Abstract：
OBJECTIVE:To investigate whether the 2006 American Society for Colposcopy and Cervical Pathology guidelines for conservative management of minimally abnormal Pap test results (atypical squamous cells of undetermined significance, human papillomavirus-positive, and low-grade squamous intraepithelial lesions) and moderate dysplasia (cervical intraepithelial neoplasia 2) in adolescents 1) resulted in fewer colposcopies and loop electrosurgical excision procedures (LEEPs) in adolescents or 2) resulted in unintended treatment changes in older age groups. METHODS:We analyzed data from 1,806 women aged 18 years and older attending one of six community health centers who were diagnosed with abnormal Pap test results between January 1, 2004, and December 31, 2008. We used multivariable logistic regression to examine treatment differences in women with minimally abnormal Pap test results before and after guideline changes. Variables included date of abnormality, site of care, race or ethnicity, language, and insurance type. We used Fisher exact tests to examine rates of LEEP in patients with moderate dysplasia before and after guideline publication. RESULTS:Among 206 women aged 18-20 years, rates of colposcopy after a minimally abnormal Pap test result decreased from 78% (n=102) to 45% (n=34) after guideline changes (P<.001). Colposcopy among women over age 21 (n=1,542) remained unchanged (greater than 90%). Multivariable logistic regression indicated that both date of abnormality and site of care were associated with colposcopy referral. After guideline changes, management of moderate dysplasia with LEEP in women aged 18-23 decreased from 55% to 18% (P=.04); rates remained stable in women ages 24 and older (70% compared with 74%; P=.72). CONCLUSION:Health care providers quickly adopted new conservative management guidelines for low-income, minority adolescents, which may reduce preterm deliveries in these high-risk populations. LEVEL OF EVIDENCE:II.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Perkins RB,Jorgensen JR,McCoy ME,Bak SM,Battaglia TA,Freund KMdoi
10.1097/AOG.0b013e31824e9f2fsubject
Has Abstractpub_date
2012-06-01 00:00:00pages
1157-63issue
6eissn
0029-7844issn
1873-233Xpii
00006250-201206000-00013journal_volume
119pub_type
杂志文章abstract：:We reviewed our experience with a policy of revising the estimated probability of an open neural tube defect for those cases in which maternal serum alpha-fetoprotein (MSAFP) was elevated and the ultrasound examination was normal. Assuming a sensitivity for the ultrasound diagnosis of neural tube defects of 90%, the r...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1988-02-01 00:00:00
abstract：:The value of the contraction stress test (CST), although well documented in late pregnancy, has been questioned earlier in gestation. We have evaluated the reliability of the CST in 102 patients tested before 33 weeks' gestation. Eighteen patients with a positive CST had a significantly higher incidence of abnormal ur...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1978-12-01 00:00:00
abstract：:Mental health disorders in adolescence are a significant problem, relatively common, and amenable to treatment or intervention. Obstetrician-gynecologists who see adolescent patients are highly likely to see adolescents and young women who have one or more mental health disorders. Some of these disorders may interfere...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,实务指引
doi：10.1097/AOG.0000000000002153
更新日期：2017-07-01 00:00:00
abstract：:Cervical pregnancy was diagnosed at 12 weeks' gestation in a young nulliparous woman presenting with vaginal bleeding. Initial treatment with methotrexate was unsuccessful. The patient was ultimately treated by internal iliac artery ligation, hysterotomy, and intracervical balloon tamponade. Nineteen months after surg...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1988-06-01 00:00:00
abstract：OBJECTIVE:To compare surgical outcome and quality of life of robot-assisted laparoscopic hysterectomy with conventional laparoscopic hysterectomy. METHODS:For this controlled clinical trial, patients with benign indications for hysterectomy were randomized to receive either a robotic (robotic group) or conventional la...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,随机对照试验
doi：10.1097/AOG.0b013e318265b61a
更新日期：2012-09-01 00:00:00
abstract：OBJECTIVE:To investigate whether pregnancy-induced regulatory T cells are generated specifically for paternal antigens or expanded by hormonal changes and to study regulatory T cell-related mechanisms during pregnancy. METHODS:We used murine models of normal, abortion-prone, and pseudopregnancy to characterize regulat...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/01.AOG.0000284625.10175.31
更新日期：2007-11-01 00:00:00
abstract：OBJECTIVE:To compare extra-amniotic infusion of diluted prostaglandin (PG) E2 solution with saline infusion in balloon cervical ripening and labor induction. METHODS:Women with pregnancy complications and Bishop scores of 3 or lower (n = 116) were assigned randomly to receive extra-amniotic infusion (1 mL/minute) of n...
