Abstract:
OBJECTIVE:To comprehensively review and critically assess the available gynecologic surgery venous thromboembolism prophylaxis literature and provide clinical practice guidelines. DATA SOURCES:MEDLINE and Cochrane databases from inception to July 2010. We included randomized controlled trials in gynecologic surgery populations. Interventions and comparators included graduated compression stockings, intermittent pneumatic compression, unfractionated heparin, and low molecular weight heparin; placebo and routine postoperative care were allowed as comparators. METHODS OF STUDY SELECTION:One thousand two hundred sixty-six articles were screened, and 14 randomized controlled trials (five benign gynecologic, nine gynecologic oncology) met eligibility criteria. In addition, nine prospective or retrospective studies with at least 150 women were identified and provided data on venous thromboembolism risk stratification, gynecologic laparoscopy, and urogynecologic populations. TABULATION, INTEGRATION, AND RESULTS:Two reviewers independently screened articles with discrepancies adjudicated by a third. Eligible randomized controlled trials were extracted for these characteristics: study, participant, surgery, intervention, comparator, and outcomes data, including venous thromboembolism incidence and bleeding complications. Studies were individually and collectively assessed for methodologic quality and strength of evidence. Overall incidence of clinical venous thromboembolism was 0-2% in the benign gynecologic population. With use of intermittent pneumatic compression for benign major procedures, venous thromboembolism incidence was less than 1%. No venous thromboembolisms were identified in prospective studies of benign laparoscopic procedures. Overall quality of evidence in the benign gynecologic literature was poor. Gynecologic-oncology randomized controlled trials reported venous thromboembolism incidence (including "silent" venous thromboembolisms) of 0-14.8% with prophylaxis and up to 34.6% without prophylaxis. Fair quality of evidence supports that unfractionated heparin and intermittent pneumatic compression are both superior to placebo or no intervention but insufficient to determine whether heparins are superior to intermittent pneumatic compression for venous thromboembolism prevention. Combining two of three risks (aged 60 years or older, cancer, or personal venous thromboembolism history) substantially elevated the risk of venous thromboembolism. CONCLUSION:Intermittent pneumatic compression provides sufficient prophylaxis for the majority of gynecology patients undergoing benign surgery. Additional risk factors warrant the use of combined mechanical and pharmacologic prophylaxis.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Rahn DD,Mamik MM,Sanses TVD,Matteson KA,Aschkenazi SO,Washington BB,Steinberg AC,Harvie HS,Lukban JC,Uhlig K,Balk EM,Sung VW,Society of Gynecologic Surgeons Systematic Review Group.doi
10.1097/AOG.0b013e318232a394subject
Has Abstractpub_date
2011-11-01 00:00:00pages
1111-1125issue
5eissn
0029-7844issn
1873-233Xpii
00006250-201111000-00021journal_volume
118pub_type
杂志文章,评审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:OBJECTIVE:To evaluate pregnancy outcome among women with isolated polyhydramnios at admission for labor at or beyond 34 weeks of gestation. METHODS:Retrospective cohort study at a tertiary medical center between 2007 and 2012. Isolated polyhydramnios was defined as amniotic fluid index (AFI) greater than 25 cm at admi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000740
更新日期:2015-04-01 00:00:00
abstract::The fascia lata sling procedure has been used over the past 22 years in our unit for treating recurrent urinary stress incontinence when irreparably poor local support tissues were suspected. Sixty-nine patients had undergone one previous operation to correct urinary stress incontinence. One hundred one patients had t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-11-01 00:00:00
abstract::On an infertility service, 170 patients were evaluated for possible ectopic pregnancy using tests for beta-human chorionic gonadotropin levels, ultrasound, and clinical examination. Thirty-four (20%) of those evaluated underwent laparoscopy, of whom 31 (91%) were found to have ectopic pregnancies. Only three of the ec...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-12-01 00:00:00
abstract:BACKGROUND:Tension-free vaginal tape procedure is a popular surgical treatment of genuine stress urinary incontinence. CASES:Two cases of retropubic hematoma after tension-free vaginal tape procedure are reported. One woman with an 8 x 10 cm hematoma localized to the retropubic space required transfusion of two units ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01560-5
