Abstract:
OBJECTIVE:Emerging data suggest that oophorectomy at the time of hysterectomy for benign indications may increase long-term morbidity and mortality. We performed a population-based analysis to estimate the rates of oophorectomy in women undergoing hysterectomy for benign indications. METHODS:The Perspective database was used to estimate the rate of ovarian preservation in women aged 40-64 years who underwent hysterectomy for benign indications. Hierarchical mixed-effects regression models were developed to estimate the influence of patient, procedural, physician, and hospital characteristics on ovarian conservation. Between-hospital variation in ovarian preservation also was estimated. RESULTS:Among 752,045 women, 348,972 (46.4%) underwent bilateral oophorectomy, whereas 403,073 (53.6%) had ovarian conservation. Stratified by age, the rate of ovarian conservation was 74.3% for those younger than 40 years of age; 62.7% for those 40-44 years of age; 40.8% for those 45-49 years of age; 25.2% for those 50-54 years of age; 25.5% for those 55-59 years of age; and 31.0% for those 60-64 years of age. Younger age and more recent year of surgery had the strongest association with ovarian conservation. The observed patient, procedural, physician, and hospital characteristics accounted for only 46% of the total variation in the rate of ovarian conservation; 54% of the variability remained unexplained, suggesting a large amount of intrinsic between-hospital variation in the decision to perform oophorectomy. CONCLUSION:The rate of ovarian conservation is increasing, particularly among women younger than 50 years old. Although demographic and clinical factors influence the decision to perform oophorectomy, there appears to be substantial between-hospital variation in performance of oophorectomy that remains unexplained by measurable patient, physician, or hospital characteristics. LEVEL OF EVIDENCE:II.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Perera HK,Ananth CV,Richards CA,Neugut AI,Lewin SN,Lu YS,Herzog TJ,Hershman DL,Wright JDdoi
10.1097/AOG.0b013e3182887a47subject
Has Abstractpub_date
2013-04-01 00:00:00pages
717-726issue
4eissn
0029-7844issn
1873-233Xpii
00006250-201304000-00005journal_volume
121pub_type
杂志文章abstract:OBJECTIVE:To investigate factors associated with differential state maternal mortality ratios and to quantitate the contribution of various demographic factors to such variation. METHODS:In a population-level analysis study, we analyzed data from the Centers for Disease Control and Prevention National Center for Healt...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,收录出版
doi:10.1097/AOG.0000000000001628
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of transcervical Foley catheter alone (Foley) to transcervical Foley catheter with extraamniotic saline infusion for labor induction and cervical ripening in women with an unfavorable cervix. METHODS:This was a multicenter, randomized, controlled trial of women presenting for labor in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/01.AOG.0000278077.30890.87
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:To describe the human papillomavirus (HPV) genotype distribution in invasive vaginal cancers diagnosed before the introduction of the HPV vaccine and evaluate if survival differed by HPV status. METHODS:Four population-based registries and three residual tissue repositories provided formalin-fixed, paraffin-...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000171
更新日期:2014-04-01 00:00:00
abstract::Recent reports have suggested that focal hyperechoic abdominal masses detected during the second trimester may represent a normal variation in fetal intestinal development that is transient in nature and not associated with pathologic conditions. The patient described here had second-trimester ultrasonic findings of f...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:Because of donor oocyte programs, women who previously were considered too old to successfully achieve conception and delivery can now bear children. To our knowledge, there have been no previous reports of pregnancy outcome in women over age 50 who conceived using donor oocytes. This study presents the preg...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::Endometriotic ureteral obstruction is a serious event commonly diagnosed late and therefore associated with a major risk of hydronephrotic renal atrophy. The standard therapy is surgical. However, medical treatment has been reported using danazol, progestins, and estrogen-progestin combinations, although solid documen...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::This report describes an instrument to recover fertilized ova from the human uterus without anesthesia. Two hundred sixty-five lavages were performed on 20 normal and presumed fertile women and on seven infertile women. Using 60 mL of fluid, median fluid recovery was 97% (range 65-100%). In the fertile women, ova were...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-05-01 00:00:00
abstract::Female sexual dysfunction (FSD) is characterized as chronic sexual symptoms that manifest with personal distress in the domains of desire, arousal, orgasm, and pain. Extensive epidemiologic evidence estimates that almost 50% of perimenopausal and postmenopausal women experience FSD. Screening for FSD is not readily co...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002268
更新日期:2017-10-01 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 examine the frequency of pregnancy loss following successful development of anatomical embryonic landmarks identified with endovaginal ultrasound. METHODS:Two hundred thirty-two women with positive urinary pregnancy tests and no antecedent history of vaginal bleeding had endovaginal sonography performed a...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract::This is a case report of a woman having an IUD which became partially extruded through the uterine wall and went undetected until the patient became pregnant. Severe metritis followed premature rupture of the membranes during the early part of the third trimester. Cesarean section hysterectomy led to a salutary outc...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1969-12-01 00:00:00
abstract::Postpartum hemorrhage is a common and serious complication of the third stage of labor resulting in anemia and increased morbidity in the puerperium. Administration of uterotonic drugs and suitable mechanical assistance in delivery of the placenta may significantly reduce this hazard. Ergometrine and oxytocin have bee...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-12-01 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::Findings on ultrasound scanning of the cervix and lower uterine segment were compared with those on digital examination in patients in preterm labor or those in whom induction was planned. An ultrasound scoring system gave results that corresponded closely to those of the Bishop score. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract:OBJECTIVE:To compare the Centers for Disease Control and Prevention's (CDC) contraceptive effectiveness poster with a more patient-centered poster on factors affecting the likelihood of using effective contraceptives. METHODS:The posters were tested in a randomized controlled trial. Women were eligible if they were ag...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/AOG.0000000000003012
