Abstract:
OBJECTIVE:To evaluate whether preoperative dilation and curettage (D&C) lowers the risk of unexpected cancer at hysterectomy. METHODS:Women with complex atypical endometrial hyperplasia on sampling from January 2000 to May 2008 who underwent hysterectomy within 6 months were identified using a pathology database. Patient age, sampling procedures, and hysterectomy pathology were recorded. Women were categorized as having either an office biopsy-based evaluation or a curettage-based evaluation. The proportion of women with cancer at surgery was estimated and compared for the two groups. RESULTS:Of 824 women with complex atypical endometrial hyperplasia on initial sampling, 48% were found to have cancer. For 100 women, cancer was diagnosed preoperatively by additional sampling before hysterectomy. For the remaining 724, 298 (41%) had unexpected cancer at hysterectomy. The diagnosis of complex atypical endometrial hyperplasia was biopsy-based for 531 (73%) and curettage-based for 193 (27%). The risk of cancer for women who had a D&C was significantly lower than for those who had biopsy, but still of concern (30% compared with 45%, P<.001), as was the risk of myometrial invasion (18% compared with 25%, P=.05). Age was strongly correlated to risk of cancer, invasive cancer, and deeply invasive or grade 3 disease. CONCLUSION:Dilation and curettage lowered the risk of unexpected cancer compared with biopsy, but 18% of women still had invasive cancer found at hysterectomy. The risk of unexpected cancer is strongly related to age. Dilation and curettage can help detect cancer preoperatively but is not reliable for excluding cancer. LEVEL OF EVIDENCE:II.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Suh-Burgmann E,Hung YY,Armstrong MAdoi
10.1097/AOG.0b013e3181b190d5subject
Has Abstractpub_date
2009-09-01 00:00:00pages
523-529issue
3eissn
0029-7844issn
1873-233Xpii
00006250-200909000-00007journal_volume
114pub_type
杂志文章abstract:OBJECTIVE:To compare one-year outcomes of primary overlap versus end-to-end repair of the external anal sphincter after acute obstetric anal sphincter injury. METHODS:Women who sustained third-degree (3b = greater than 50% external anal sphincter thickness, 3c = internal sphincter injury) or fourth-degree (including a...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.AOG.0000218693.24144.bd
更新日期:2006-06-01 00:00:00
abstract::An analysis was performed of malignant and host cells found in peritoneal fluids obtained during intraperitoneal chemotherapy and immunotherapy in patients with ovarian cancer. The concentration of malignant cells and the surgically documented response to the intraperitoneal treatment were correlated. Twenty-three pat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-11-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that fetal growth restriction (FGR) associated with a maternal hypertensive disorder results in worse perinatal outcome than FGR in pregnancies without maternal hypertension. METHODS:All consecutive, singleton, nondiabetic, small for gestational age (SGA) deliveries (birth weight at or...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)02169-2
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:Vaginal aplasia occurs in 1 in 5,000-10,000 female live births. In this report, we evaluated a novel dual-force vaginoplasty technique for treatment of 11 patients with segmental vaginal aplasia. TECHNIQUE:The principle of the approach is to thin the atretic part between two counteracting forces. The instru...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001974
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:We sought to examine prescribing patterns (prevalence and rates of initiation and discontinuation) for estrogen plus progestin (hormone therapy [HT] and estrogen alone [ET]) in the United States in the 2 years before the published results of Women's Health Initiative's (WHI) HT trial's early termination and f...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000143826.38439.af
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:To estimate whether higher magnesium levels in umbilical cord blood at delivery are associated with increased total pediatric (fetal + neonatal + postneonatal) mortality. METHODS:During the Magnesium and Neurologic Endpoints Trial, in addition to randomizing mothers having preterm labor into arms containing ...
