Abstract:
BACKGROUND AND OBJECTIVE:In some women placental function may not be adequate to meet fetal growth requirements in late pregnancy or the additional demands during labor, thus predisposing these infants to intrapartum fetal compromise and subsequent serious morbidity and mortality. The objective of this study was to determine if the introduction of a prelabor screening test at term combining the cerebroplacental ratio and maternal placental growth factor level would result in a reduction in a composite of adverse outcomes. STUDY DESIGN:Single-site, nonblinded, randomized controlled trial conducted at a tertiary hospital in Brisbane, Australia. Eligible women were randomized to either receive the screening test performed between 37-38 weeks or routine obstetric care. Screen-positive women were offered induction of labor. The primary outcome was a composite of emergency cesarean delivery for nonreassuring fetal status (fetal distress) or severe neonatal acidosis or low Apgar score or stillbirth or neonatal death. RESULTS:Women were recruited and randomized (n = 501) between April 2017 and January 2019. Sixty-three of 249 subjects (25.3%) in the screened group compared to 56 of 252 (22.2%) in the control group experienced the primary outcome (relative risk = 1.14 [95% confidence interval, 0.83-1.56]; P = .418). Women who screened positive were more likely to require operative delivery for fetal distress, have meconium-stained liquor, have pathologic fetal heart rate abnormalities, and have infants with lower birthweight compared to women that screened negative. CONCLUSION:The introduction of this test did not result in improvements in intrapartum intervention rates or neonatal outcomes. However, it did show discriminatory potential, and future research should focus on refining the thresholds used.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Sherrell HC,Clifton VL,Kumar Sdoi
10.1016/j.ajog.2020.02.034subject
Has Abstractpub_date
2020-09-01 00:00:00pages
429.e1-429.e9issue
3eissn
0002-9378issn
1097-6868pii
S0002-9378(20)30222-2journal_volume
223pub_type
杂志文章,随机对照试验abstract::Of 468 diagnosis-related groups identified by the federal government for Medicaid reimbursement, 15 are related to obstetric hospital care. Each diagnosis-related group is considered a distinct group in which cases are homogeneous with respect to resource consumption. Because the diagnosis-related group system is base...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(87)90052-4
更新日期:1987-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine whether changes in vaginal dimensions after transvaginal reconstructive pelvic surgeries affect the risk for postoperative dyspareunia. STUDY DESIGN:Charts of all sexually active patients who underwent transvaginal reconstructive pelvic surgeries in our institution ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.10.628
更新日期:2005-05-01 00:00:00
abstract::Over a 10-year period, 65 of 196 patients (33%) with ovarian epithelial malignancy, previously treated with chemotherapy, had a second-look operation if the disease was clinically absent. All procedures were done by one of three gynecologic oncologists, and 48% of the patients had a positive second-look procedure. Of ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80012-1
更新日期:1987-09-01 00:00:00
abstract::While observation of fetal breathing movements has been used in fetal assessment, quantitative parameters (percent time spent in breathing [incidence], breath rate, or breath rate variability) have not been adequately evaluated as predictive tools. We examined 283 patients with high-risk pregnancies between 32 and 42 ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90112-9
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:Our purpose was to develop a method to induce premature delivery in rats and to use this method to identify biochemical changes that are critical to cervical dilatation by comparison to changes that occur during term delivery. STUDY DESIGN:Rats were treated with antiprogestational agents onapristone or lilo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1053/ob.1996.v175.a74254
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to test the null hypothesis that continuing vigorous weight-bearing exercise throughout pregnancy has no discernible long-term effect on indices of fitness and/or cardiovascular risk. STUDY DESIGN:This was a follow-up observational study of the fitness and cardiovascular risk p...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.05.006
更新日期:2008-11-01 00:00:00
abstract::Fetal heart rate (FHR) is influenced by the central nervous system, cardiac automatism, biochemical factors, etc. Changes in FHR were correlated with the anatomic defect in autopsy material from 20 anencephalic infants, and, on this basis, the following hypotheses were formed, subject to later experimental proof. (1) ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90199-6
更新日期:1984-05-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine whether nuclear magnetic resonance-based metabolomic markers in first-trimester maternal serum can detect fetuses with trisomy 18. STUDY DESIGN:This was a study of pregnancies between 11 weeks and 13 weeks 6 days' gestation. We analyzed 30 cases of trisomy 18 and a ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.03.028
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Polycystic ovary syndrome is the most common endocrine disorder affecting women of reproductive age. A number of criteria have been developed for clinical diagnosis of polycystic ovary syndrome, with the Rotterdam criteria being the most inclusive. Evidence suggests that polycystic ovary syndrome is signific...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2020.04.004
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:Our objective was to study the prevalence of genital prolapse and possible related factors in a general population of women 20 to 59 years of age. STUDY DESIGN:Of 641 eligible women in a primary health care district, 487 (76%) answered a questionnaire and accepted an invitation to a gynecologic health examin...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70203-6
更新日期:1999-02-01 00:00:00
abstract::The effect upon fetal breathing movements (FBM) in 49 women with uncomplicated pregnancies who inhaled 5% carbon dioxide in air for 15 minutes was observed with an ADR real-time ultrasound scanner. A threefold increase in FBM occurred during the inhalation of CO2. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(80)90867-4
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess whether vaginal sialidases level in early pregnancy is associated with preterm birth among women who are bacterial vaginosis-positive. STUDY DESIGN:Of the 1806 women who were enrolled at < 20 weeks of gestation, 800 of the women were bacterial vaginosis-positive (Nugen...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.08.061
