Abstract:
OBJECTIVE:To examine factors that influence the morbidity and mortality of peripartum hysterectomy and analyze the effect of hospital volume on maternal mortality. METHODS:We examined women who underwent peripartum hysterectomy at the time of cesarean delivery in a quality and resource utilization database. Procedure-associated intraoperative, perioperative, and postoperative medical complications, length of stay, intensive care unit use, and maternal mortality were analyzed. Hospitals were stratified into tertiles based on procedure volume and complications and compared using adjusted generalized estimating equations. Results are reported as odds ratios. RESULTS:Maternal mortality among the 2,209 women who underwent peripartum hysterectomy was 1.2%. After adjusting for other clinical and demographic factors, perioperative mortality was 71% (odds ratio 0.29, 95% confidence interval 0.10-0.88) lower in women who underwent operation at high-volume hospitals compared with those treated at low-volume facilities. Hospital volume had no effect on the rates of intraoperative injuries, medical complications, length of stay, or transfusion. In contrast, compared with women treated at low-volume centers, patients who underwent operation at high-volume hospitals had a lower incidence of perioperative surgical complications (odds ratio 0.66, 95% confidence interval 0.47-0.93) and a lower rate of intensive care unit usage (odds ratio 0.53, 95% confidence interval 0.34-0.83). CONCLUSION:Peripartum hysterectomy is associated with substantial morbidity and mortality. Maternal mortality is lower when the procedure is performed in high-volume hospital settings. LEVEL OF EVIDENCE:II.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Wright JD,Herzog TJ,Shah M,Bonanno C,Lewin SN,Cleary K,Simpson LL,Gaddipati S,Sun X,D'Alton ME,Devine Pdoi
10.1097/AOG.0b013e3181df94e8subject
Has Abstractpub_date
2010-06-01 00:00:00pages
1194-1200issue
6eissn
0029-7844issn
1873-233Xpii
00006250-201006000-00015journal_volume
115pub_type
杂志文章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:Our objective was to determine the potential for chlorhexidine used as a vaginal and neonatal wash to reduce adverse outcomes of pregnancy, especially in developing countries. DATA SOURCES:We searched the English literature from January 1950 through October 2005 for all articles related to the use of chlorhe...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000215000.65665.dd
更新日期:2006-05-01 00:00:00
abstract::Blood transfusions performed earlier in the 20th century were often accompanied by significant complications. Today, with an increased knowledge of blood type compatibility, the majority of risks have been eliminated. However, hazards still remain. The authors report on a potentially fatal pulmonary disorder caused by...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVE:To use a decision-analytic model to assess a comprehensive set of outcomes of prenatal genetic testing strategies among women of varying ages. METHODS:We assessed outcomes of six testing strategies incorporating diagnostic testing with chromosomal microarray, multiple marker screening, cell-free DNA screenin...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001029
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy and acceptability of same-day misoprostol and overnight laminaria for cervical ripening before early second-trimester surgical abortion. METHODS:We performed a randomized, double-blinded, controlled trial comparing 400 microg of vaginal misoprostol, given 3-4 hours preoperatively, wit...
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.0000168629.17326.00
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:To compare the patterns of perioperative blood transfusion in patients undergoing radical hysterectomy in time periods before and after the discovery of transfusion-related human immunodeficiency virus (HIV) infection. METHODS:We reviewed the medical records of all patients who underwent radical hysterectomy...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract::A follow-up study of more than 65,000 healthy women aged 15 to 44 was conducted to assess the association between oral contraceptive use and thromboembolism, stroke, or nonfatal myocardial infarction from 1980 through 1982 at Group Health Cooperative of Puget Sound. A positive association existed between current oral ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVE:To estimate the effect of hormone therapy on risk of stress and urge urinary incontinence. METHODS:The Heart Estrogen/progestin Replacement Study was a randomized, placebo-controlled, double-blinded trial to evaluate daily oral conjugated estrogen (0.625 mg) plus medroxyprogesterone acetate (2.5 mg) therapy ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.AOG.0000180394.08406.15
更新日期:2005-11-01 00:00:00
abstract::The male sexual partners of 34 women with cervical condyloma or cervical intraepithelial neoplasia (CIN) were examined for penile condylomata and/or urinary tract lesions. External lesions were detected in 18 (53%) of the male consorts of women with cervical lesions including 14 of 22 whose consorts had cervical condy...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract::Characteristics of the fetal heart rate (FHR) were studied longitudinally throughout the second and third trimesters in 43 low-risk singleton fetuses. The second trimester was characterized by an FHR pattern showing minimal differences between quiet and active intervals of fetal behavior. Few movements were accompanie...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199011000-00017
更新日期:1990-11-01 00:00:00
abstract::A 19-year-old phenotypic female with primary amenorrhea and 45X,0/46X,Y chromosomal mosaicism was found to have asymmetrical gonadal dysgenesis. Her lack of virilization precludes her precise categorization in the current nomenclature of gonadal dysgenesis and she is considered a unique variant of the syndrome of mixe...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-10-01 00:00:00
abstract:OBJECTIVE:To determine the opinions of obstetrics and gynecology residency program directors regarding the Residency Review Committee mandate, requires 6 months of primary care training in obstetrics and gynecology. METHODS:A ten-question survey was mailed to the 272 accredited obstetrics and gynecology programs in th...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00600-5
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of group B streptococci (GBS) colonization in a subsequent pregnancy in women with and without GBS colonization in an index pregnancy. METHODS:A retrospective cohort study of women who had two consecutive deliveries with the availability of GBS culture result at 35 to 37 weeks of g...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31817f5cb9
