, acute respiratory distress syndrome, sepsis, and in-hospital death. CONCLUSION:Massive blood transfusion was infrequent, regardless of facility size. In the presence of known risk for receipt of massive blood transfusion, women should be informed of this possibility, should deliver in a well-resourced facility if possible, and should receive appropriate blood product preparation and venous access in advance of delivery. LEVEL OF EVIDENCE:: II.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Mhyre JM,Shilkrut A,Kuklina EV,Callaghan WM,Creanga AA,Kaminsky S,Bateman BTdoi
10.1097/AOG.0000000000000021subject
Has Abstractpub_date
2013-12-01 00:00:00pages
1288-94issue
6eissn
0029-7844issn
1873-233Xjournal_volume
122pub_type
杂志文章abstract：:The present study is concerned with surveillance/management programs for hereditary ovarian cancer syndromes. These syndromes lack distinguishing premonitory physical signs or biomarkers; therefore, in these genotypic settings, ovarian cancer risk must be assessed by analysis of the patient's pedigree. The authors des...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1982-05-01 00:00:00
abstract：OBJECTIVE:To assess changes in the prescribing practices, knowledge, attitudes, and perceptions of health care providers after an educational program about emergency contraception. METHODS:Health care providers completed self-administered questionnaires before and 1 year after full implementation of the project. The 1...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(01)01365-5
更新日期：2001-06-01 00:00:00
abstract：OBJECTIVE:To determine whether peak expiratory flow rate changes with pregnancy and advancing gestation. METHODS:We measured the peak expiratory flow rate in 57 women during each trimester of pregnancy and postpartum. During four visits, all subjects exhaled forcefully three times into a peak flow meter. For each visi...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/S0029-7844(96)00512-1
更新日期：1997-03-01 00:00:00
abstract：OBJECTIVE:To compare biopsychologic profiles of women with dyspareunia with a matched no-pain control sample, and to determine whether dyspareunia subtypes based on physical findings have different psychosocial profiles from matched controls. METHODS:One hundred and five women with dyspareunia and 105 matched no-pain ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(98)80136-1
更新日期：1997-10-01 00:00:00
abstract：:Fertility and pregnancy complications were assessed in 137 women at risk of having inherited the gene for autosomal dominant polycystic kidney disease. Seventy-six (55%) of these subjects were found to have polycystic kidney disease (multiple renal cysts). The remaining 61 women served as controls. The prevalence of f...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1983-05-01 00:00:00
abstract：OBJECTIVE:Women with diabetes need safe, effective contraception. Although intrauterine devices provide superior contraception, concerns remain that progestin absorbed systemically from the levonorgestrel-releasing device may impair carbohydrate metabolism. To examine the effect of the levonorgestrel-releasing intraute...
journal_title：Obstetrics and gynecology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1097/01.AOG.0000156301.11939.56
更新日期：2005-04-01 00:00:00
abstract：:The weights of 101 neonates delivered within 72 hours of real-time ultrasound examination were compared with the weight calculated from the ultrasonically measured biparietal diameter and abdominal circumference. A high degree of correlation (4 = .9624) was found between actual and calculated weights. This method of w...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1981-06-01 00:00:00
abstract：:Moderate caffeine consumption (less than 200 mg per day) does not appear to be a major contributing factor in miscarriage or preterm birth. The relationship of caffeine to growth restriction remains undetermined. A final conclusion cannot be made at this time as to whether there is a correlation between high caffeine ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0b013e3181eeb2a1
更新日期：2010-08-01 00:00:00
abstract：:The Acyclovir in Pregnancy Registry was established to gather data on prenatal exposure to acyclovir. Exposed pregnancies are tracked prospectively to ascertain exposure, risk factors, and pregnancy outcome. Through June 30, 1990, 312 acyclovir-exposed pregnancies had been reported and followed. Of these, 239 were exp...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1992-01-01 00:00:00
abstract：:Family planning plays a pivotal role in population growth, poverty reduction, and human development. Evidence from the United Nations and other governmental and nongovernmental organizations supports this conclusion. Failure to sustain family planning programs, both domestically and abroad, will lead to increased popu...