更新日期:2011-02-01 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::There is little insight into the pathogenesis of most of the dermatoses specifically associated with pregnancy. We evaluated the hormonal profile and the autoimmune background in 11 pregnant women with pruritic urticarial papules and plaques of pregnancy. No statistically significant difference was found between the s...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90168-8
更新日期:1988-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the relationship between maternal obesity that is calculated 9 months after delivery and sociodemographic variables. STUDY DESIGN:A national cohort of mothers was sampled 9 months after delivery as part of the Growing Up in Ireland Study Infant Cohort. Sociodemographi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.04.020
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:Examine temporal alterations in vascular angiotensin II receptors (AT(1)R and AT(2)R) and determine vascular response to angiotensin II in growth-restricted offspring. STUDY DESIGN:Offspring of pregnant rats fed low-protein (6%) and control (20%) diet were compared. RESULTS:Prenatal protein restriction repr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.04.010
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:The objectives of the investigation were to study the association between levator hiatus dimensions in late pregnancy and both the length of second stage of labor and also the delivery mode in women delivering their first child. STUDY DESIGN:In this cohort study, 231 nulliparous women were examined with 3- a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.02.021
更新日期:2014-05-01 00:00:00
abstract::Fetal malpositions and cephalic malpresentations are well-recognized causes of failure to progress in labor. They frequently require operative delivery, and are associated with an increased probability of fetal and maternal complications. Traditional obstetrics emphasizes the role of digital examinations, but recent s...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2017.07.025
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:Studies in animals and human muscle have demonstrated differential splicing of the insulin-like growth factor-1 gene in response to mechanical strain and damage. We conducted a study on the expression of insulin-like growth factor-1 splice variants in the levator ani muscle after the first vaginal delivery. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.12.088
更新日期:2005-07-01 00:00:00
abstract::Cyclic adenosine 3',5'-monophosphate is known to modulate smooth muscle contractility. Because both relaxin and progesterone have been demonstrated to affect myometrial cyclic adenosine monophosphate activity, we questioned whether the previously observed synergism of these two hormones in inhibiting uterine contracti...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90564-9
更新日期:1988-12-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to describe the assessment of lower segment uterine scar (LSCS) by transvaginal ultrasound (TVUS) during a first-trimester scan. STUDY DESIGN:Patients with a history of LSCS were prospectively enrolled over a 6 month period. Four groups were defined: type 1A, thin scar within c...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/j.ajog.2011.06.104
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:Our goal was to determine whether laparoscopic salpingostomy is preferable to laparoscopic methotrexate injection in the management of unruptured tubal gestation. STUDY DESIGN:Forty-eight patients with unruptured tubal pregnancy were prospectively randomized to either laparoscopic salpingostomy or laparoscop...
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:10.1053/ob.1996.v175.a74249
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:To determine whether maternal placental perfusion occurs in the first trimester, this study compared veins in endometrium with those in decidua. We hypothesize that veins draining the placenta become dilated and contain syncytiotrophoblastic fragments. STUDY DESIGN:Normal late-secretory endometrial biopsy sp...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70578-8
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:Placental insufficiency is a primary cause of intrauterine growth restriction (IUGR). In our study, microarray technology was used to identify genes, which may impair placentation resulting in IUGR. STUDY DESIGN:The RNA was isolated from both IUGR term placentas and normal term placentas. Microarray experime...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.08.027
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:To determine the incidence of vaginal cuff dehiscence after minimally invasive hysterectomy, we reported our series of total laparoscopic hysterectomies with transvaginal colporraphy. STUDY DESIGN:We then conducted a systematic search of PubMed to retrieve published series of laparoscopic and robotic hystere...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2011.03.024
更新日期:2011-08-01 00:00:00
abstract::The possibility of Rh immune globulin failure exists when a fetomaternal hemorrhage exceeds 25 to 30 ml of whole blood and only one 300 micrograms vial of Rh immune globulin is administered. In this prospective study of 1000 consecutive Rh-negative women who were delivered of Rh-positive newborn infants, the presence ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90725-8
更新日期:1986-06-01 00:00:00
abstract:OBJECTIVE:The basic mechanisms responsible for human parturition remain to be elucidated. The influx of fetal leukocytes into the myometrium has been recently proposed to be a crucial event in the onset of murine parturition. Surfactant protein-A has been implicated in the initiation of labor. In mice, it is thought th...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.06.052
更新日期:2006-09-01 00:00:00
abstract::This article reviews the epidemiology, management, and outcome of 71 quadruplet pregnancies that occurred between 1980 and 1989. A study of detailed medical questionnaires and medical records revealed that 67 (94%) of the pregnancies followed ovulation induction therapy. A majority of the pregnancies were diagnosed by...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90896-f
更新日期:1990-06-01 00:00:00
abstract:OBJECTIVE:The purpose of our study was to determine whether maternal vitamin K1 administered antenatally improved global coagulation parameters and the levels of specific vitamin K-dependent proteins in low-birth-weight infants. STUDY DESIGN:Thirty-three preterm mothers admitted in labor were assigned in a prospective...
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)70389-2
更新日期:1994-01-01 00:00:00
abstract::Skillful laser ablation can remove any volume of human papillomavirus-associated vulvar disease but cannot prevent reactivation of the surrounding latent viral reservoir during postoperative healing. Conversely, interferon and 5-fluorouracil are relatively ineffective as primary therapies in clearing bulky lesions. In...
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:10.1016/0002-9378(92)91339-c
更新日期:1992-03-01 00:00:00