更新日期:2008-08-01 00:00:00
abstract::The effect of an 8-hour, 3-dose perioperative regimen of cefazolin or placebo was evaluated in 97 patients. Postoperative morbidity occurred in 13 patients (27.1%) in the cefazolin group and in 17 patients (34.7%) who received placebo. The clinical sites of infection were similar in both groups except that wound infec...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1978-09-01 00:00:00
abstract::Toxic vapor abuse during pregnancy was found to be associated with increased maternal and fetal morbidity. Toluene-induced renal tubular acidosis occurred in over half of these women and was clustered among long-duration abusers. The renal acidosis placed the mother at risk for hypokalemia, with associated cardiac dys...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-04-01 00:00:00
abstract::Restriction enzyme digestion and Southern blot hybridization were used to analyze deoxyribonucleic acid (DNA) extracted from exfoliated cervical cells for the presence of human papillomavirus sequences and these results were correlated with cytologic findings on Papanicolaou smears. Specimens (N = 204) were obtained f...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-10-01 00:00:00
abstract:OBJECTIVE:To examine a wide range of study designs and outcomes to estimate the extent to which interventions in outpatient perinatal care settings are associated with an increase in the uptake of depression care. DATA SOURCES:PubMed, CINAHL, PsycINFO, ClinicalTrials.gov, and Scopus (EMBASE) were searched for studies ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0000000000001067
更新日期:2015-11-01 00:00:00
abstract::Obstructed labor due to a large sacrococcygeal tumor is reported. A technique of transabdominal intrauterine reduction in the size of the tumor to allow delivery of the infant in satisfactory condition is described. The method and the successful outcome have not previously been reported. It is recommended as a combine...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract:BACKGROUND:Atypical hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy often caused by mutations in complement genes. During pregnancy, disease outcome is poor both for mother and fetus. Since 2009, the humanized monoclonal antibody eculizumab has been successfully used in the treatment of atypical HUS in ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31828e2612
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To investigate trends in the incidence of shoulder dystocia, methods used to overcome the obstruction, and rates of maternal and neonatal morbidity. METHODS:Cases of shoulder dystocia and of neonatal brachial plexus injury occurring from 1991 to 2005 in our unit were identified. The obstetric notes of cases ...
journal_title:Obstetrics and gynecology
pub_type: 评论,杂志文章
doi:10.1097/01.AOG.0000287615.35425.5c
更新日期:2007-11-01 00:00:00
abstract::The purpose of this study was to investigate the potential relationship between the salivary electrical resistance, as measured by the Cue Fertility Monitor, and the time of ovulation. Twenty-seven cycles in 18 volunteers were analyzed. A slight correlation could be demonstrated between the day of salivary electrical ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To examine levels of serum tryptophan and its degradation product kynurenine in uncomplicated pregnancy, according to the week of pregnancy and the concentrations of neopterin. METHODS:Plasma was analyzed from 45 healthy pregnant women (15 in each trimester), 15 healthy puerperas, and 20 nonpregnant controls...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00084-1
更新日期:1996-07-01 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::The nonstress test is a commonly used tool for fetal well-being assessment. The antenatal death rate using the nonstress test as a primary modality is significantly higher than that with the use of the contraction stress test. The nonstress test is commonly performed on a once-a-week basis. The rate of stillbirths wit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract:OBJECTIVE:To estimate the changes in central hemodynamics features of pregnant women presenting with hypertensive disorders and to analyze the effects of standard antihypertensive treatment on maternal central hemodynamics. METHODS:Applanation tonometry was used to record the radial artery pulse waveform in 80 women p...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318197c392
更新日期:2009-03-01 00:00:00
abstract::A 19-year-old primigravida at term presented with bilateral, spontaneous pneumothorax. The maternal and infant outcomes were successful. The impact on pregnancy is discussed, and suggestions are made for obstetric management. ...
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 examine the association between the mode of delivery and the risk of offspring obesity by age 21 years using a large community-based birth cohort study in Australia. METHODS:We followed-up a subsample of 2,625 offspring for whom we had measured physical assessments, including height and weight at 21 years...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000016
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:Women with diabetes need safe, effective contraception. Although intrauterine devices provide superior contraception, concerns remain that progestin absorbed systemically from the levonorgestrel-releasing device may impair carbohydrate metabolism. To examine the effect of the levonorgestrel-releasing intraute...
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.0000156301.11939.56
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:To estimate the association between vaginal birth after cesarean delivery (VBAC) rates and primary cesarean delivery rates in California hospitals. METHODS:Hospital VBAC rates were calculated using birth certificate and discharge data from 2009, and hospitals were categorized by quartile of VBAC rate. Multiv...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182a91e0f
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Gestational alloimmune liver disease, a form of profound liver failure in the newborn, is the main underlying cause of the entity formerly known as neonatal hemochromatosis. Antepartum maternal intravenous immunoglobulin (IVIG) has been shown to prevent gestational alloimmune liver disease, which otherwise h...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001569
更新日期:2016-11-01 00:00:00