Abstract:
BACKGROUND:Controversy surrounds the definition of "normal" and "abnormal" labor. OBJECTIVE:In this study, we used contemporary labor charts to explore labor patterns in large obstetric population (2011-2016). STUDY DESIGN:Detailed information from electronic medical records of live singleton deliveries at term (≥37 weeks of gestation) was extracted. Cases of elective cesarean deliveries, nonvertex presentation, and cesarean deliveries during the first stage of labor were excluded. RESULTS:Overall, 35,146 deliveries were included, of whom 15,948 deliveries (45.3%) were of nulliparous women. Median cervical dilation at admission was not significantly different between nulliparous (median, 4 cm; interquartile range, 3-5 cm) and multiparous women (median, 4 cm; interquartile range, 3-6 cm). In all, 99.3% of the women delivered vaginally. For nulliparous women, the median duration of the first stage of labor was 274 minutes (interquartile range, 145-441 minutes; 95th percentile, 747.5 minutes). Likewise, for multiparous women, the corresponding duration was 133 minutes (interquartile range, 56-244 minutes; 95th percentile, 494 minutes). During the latent phase (cervical dilation at admission, ≤4 cm), the time elapsed to the second stage of labor was 120-140 minutes longer in nulliparous women, whereas the gap between the groups decreased dramatically with advanced cervical dilation on admission. Nulliparous and multiparous women appeared to progress at a similar pace during the latent phase; however, after 5 cm, labor accelerated faster in multiparous women. Epidural anesthesia lengthens duration first and second stages of labor in all parities. Partograms according to cervical dilation at presentation are proposed. CONCLUSION:Cervical dilation rate is relatively constant between nulliparous and multiparous pregnant women during the latent phase. Time interval of the first stage was far slower than previously described, which allowed labor to continue for a longer period during this stage. These findings may reduce the rate of intrapartum iatrogenic interventions.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Ashwal E,Livne MY,Benichou JIC,Unger R,Hiersch L,Aviram A,Mani A,Yogev Ydoi
10.1016/j.ajog.2019.09.035subject
Has Abstractpub_date
2020-03-01 00:00:00pages
267.e1-267.e9issue
3eissn
0002-9378issn
1097-6868pii
S0002-9378(19)31164-0journal_volume
222pub_type
杂志文章abstract::The rates of regression of human chorionic gonadotropin (hCG) in patients with complete hydatidiform moles, partial hydatidiform moles, and nonmolar abortions were compared. No difference in rates of regression was found among the three groups, but levels of hCG immediately after uterine evacuation were significantly ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90184-4
更新日期:1984-05-15 00:00:00
abstract::Seventy-three women, primigravidas and multigravidas, received 1.0 mg PGE2 tablets hourly for 5 doses the evening prior to scheduled induction of term labor to improve cervical ripeness. The over-all response to treatment depended upon the initial cervical score. Gastrointestinal side effects occurred infrequently and...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90736-1
更新日期:1979-12-15 00:00:00
abstract::Maternal sepsis is a significant cause of maternal morbidity and mortality and is a preventable cause of maternal death. The purpose of this guideline is to summarize what is known about sepsis and to provide guidance for the management of sepsis in pregnancy and the postpartum period. The following are SMFM recommend...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2019.01.216
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Women with disabilities are increasingly becoming pregnant, and growing evidence suggests maternal disability may be associated with increased risk for perinatal complications. OBJECTIVE:A systematic review and meta-analysis were undertaken to examine the association between maternal disabilities and risk f...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ajog.2019.07.015
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Our objective was to study the effect of estrogen administration and moderate hypertension on left ventricular size, pump function, and contractility in chronically instrumented ewes. STUDY DESIGN:Ewes were either given 0.06 mg/kg 17beta-estradiol intramuscularly (n = 8) or were made hypertensive (n = 6) by ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70053-5
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:Our purpose was to evaluate the effect of breast-feeding frequency on serum bilirubin levels in the first 3 days after birth. STUDY DESIGN:Two hundred seventy-five infants were randomly assigned to a frequent or demand breast-feeding schedule. RESULTS:Infants in the frequent group (n = 131) nursed nine (7.5...