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(00)01168-6
更新日期：2001-03-01 00:00:00
abstract：OBJECTIVE:To examine preterm births among African-American and Hispanic women who delivered at an inner-city public hospital in the context of contemporaneously increasing rates in the United States. METHODS:The rates of preterm birth, defined as birth before 37 weeks of gestation, for singleton neonates with birth we...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0b013e318195e257
更新日期：2009-03-01 00:00:00
abstract：BACKGROUND:Postoperative bleeding may be complicated by failure to identify the site of bleeding, multiple bleeding points, and persistent hemorrhage despite surgical intervention. CASE:Activated recombinant factor VII was used successfully in a patient with life-threatening postsurgical bleeding after resection of tw...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：2003-06-01 00:00:00
abstract：:Injury to the sciatic nerve is an infrequent but important complication of gynecologic procedures in which the lithotomy position is used. This lesion may occur after vaginal hysterectomy or after short procedures such as dilatation and curettage or laparoscopy. Few reports are found in the gynecologic literature. The...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1983-09-01 00:00:00
abstract：OBJECTIVE:To estimate whether the use of specific types of assisted reproductive technology (ART) is associated with an increased risk of placenta-mediated pregnancy complications, which include preeclampsia, stillbirth, small for gestational age at birth, and placental abruption. METHODS:A population-based retrospect...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0b013e3181b76bd1
更新日期：2009-10-01 00:00:00
abstract：OBJECTIVE:To determine clinical characteristics of women with endometriosis-associated intraperitoneal cancers, to assess differences based on the relationship of the cancer to the endometriosis, and to assess factors associated with survival. METHODS:A search of medical records at The University of Texas M. D. Anders...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(02)02149-x
更新日期：2002-10-01 00:00:00
abstract：:In ovarian cancer stages IIB-IV, pre-treatment variables and variables obtained intraoperatively at second-look laparotomy were investigated for their prognostic influence on the outcome of 109 patients and survival after second-look laparotomy in 131 patients. The subjects came from a randomized trial of sequential v...
journal_title：Obstetrics and gynecology
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1990-10-01 00:00:00
abstract：BACKGROUND:Refeeding syndrome is a rare constellation of electrolyte abnormalities after reintroduction of glucose during an adaptive state of starvation and malnutrition, resulting in fluid shifts, end-organ damage, and, potentially, death. We present a case of fetal death in a patient with hyperemesis gravidarum comp...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000003276
更新日期：2019-06-01 00:00:00
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：OBJECTIVE:To examine whether there are: 1) regional differences in three perinatal interventions that reflect active treatment among periviable gestations and 2) racial-ethnic differences in the receipt of these perinatal interventions after accounting for hospital region. METHODS:We conducted a retrospective study on...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000003747
更新日期：2020-04-01 00:00:00
abstract：OBJECTIVE:To estimate normal ranges for postpartum maternal vital signs. METHODS:We conducted a multicenter prospective longitudinal cohort study in the United Kingdom. We recruited women before 20 weeks of gestation without significant comorbidities and with accurately dated singleton pregnancies. Women recorded thei...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000004239
更新日期：2021-02-01 00:00:00
abstract：:During the 1970s in the United States, the number of hospitalizations for ectopic pregnancy increased more than twofold, and ectopic pregnancy emerged as a leading cause of maternal mortality. All known deaths from ectopic pregnancy in the United States from January 1, 1979, to December 31, 1980, were investigated by ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/00006250-198309000-00014
更新日期：1983-09-01 00:00:00
abstract：:In 1000 Rh-negative women who are delivered of Rh-positive fetuses and receive passive immunity postpartum, there will be 5-10 failures to protect against sensitization. Studies have been conducted to find out possible explanations for the failures and to devise means of preventing some or all of them. Results from ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1974-04-01 00:00:00