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:Aggressive angiomyxoma is a rare, locally infiltrative tumor, frequently occurring in female patients. Although wide local excision is considered standard therapy, radical surgery may be needed. CASE:A 49-year-old woman presented with an aggressive angiomyxoma involving the vulva and bladder. Given the horm...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002254
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To evaluate fetal outcome and long-term impact of very early preterm premature rupture of membranes (PROM). METHODS:In a retrospective cohort study, 78 women with singleton pregnancies who delivered at the Oulu University Central Hospital between 1990 and 1996 and who had early PROM, between the 17th and 30t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00213-0
更新日期:1998-09-01 00:00:00
abstract::Rates of perforation for different types of IUDs vary from 1 per 150 insertions with the bow to 1 per 2500 with the loop. Incidence of perforation varies with insertion technic. Not all perforations occur at the time of insertion but most do. These perforations may be partial or complete, with or without symptoms, ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1972-08-01 00:00:00
abstract:OBJECTIVE:To examine the association between maximum urethral closure pressure and Valsalva leak-point pressure in women with genuine stress incontinence (GSI). METHODS:Fifty-six women with GSI were evaluated in a urodynamics laboratory. Maximum urethral closure pressure and vesical leak-point pressure were measured w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00263-Q
更新日期:1995-11-01 00:00:00
abstract::Almost 50% of married female residents become pregnant during their residency. The desire to have a baby and a concern about age influence the decision to become pregnant. Career concerns, financial issues, and child care are less important. In addition, support of the faculty or house staff is not a crucial factor in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::Two hundred ten rats were randomized into one of five study groups to compare standard absorbable sutures with a new synthetic absorbable suture. We evaluated Maxon (polyglyconate), Vicryl (polyglactin), chromic catgut (catgut), and PDS (polydioxanone) with respect to tissue inflammatory reaction, knot security, sutur...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-03-01 00:00:00
abstract::This study was conducted to evaluate the prevalence of transient hyperprolactinemia in infertile women with luteal phase deficiency. One hundred fifty-one luteal phase deficiency patients and 11 controls had serum prolactin (PRL) measured daily for 3-4 days near ovulation. Thirty-three subjects (21.9%) had transient h...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::Immediate postpartum long-acting reversible contraception (LARC) has the potential to reduce unintended and short-interval pregnancy. Women should be counseled about all forms of postpartum contraception in a context that allows informed decision making. Immediate postpartum LARC should be offered as an effective opti...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001583
更新日期:2016-08-01 00:00:00
abstract::A rising cesarean birth rate, both nationally and at our institution, led us to attempt to reverse the trend. Vaginal birth after cesarean (VBAC) was introduced as an alternative to repeat cesarean in 1982. The impact of VBAC on the cesarean rate for our institution was assessed from 1982-1988. Over the period studied...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199102000-00006
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:Placental site trophoblastic tumor is a rare subtype of gestational trophoblastic neoplasia affecting women of reproductive age. The preferred method of treatment is surgical resection. CASE:A 33-year-old woman, gravida 3 para 1111, was incidentally diagnosed with placental site trophoblastic tumor during a...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/aog.0b013e31826d7da6
更新日期:2013-02-01 00:00:00
abstract::A prospective, double blind study was initiated to compare flow cytometry to cytopathology in detecting malignant cells within peritoneal washings. Deoxyribonucleic acid (DNA) histograms were generated using 4',6-diamidino-2-phenylindole (DAPI) as a DNA fluorochrome. Evaluation of these data revealed a correlation of ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198605000-00014
更新日期:1986-05-01 00:00:00
abstract:OBJECTIVE:To investigate the differences in costs and outcomes of Down syndrome screening using data from the First and Second Trimester Evaluation of Risk (FASTER) Trial. METHODS:Seven possible screening options for Down syndrome were compared: 1) Triple Screen-maternal serum alpha fetoprotein, estriol, and hCG; 2) Q...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000263470.89007.e3
更新日期:2007-07-01 00:00:00
abstract::All cases of dermatomyositis-polymyositis in women seen between 1970 and 1977 at Baylor Affiliated Hospitals were reviewed. Twenty-five patients were identified with this diagnosis. Of these women, 5 were found to have a malignant tumor: 3 ovarian carcinomas, 1 cervical intraepithelial carcinoma, and 1 colon carcinoma...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-10-01 00:00:00