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/s0002-9378(94)70302-7
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVE:Our purpose was to report the cancers arising during a familial ovarian cancer screening program and investigate the tumor's clonality and association with BRCA1 and BRCA2 mutations. STUDY DESIGN:Program participants with a diagnosis of ovarian cancer or peritoneal serous papillary carcinoma were identified ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70663-0
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to determine the association between genitourinary tract infection with Chlamydia trachomatis and spontaneous preterm birth. STUDY DESIGN:Genitourinary tract infection with C trachomatis was determined with a ligase chain reaction assay of voided urine samples collected at 24 weeks'...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.106556
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:Our purpose was to define the diagnostic value of a new fetal assessment score that is based on each of the components of the Apgar score. STUDY DESIGN:A fetal assessment score was established to study the main fetal vital functions: (1) cardiovascular (heart rate, color of the skin in the Apgar score), now ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90618-s
更新日期:1993-09-01 00:00:00
abstract::Advances in modern medicine invite the assumption that medicine can control human biology. There is a perilous logic that leads from expectations of medicine's control over reproductive biology to the expectation of having a perfect baby. This article proposes that obstetricians should take a preventive ethics approac...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2010.01.058
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:Photodynamic therapy is a technique in which tissue is irradiated with light after the use of a photosensitizing drug that produces singlet oxygen, which has a cytotoxic effect. The feasibility of using photodynamic therapy with photofrin II for endometrial ablation was studied. STUDY DESIGN:Fifty-eight rabb...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91787-b
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVE:Acardiac/acephalic twinning is a rare anomaly in which a normal "pump" twin perfuses an acardiac twin, which results in twin reversed arterial perfusion sequence. A novel technique for selective reduction and obliteration of blood flow in the acardiac twin is described. STUDY DESIGN:Thirteen consecutive case...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.125242
更新日期:2002-09-01 00:00:00
abstract::Four cases of immature teratoma of the ovary are presented and the recent literature is reviewed. The majority of these tumors were confined to one ovary at the time of diagnosis, and more than 75% occurred in women under 25 years of age. The two most important prognostic parameters were stage of disease and histologi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(83)90813-x
更新日期:1983-06-15 00:00:00
abstract:OBJECTIVE:Many obstetric interventions are performed to improve long-term neonatal outcome. However, long-term neonatal outcome is usually not a primary outcome because it is time-consuming and expensive. The aim of this project was to identify different perinatal risk indicators and to develop prediction models for ne...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.02.055
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the effects of raloxifene on endothelial function in healthy, postmenopausal women. STUDY DESIGN:This was a randomized, double-blind, placebo-controlled crossover trial. Subjects (n = 19; mean age, 61 years) underwent endothelial function testing at baseline and aft...