abstract：:Most discussion on labial adhesions is about the pediatric group. A case is presented of a postmenopausal woman whose main complaint was urinary incontinence. Etiology, symptoms, signs, and diagnosis are discussed. Guidelines for treatment and prevention are proposed. Because the number of postmenopausal women is stea...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/00006250-198409001-00020
更新日期：1984-09-01 00:00:00
abstract：:A study of 20 patients with hemoglobin E trait abnormality and 8 patients with hemoglobin E disease in pregnancy is presented. The hematologic abnormality in HbE hemoglobinopathy is mild though hemoglobin values are significantly lower than in HbA patients. Fetal wastage is no increased and the salvage rate is high (...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/00006250-197506000-00016
更新日期：1975-06-01 00:00:00
abstract：:Worldwide, sterilization (tubal sterilization and vasectomy) is used by more people than any other method of contraception. All techniques of tubal sterilization in widespread use in the United States have low risks of surgical complications. Although tubal sterilization is highly effective, the risk of pregnancy vari...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1097/01.AOG.0000298621.98372.62
更新日期：2008-01-01 00:00:00
abstract：BACKGROUND:Ehlers-Danlos syndrome is a group of inherited connective tissue diseases demonstrating autosomal-dominant, autosomal-recessive, and X-linked inheritance patterns. The diagnosis can be established by clinical, biochemical, and genetic findings. CASE:Our nulliparous patient presented with an unspecified diag...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0b013e3181898cbf
更新日期：2009-02-01 00:00:00
abstract：:A black multipara was shown, by hemoglobin electrophoresis, to have hemoglobin SD disease. The patient exhibited a typically mild anemia that probably was secondary to folate and iron deficiencies as well as to hemoglobinopathic hemolysis. The course of her pregnancy was complicated by pyelonephritis and hyposthenuria...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1982-09-01 00:00:00
abstract：:The vesicovaginal fistula from prolonged obstructed labor is a condition that is no longer seen in the affluent, industrialized world, yet it continues to exist in epidemic proportions in sub-Saharan Africa, where several million women are estimated to suffer from this condition. The unremitting urinary incontinence t...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(02)02498-5
更新日期：2002-12-01 00:00:00
abstract：:Cervical softening by vaginal administration of a prostaglandin E1 analogue (ONO-802) was studied in a double-blind, placebo-controlled study using an objective measure of cervical resistance in 121 women undergoing first trimester induced abortion. Three hours after administration, cervical resistance in control and ...
journal_title：Obstetrics and gynecology
pub_type： 临床试验,杂志文章
doi：
更新日期：1987-01-01 00:00:00
abstract：:Several pharmacologic agents are known to interfere with urinary estriol levels in pregnancy. This report implicates erythromycin as yet another agent responsible for such interference. ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1980-09-01 00:00:00
abstract：:One hundred fifty-eight cases are reported of fetal cardiocentesis during the second trimester for the prenatal diagnosis of hemoglobinopathies. In all cases, fetal blood sampling by funipuncture was technically impossible or unsuccessful. There were nine fetal deaths possibly related to the procedure, for a total fet...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1992-04-01 00:00:00
abstract：:To address the serious and seemingly intractable problem of preterm birth, the Surgeon General's Conference on the Prevention of Preterm Birth convened many of the country's experts from the public and private sectors of research, public health, and health care delivery to discuss preventive strategies. The purpose of...
journal_title：Obstetrics and gynecology
pub_type： 共识发展会议,杂志文章
doi：10.1097/AOG.0b013e31819bdba3
更新日期：2009-04-01 00:00:00
abstract：BACKGROUND:Only one case of plasma cell cervicitis, a rare variant of chronic cervicitis, has been reported. We report a second case and present data supporting the detection of human papillomavirus (HPV) outside of epithelial tissues. CASE:A 67-year-old woman was found to have a large cervical tumor. Extensive diagno...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1993-10-01 00:00:00