abstract::Abortions by cervical dilatation with laminaria tents followed by placement of a metreurynter into the lower uterine cavity to provide a mechanical stretch (the method most often used in midterm abortions in Japan) was performed in 7 normal Japanese and American women, 19-24 weeks pregnant, to determine similarities ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1973-05-01 00:00:00
abstract:OBJECTIVE:To describe obesity prevention and treatment practices of U.S. obstetrician-gynecologists. METHODS:A cross-sectional survey was mailed to 1,806 practicing members of the American College of Obstetricians and Gynecologists (ACOG) in February-April 2005. RESULTS:Of the 900 respondents who returned questionnai...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000233171.20484.db
更新日期:2006-10-01 00:00:00
abstract::A total of 4517 successful antepartum nonstress tests (NST) was performed on 2003 high- (28%) and low- (72%) risk obstetric patients. Most patients were monitored from 32 to 34 weeks' gestation onward. A reactive NST was defined as 2 accelerations in 10 minutes--15 beats/min minimum amplitude; 15 seconds minimum durat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-197907000-00006
更新日期:1979-07-01 00:00:00
abstract:BACKGROUND:Women with Mayer-Rokitansky-Küster-Hauser syndrome fail to develop müllerian ducts, present with primary amenorrhea, and an absent or rudimentary uterus and vagina. After creation of a neovagina, vaginal vault prolapse may occur because of lack of support to the artificially created vagina. CASES:The first ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)01969-5
更新日期:2002-05-01 00:00:00
abstract::One hundred patients undergoing pelvic exenteration (total 69, anterior 13, posterior 18) at the University of Michigan Medical Center from 1964-1984 are reported. All patients were followed for at least 5 years or until time of death. The overall cumulative survival was 66% at 3 years and 61% at 5 years. The age of t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-12-01 00:00:00
abstract::The inability to make a definitive diagnosis in the fetus with a sonographically identified abnormality often results in parental and physician uncertainty. An antenatal chromosome evaluation could resolve this uncertainty. Forty-one fetuses with an abnormal ultrasound examination were tested for karyotypic abnormalit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:Adverse fetal heart rate (FHR) changes occur frequently during the first 30 minutes after epidural analgesia. The aim of this study was to estimate whether intravenous administration of ephedrine during induction of epidural analgesia can reduce the frequency of adverse FHR changes. METHODS:We prospectively ...
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.0000146281.05275.73
更新日期:2004-12-01 00:00:00
abstract::We present a new method for vulvar reconstruction based on recently described vasculature of the lower abdominal skin and subcutaneous tissue. The superficial external pudendal artery supplies the region encompassing the suprapubic and infraumbilical skin. Thus, a pedicled skin flap based on the superficial external p...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVE:To report our institutional experience with the accuracy and usefulness of cervical conization with frozen section before planned hysterectomy. METHODS:One hundred fifty-nine patients who planned to have hysterectomies for or with a concomitant diagnosis of cervical intraepithelial neoplasia (CIN) underwent ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:Advanced abdominal pregnancy is rare, and one that occurs after uterine rupture with delivery of a viable fetus is exceptional. CASE:A multiparous patient was admitted at 29 weeks of gestation for conservative management of placenta previa. She complained of intermittent abdominal pain, but repeated assessm...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000279451.51446.c1
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:To determine whether gravidas with prior low vertical uterine incision(s) are at a higher risk for uterine rupture during a trial of labor after cesarean delivery than women with prior low transverse uterine incision(s). METHODS:The medical records of women undergoing a trial of labor after prior cesarean de...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00398-1
更新日期:1999-11-01 00:00:00
abstract::Previous reports have implicated the Dalkon shield intrauterine device (IUD) in septic second trimester abortion and maternal death from sepsis. In the case reported here, Fusobacterium necrophorum, a rarely pathogenic vaginal anaerobe, gained access to the uterus in a woman wearing a Dalkon shield and caused acute pa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-09-01 00:00:00