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:10.1067/mob.2003.28
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to characterize gestational profiles of biochemical markers that are associated with preeclampsia in the blood of pregnant women in whom preeclampsia developed later and to compare these markers with the markers of women who were delivered of small-for-gestational-age infants wit...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.122969
更新日期:2002-07-01 00:00:00
abstract::We used the placenta as a source of undifferentiated cells to study the effect high glucose levels can have on human fetal cell proliferation in vitro. Cells were subcultured in a modified minimum essential medium with 10% fetal bovine serum containing either 5.5 mmol/L (100 mg/dl) D-glucose (control), 11 mmol/L (200 ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90925-3
更新日期:1989-12-01 00:00:00
abstract::Plasma cortisol levels were studied in the cord blood and neonatal blood of the following vaginally delivered groups: (A) postmature; (B) postterm (but not postmature); and (C) term neonates. Significantly lower levels of 8 A.M. neonatal plama cortisol were found in postmature neonates when compared with term neonates...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90013-7
更新日期:1975-02-01 00:00:00
abstract::Radical trachelectomy is an effective fertility-sparing treatment for women with early-stage cervical cancer. We describe the first reported ovarian recurrence after radical trachelectomy for stage IB1 adenocarcinoma cervical cancer. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.03.071
更新日期:2005-10-01 00:00:00
abstract::In the rabbit model of the ovarian hyperstimulation syndrome, animals given ovine prolactin with human menopausal gonadotropins (hMGs), as compared to animals receiving hMGs alone, demonstrated an increase in the formation of ascitic fluid, a decrease in mean plasma estradiol, and an increase in the mean plasma proges...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)90690-7
更新日期:1983-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess the influence of maternal age on obstetric indices of uterine efficiency in spontaneous nulliparous labor managed according to a standardized protocol in order to determine whether increasing maternal age is more commonly associated with dystocia. STUDY DESIGN:Informat...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.05.052
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine the impact of delivery site, delivery mode, and delivery-to-surgery interval on outcomes for neonates diagnosed with gastroschisis. STUDY DESIGN:Data were obtained retrospectively by chart review on 56 newborns diagnosed with gastroschisis. Outcome measures examined included prim...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70655-5
更新日期:1996-04-01 00:00:00
abstract::Hemorrhagic endovasculitis of the placenta is a distinct vasodestructive process of unknown cause that has been associated with perinatal morbidity and mortality. A relationship between nonimmune hydrops fetalis and hemorrhagic endovasculitis has not been previously described. At a large teaching hospital, six cases o...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90445-w
更新日期:1991-10-01 00:00:00
abstract::Fifty-seven prenatal patients with no known exposure to the element mercury, or any of its compounds, were observed for change in whole blood total mercury concentration from the initial prenatal clinic examination through delivery and postpartum hospitalization. On hospital admission for labor and delivery, whole blo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(82)90087-4
更新日期:1982-06-15 00:00:00
abstract::Peritoneal fluid from women with endometriosis, unexplained infertility, and fertile controls were compared to one another and to normal human serum for effects on lymphocyte proliferation in vitro. Peritoneal fluid samples were also assayed for both interleukin-1 and interleukin-2. All peritoneal fluid samples signif...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90736-9
更新日期:1989-10-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine the effect of in utero exposure to indomethacin on the need for surgical closure of a patent ductus arteriosus (PDA). STUDY DESIGN:Perinatal variables were compared between infants at <32 weeks who required surgical closure of PDA after failed medical management and those who did...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.127464
更新日期:2002-10-01 00:00:00
abstract::Most pregnancies in women under age 20 years, as well as more than half of the pregnancies in the United States, are unintended. Contraceptive use is especially poor in adolescents, for whom the socioeconomic and educational consequences are great. A 1988 study indicated that more than 8% of sexually active adolescent...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0002-9378(94)05023-4
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the effect of an obstetrics patient safety program on staff safety culture. STUDY DESIGN:We implemented (1) obstetrics patient safety nurse, (2) protocol-based standardization of practice, (3) crew resource management training, (4) oversight by a patient safety comm...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.11.004
更新日期:2011-03-01 00:00:00
abstract::The concentrations of certain steroids in arterial and ovarian venous blood were measured in 42 postmenopausal women undergoing hysterectomy for uterine disease. A concentration gradient across the ovary was found for testosterone in 21 women, for androstenedione in 16, for estradiol in 15, for estrone in 8, and for d...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(80)90287-2
更新日期:1980-11-01 00:00:00
abstract::Real time ultrasound was used in pregnant women who were considered to be at risk for development of pulmonary hypoplasia (n = 26). The population consisted of women who had either premature rupture of membranes (n = 16) or oligohydramnios (n = 10). The ratio calculated by comparing the fetal thoracic circumference to...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80046-7
更新日期:1987-09-01 00:00:00