journal_title：Obstetrics and gynecology
pub_type： 评论,杂志文章,评审
doi：10.1097/01.AOG.0000287063.32004.23
更新日期：2007-11-01 00:00:00
abstract：:The group A streptococcus is capable of producing exotoxins that have been linked to a toxic shock-like syndrome. Streptococcal toxic shock is a rapidly progressive disease associated with injury to multiple organ systems and a 30-60% mortality rate. We present a case of a 40-year-old woman who developed group A strep...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1991-09-01 00:00:00
abstract：:The maternal serum alpha-fetoprotein (AFP) in 6161 women in routine pregnancy [2771 in a hospital obstetric clinic (group 1) and 3390 in private practices (group 2)] was studied. Group 1 studies enabled the delineation of the normal range of serum AFP, whereas group 2 represented a true screening experience. In group ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1980-01-01 00:00:00
abstract：OBJECTIVE:To compare composite maternal and neonatal adverse outcomes among women with at least a bachelor's degree by racial and ethnic groups. METHODS:This was a retrospective cohort study using the U.S. vital statistics data sets. We included women with at least a bachelor's degree who delivered a nonanomalous live...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000003887
更新日期：2020-07-01 00:00:00
abstract：OBJECTIVE:To compare the outcomes of women with stage III uterine cancer treated with chemotherapy alone, external beam radiation alone, and combination chemotherapy and radiation. METHODS:The National Cancer Database was used to identify women with stage III endometrioid, serous, and clear cell uterine cancer treated...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000003287
更新日期：2019-07-01 00:00:00
abstract：BACKGROUND:Small cell carcinoma of the ovary is an aggressive tumor primarily affecting young women. Despite adjuvant therapy, the majority of patients described in the literature have fared poorly, even when the disease is diagnosed at an early stage. CASE:A 19-year-old nulligravida with small cell carcinoma of the l...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/01.AOG.0000124996.56880.d9
更新日期：2004-05-01 00:00:00
abstract：:Patient choices and plans may sometimes carry increased risk or include alternatives that individual physicians feel uncomfortable supporting or recommending. We consider in this commentary how the ethical principles of respect for autonomy and nonmaleficence can be balanced using, among other examples, the choice by ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0b013e3182167413
更新日期：2011-05-01 00:00:00
abstract：:Prenatal genetic screening is designed to assess whether a patient is at increased risk of having a fetus affected by a genetic disorder. In contrast, prenatal genetic diagnostic testing is intended to determine, with as much certainty as possible, whether a specific genetic disorder or condition is present in the fet...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,实务指引
doi：10.1097/AOG.0000000000001439
更新日期：2016-05-01 00:00:00
abstract：:Over half the patients with proven ectopic pregnancies have negative urinary slide or tube pregnancy tests at the time they present with symptoms. Because of the morbidity and mortality associated with unrecognized ectopic pregnancy, the need for an accurate, rapid, sensitive, and specific method for measuring low lev...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1977-11-01 00:00:00
abstract：OBJECTIVE:To explore the pregnancy and childbirth experiences and preferences of women with a history of sexual trauma in order to identify trauma-informed care practices that health care providers may use to improve obstetric care. METHODS:We conducted a qualitative study consisting of semistructured interviews with ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000002956
更新日期：2018-12-01 00:00:00
abstract：OBJECTIVE:To determine the influence of maternal blood contamination on amniotic fluid (AF) glucose and white blood cell count (WBC). METHODS:Amniotic fluid from 23 preterm, nondiabetic pregnant women was studied. Maternal blood was added to the AF at increasing concentrations, and glucose and WBCs were assessed. RES...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0029-7844(95)00354-1
更新日期：1996-02-01 00:00:00
abstract：OBJECTIVE:To assess the value of the fetal nonstress test (NST) in predicting neonatal transfusion in pregnancies complicated by red cell isoimmunization. METHODS:We retrospectively reviewed the records of all patients evaluated for isoimmunization in pregnancy for the period January 1992 to December 1994. In addition...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0029-7844(96)00180-9
更新日期：1996-09-01 00:00:00
abstract：OBJECTIVE:To evaluate the comparative safety of transcervical and transabdominal chorionic villus sampling (CVS). METHODS:From May 1988 to January 1992, CVS was performed by two operators at 9-12 weeks' gestation in 1048 singleton pregnancies. The sampling method for each patient, transabdominal or transcervical, was ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1994-05-01 00:00:00
abstract：:The postpartum dose of Rh immune globulin varies according to an individual laboratory estimation of fetal red blood cells in each mother's peripheral blood. In the United States, a four-step procedure determines the postpartum dose (number of vials of 300 micrograms; 1,500 international units) of Rh immune globulin (...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1097/aog.0b013e3182742eba
更新日期：2012-12-01 00:00:00
abstract：:Three cases of mucinous carcinoma of the endometrium are presented. These can be distinguished anatomically from endocervical carcinomas and histochemically from endometrial clear cell carcinomas. Clinically these patients do not differ significantly from others with endometrial carcinoma, but the tumors produce large...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1980-02-01 00:00:00
abstract：:Preoperative abdominopelvic computed tomography results and operative findings were compared in 52 patients undergoing second-look laparotomy to confirm tumor status. Seventeen true-negative, 22 false-negative, and 13 true-positive scans were found. The sensitivity was 0.38, specificity was 1.0, and diagnostic accurac...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1985-05-01 00:00:00
abstract：BACKGROUND:Pellagra is a rare clinical syndrome caused by niacin deficiency, and although most commonly nutritional in origin, may be secondary to carcinoid syndrome. CASE:A premenopausal nulliparous woman with metastatic carcinoid tumor developed isolated vulvovaginal manifestations characterized by well-demarcated s...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0b013e318191bb51
更新日期：2009-02-01 00:00:00
abstract：:We compared the TDx Fetal Lung Maturity test and the fluorescence polarization method using 1-palmitoyl-2(6-[(7-nitro-2,1,3-benzoxadiazol-4- yl)amino]caproyl)phosphatidylcholine (NBD-phosphatidylcholine). Using 76 paired human amniotic fluid samples, the fluorescence polarization values of the two methods were found t...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1992-12-01 00:00:00
abstract：:In experiments performed in anesthetized monkeys in the third trimester of pregnancy, mean maternal arterial blood pressure was continuously monitored, the uterine artery blood flow was measured with an electromagnetic flow probe, and prostaglandin levels were assayed in the uterine venous effluent. After inhibition o...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1977-11-01 00:00:00
abstract：OBJECTIVE:Maternal anal sphincter tears after vaginal delivery are frequently not diagnosed clinically and are associated with subsequent fecal incontinence. This study examined whether diagnosis of these tears by ultrasonography, followed by immediate surgical repair, reduces the occurrence of incontinence. METHODS:W...
journal_title：Obstetrics and gynecology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1097/01.AOG.0000165273.68486.95
更新日期：2005-07-01 00:00:00
abstract：OBJECTIVE:To compare the incidence of hypertensive disorders of pregnancy among women living with human immunodeficiency virus (HIV) on combination antiretroviral therapy (ART) to women without HIV, and to evaluate the association of hypertensive disorders of pregnancy with ART regimens or timing of ART initiation. ME...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000003584
更新日期：2019-12-01 00:00:00