更新日期:2019-01-01 00:00:00
abstract::Amniotic fluid prostaglandin levels were measured serially in 15 patients who underwent successful induction of labor and compared with those of patients presenting in spontaneous labor. At comparable cervical dilation the induced group demonstrated significantly lower prostaglandin levels. Four of these patients deli...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract:OBJECTIVE:To identify risk factors for fever in labor. METHODS:A retrospective case-control study was conducted. Maternal sublingual temperature was measured every 2-4 hours during labor in 3109 of 3860 consecutive term parturients presenting from September 1992 through December 1993. Women who had fever (at least one...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00254-O
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:To determine the incidence, features, and surgical treatment of vulvovaginal lesions in toxic epidermal necrolysis. METHODS:Acute genital lesions were studied retrospectively in 40 women hospitalized for toxic epidermal necrolysis in a dermatologic intensive care unit. A questionnaire was sent to evaluate se...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00596-6
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:We report a highly exceptional case in which a gonadotroph adenoma was diagnosed in a patient with normal follicle-stimulating hormone (FSH) levels. CASE:A 30-year-old woman with a gonadotroph adenoma presented with hyperstimulation syndrome and normal FSH levels. After treatment of her adenoma she had regu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000247316.60573.4a
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:Visual estimation of blood loss is often inaccurate and imprecise. Obstetric bleeding requires expedient identification and intervention to prevent maternal morbidity and mortality. We aimed to create a visual aid to improve accuracy of estimated obstetric blood loss. METHODS:We designed a pocket card contai...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1097/AOG.0000000000000233
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:To develop a model based on factors available at the first prenatal visit that predicts chance of successful vaginal birth after cesarean delivery (VBAC) for individual patients who undergo a trial of labor. METHODS:All women with one prior low transverse cesarean who underwent a trial of labor at term with ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/01.AOG.0000259312.36053.02
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that increasing the intravenous fluid bolus volume at the time of epidural placement in women with narrow pulse pressure would reduce postepidural fetal heart rate (FHR) abnormalities, hypotension, and resuscitative obstetric interventions. METHODS:We performed a single-center randomiz...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/AOG.0000000000002326
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Malignant transformation of endometriosis in an episiotomy site is rare. CASE:A 42-year-old woman presented with a palpable mass, 2.5 cm in size, just inside the posterior commissure of the vagina, at the site of a previous episiotomy for a vaginal delivery. Three years previously, an endometriotic cyst had...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318179475b
更新日期:2008-08-01 00:00:00
abstract::In a paired, controlled, retrospective study, 44 low birth weight breech fetuses delivered vaginally were compared with 44 breech fetuses delivered by cesarean section. Seven deaths occurred in the vaginal delivery group, compared with only 1 in the abdominal delivery group. Asphyxia, trauma, and intracranial hemorrha...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract::Single-incision laparoscopy is a minimally invasive technique that decreases the number of operative sites used in traditional laparoscopic surgery to one skin incision, with the potential advantages of improving cosmesis and decreasing postoperative pain. There are limited data to demonstrate the safety and feasibili...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000433009.93971.23
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To determine factors associated with delay of induced abortion into the second trimester of pregnancy. METHODS:Using audio computer-assisted self-interviewing, 398 women from 5 to 23 weeks of gestation at an urban hospital described steps and reasons that could have led to a delayed abortion. Multivariable l...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000189095.32382.d0
更新日期:2006-01-01 00:00:00
abstract::Given that practice variation exists in the frequency and performance of ultrasound and magnetic resonance imaging (MRI) in pregnancy, the Eunice Kennedy Shriver National Institute of Child Health and Human Development hosted a workshop to address indications for ultrasound and MRI in pregnancy, to discuss when and ho...
journal_title:Obstetrics and gynecology
pub_type:
doi:10.1097/AOG.0000000000000245
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:To determine how long fetal nucleated cells can be detected in maternal peripheral blood after delivery in cases of fetomaternal hemorrhage, using fluorescence in situ hybridization or polymerase chain reaction. METHODS:Nucleated cells with Y chromosomes were analyzed in 90 blood samples using fluorescence i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(94)00414-9
更新日期:1995-03-01 00:00:00
abstract::Twenty-one subjects with pregnancy-induced hypertension were investigated with regard to the relationship between maternal hemodynamics and fetal growth. Five of the infants were small for gestational age (SGA) (less than tenth percentile) and 16 were appropriate for gestational age (AGA) (greater than tenth percentil...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-02-01 00:00:00
abstract:OBJECTIVE:To analyze the change in serial human chorionic gonadotropin (hCG) levels in women symptomatic with pain or bleeding who presented with nondiagnostic ultrasonography but were ultimately confirmed to have a viable intrauterine pregnancy. METHODS:The rise in serial hCG measures were modeled over time, with the...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000128174.48843.12
更新日期:2004-07-01 00:00:00