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(01)01398-9
更新日期:2001-07-01 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:OBJECTIVE:To compare the prevalence of large-for-gestational-age (LGA) newborns across categories of body mass index (BMI) in five racial and ethnic groups. METHODS:This cohort study examined 7,468 women with gestational diabetes mellitus (GDM) who delivered a live newborn between 1995 and 2006 at Kaiser Permanente No...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318291b15c
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:To determine the accuracy of the Q-tip test to measure urethrovesical junction mobility. METHODS:One hundred fourteen women with urinary incontinence or genital prolapse were evaluated with a Q-tip test and perineal ultrasound scanning to measure urethrovesical junction mobility with strain. The sensitivity,...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract::The effectiveness of the carbon dioxide laser was evaluated in the treatment of penile, anorectal, and urethral condylomata acuminata in 40 men. All but six cases of urethral condylomata were prior conventional treatment failures. Postlaser follow-up ranged between one and two years, with an average of 16 months. No p...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-05-01 00:00:00
abstract:OBJECTIVE:To determine whether resistance index values obtained by color Doppler ultrasound contribute to the accuracy in diagnosing ovarian malignancies. METHODS:Four hundred ten patients with ovarian neoplasms referred for color Doppler ultrasound evaluation were enrolled, excluding patients examined during the lute...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:To examine current levels, current correlates of, and changes in long-acting reversible contraceptive (LARC) use, including intrauterine devices and implants, among females aged 15-44 years using contraception between 2008-2010 and 2011-2013 with specific attention to associations between race, income, and ag...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001094
更新日期:2015-11-01 00:00:00
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 po...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0b013e318232a394
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:To explore the outcome and long-term follow-up of fertility sparing surgery for cervical adenocarcinoma in situ and early invasive adenocarcinoma. METHODS:Between 1985 and 1996, all women with adenocarcinoma in situ (AIS) and stage I adenocarcinoma were identified. Data were abstracted from clinical records ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01544-7
更新日期:2001-11-01 00:00:00
abstract::Sixty-two patients with primary amenorrhea were retrospectively categorized into 4 groups: 1) breast development absent and uterus present (29 patients), 2) breast development present and uterus absent (9 patients), 3) both breast development and uterus absent (2 patients), and 4) both breast development and uterus pr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-06-01 00:00:00
abstract:OBJECTIVE:To evaluate changes over the past decade in the mode of delivery and second-stage duration in nulliparous women. METHODS:We conducted a retrospective cohort study at a single institution of nulliparous women reaching complete cervical dilation with singleton gestations 36 weeks or greater from January 1, 201...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000872
更新日期:2015-07-01 00:00:00
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::A 31-year-old patient with incomplete testicular feminization syndrome characterized by a 46, XY karyotype in a phenotypic female with absent müllerian structures, marked clitoromegaly, testes and wolffian duct structures, partial labioscrotal fold fusion, and male levels of circulating androgens is described. She was...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:To determine whether serum vascular endothelial growth factor is an independent prognostic factor in ovarian cancer patients. METHODS:We measured vascular endothelial growth factor in pretreatment serum samples of 60 women with International Federation of Gynecology and Obstetrics stages I to IV epithelial o...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00190-2
更新日期:1998-09-01 00:00:00
abstract::A 22-month-old child with a large cyst of Gartner's duct suffered from recurrent episodes of urinary retention. Excision of such large symptomatic cysts has been recommended in the past. Marsupialization is discussed as an alternative to extensive excision. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:We describe a case of arteriovenous fistula of the middle and posterior cerebral arteries detected in a fetus. CASE:Fetal echocardiography revealed a high-output cardiac failure. Color Doppler ultrasound demonstrated an arteriovenous fistula, localized at the middle and posterior cerebral arteries, which dr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00100-7
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVE:To estimate both human immunodeficiency virus (HIV) testing acceptance rates in pregnancy using an opt-out policy and patient characteristics influencing acceptance. METHODS:At the first prenatal visit, HIV testing was offered using an opt-out approach. Reasons for refusing testing were explored. Demographic...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000267497.39041.06
更新日期:2007-07-01 00:00:00
abstract::Autoimmune oophoritis is a rare cause of premature ovarian failure. Previous studies of autoimmune oophoritis have detailed the clinical, immunologic, and histologic findings. The gross pathologic features of the involved ovaries have detailed the clinical, immunologic, and histologic findings. The gross pathologic fe...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the feasibility of the detection of ureteral jets into the bladder in obstetric-gynecologic patients using transvaginal color Doppler ultrasound. METHODS:Fifty-two women were recruited and categorized into four groups: 1) 20 normal nonsurgical, 2) 17 post-cesarean delivery, 3) 12 post-total abdom...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/s0029-7844(96)00373-0
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:To compare sexual function in women with urinary incontinence and pelvic organ prolapse and to determine the effects of therapy on sexual function. METHODS:343 community-dwelling women older than 45 years with urinary incontinence or advanced prolapse were recruited into a multi-armed clinical trial. Women w...
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(01)01727-6
更新日期:2002-02-01 00:00:00
abstract::Elevated levels of maternal serum alpha-fetoprotein (MSAFP) will identify a population at increased risk for specific congenital malformations, which are accurately diagnosed by amniotic fluid AFP and acetylcholinesterase. The risk for spontaneous abortion related to amniocentesis, combined with increasing confidence ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract::As the human immunodeficiency virus (HIV) epidemic affects more women, clinicians are increasingly observing pelvic inflammatory disease (PID) in HIV-infected women. The extent to which PID is a factor in the recognition of HIV or HIV is a factor in the recognition of PID is unknown. Even less is known about how HIV i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract::Well-documented amniotic fluid embolism with survival is an uncommon occurrence. A case is reported with characteristic clinical findings in addition to electrocardiographic evidence of acute right heart strain, disseminated intravascular coagulation, and amniotic fluid debris in central venous blood. The impact of th...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-03-01 00:00:00
abstract::The intrapartum management of pregnancy complicated by fetal hydrocephalus with macrocephaly often confronts the physician with a complex array of moral obligations to both mother and fetus that may sometimes come into direct conflict. The authors analyze the component beneficence-based and autonomy-based obligations ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract::Cerebral hemodynamics were studied in eight nonpregnant women and 24 women in late pregnancy by internal carotid artery velocimetry with a 3.5-MHz continuous-wave Doppler system. Criteria for supine hypotensive syndrome were a mean blood pressure decrease of 15 mmHg and a 2-minute sustained increase in pulse of 20 bea...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00