Abstract:
OBJECTIVE:To review facility-based maternal deaths at a tertiary-level center in Johannesburg, South Africa, during a 5-year period (2003 to 2007) and to investigate the proportion of deaths attributable to human immunodeficiency virus (HIV), the etiology of deaths, and the effects of antiretroviral treatment introduced in late 2004. METHODS:Patient case files, birth registers, death certificates, and mortality summaries were reviewed. Cause of death was assigned through clinical case discussion. Annual maternal mortality ratios were calculated and disaggregated by HIV status. RESULTS:During the 5-year period, 106 maternal deaths occurred out of 36,708 births (facility-based maternal mortality ratios 289/100,000 live births, 95% confidence interval [CI] 237-349/100,000). In 72% of cases, HIV status was known (76/106), with the majority being HIV-infected (78%, 59/76). Among HIV-infected women, only two had initiated antiretroviral treatment, and 70% of deaths were HIV-related (41/59), mainly from tuberculosis (21) and pneumonia (12). Direct obstetric causes of death such as hypertension and pregnancy-related sepsis predominated in women who were HIV-negative or of unknown status (48.9%, 23/47). Maternal mortality ratios in HIV-infected women were 776/100,000 (95% CI 591-1,000/100,000), 6.2-fold higher (95% CI 3.6-11.4) than in HIV-negative women (124/100,000, 95% CI 72-199/100,000). Changes in mortality over time were not detected. Although HIV testing increased 1.4-fold each year (95% CI 1.3-1.4) and estimated coverage of antiretroviral treatment for pregnant women reached 59.2% in 2007, levels remain suboptimal. CONCLUSION:In Johannesburg, HIV remains the major cause of maternal mortality despite integration of antiretroviral treatment into prenatal services. Maternal health services should target barriers to uptake of HIV treatment and care. LEVEL OF EVIDENCE:III.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Black V,Brooke S,Chersich MFdoi
10.1097/AOG.0b013e3181af33e6subject
Has Abstractpub_date
2009-08-01 00:00:00pages
292-299issue
2 Pt 1eissn
0029-7844issn
1873-233Xpii
00006250-200908000-00015journal_volume
114pub_type
杂志文章abstract::Vaginal cuff dehiscence is an infrequent complication of hysterectomy, with the potential for evisceration and additional morbidity. This review aims to describe the incidence, risk factors, preventative measures, and management. Identification of specific risk factors is problematic because many studies either lack c...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0000000000002852
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To determine the effect of early postpartum discharge (less than 48 hours after vaginal birth or 96 hours after cesarean delivery) on maternal and neonatal complications, maternal concerns, patient satisfaction, and cost savings. DATA SOURCES:We performed a MEDLINE search of English-language journals for per...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/S0029-7844(97)00405-5
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVE:Among all women with pelvic inflammatory disease (PID), prevention of adverse reproductive consequences appears to be similarly achieved by outpatient treatment and inpatient treatment. We assessed whether outpatient is as effective as inpatient treatment in relevant age, race, and clinical subgroups of women...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/01.AOG.0000175193.37531.6e
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:To investigate neonatal morbidity and maternal complication rates with delivery body mass index (BMI) 60 or greater. METHODS:This retrospective, multicenter cohort study included singleton pregnancies between 23 and 42 weeks of gestation from January 2005 to April 2016. Women with BMI 60 or greater were comp...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/AOG.0000000000002316
更新日期:2017-11-01 00:00:00
abstract::Multiple studies suggest that health care workers treating human papillomavirus (HPV)-associated conditions may experience occupational exposure to the virus. Case reports describe the development of cancer and other disease in health care professionals at low risk for such conditions except for their work. Despite li...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004021
更新日期:2020-10-01 00:00:00
abstract::A randomized prospective study compared the efficacy of a three-dose perioperative course of intravenously administered cefuroxime and metronidazole versus suction drainage of the vaginal vault for preventing postoperative infection in abdominal and vaginal hysterectomies. In vaginally operated patients, a significant...
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:1987-09-01 00:00:00
abstract::Despite significant changes in management of labor and delivery over the past few decades, operative vaginal birth remains an important component of modern labor management, accounting for 3.3% of all deliveries in 2013 (1). Use of obstetric forceps or vacuum extractor requires that an obstetrician or other obstetric ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000003765
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:The history of gynecology and surgery in America has been well documented. However, a landmark operation took place in 1856 that has gone unrecognized in modern surgical texts. CASE:William J. Baker and associates performed the first successful abdominal hysterectomy with bilateral salpingo-oophorectomy in ...
journal_title:Obstetrics and gynecology
pub_type: 历史文章,杂志文章
doi:10.1097/01.AOG.0000187944.96000.52
更新日期:2006-02-01 00:00:00
abstract::Re-entering the practice of obstetrics and gynecology after a period of inactivity can pose a number of obstacles for a physician. Preparing for the leave of absence may help reduce the difficulties physicians may face upon re-entering practice. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182564947
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:To investigate the value of the combined use of vaginal ultrasonography and endometrial sampling in the office for the diagnosis of endometrial disease in postmenopausal women. METHODS:One hundred forty consecutive postmenopausal women presenting with uterine bleeding or endometrial cells on cervical cytolog...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0029-7844(94)00421-9
更新日期:1995-03-01 00:00:00
abstract::To examine the accuracy and predictability of human chorionic gonadotropin concentrations in determining gestational age, serum concentrations of human chorionic gonadotropin (beta-subunit) were measured during the first 157 days after last menses. Using the regression curve generated, human chorionic gonadotropin con...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the laparoscopic management of adnexal masses suspicious at ultrasound. METHODS:In a prospective study, adnexal masses suspicious at ultrasound were managed by laparoscopy. Indications for laparotomy included general contraindications to laparoscopy, obviously disseminated ovarian cancer, and tec...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)81436-6
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:To prospectively evaluate clinical outcome of rectocele repair using xenograft 3 years after surgery. METHODS:Twenty-three patients who completed evaluation preoperatively and 1 year after surgery were assessed at a 3-year follow-up. Clinical examination was performed preoperatively, and at the 1- and 3-year...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000192547.58102.ab
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:Preeclampsia is associated with abnormal lipid metabolism, including fatty acid metabolism. Carnitine plays an indispensable role in the oxidation of fatty acids. The aim of the study was to evaluate the possible role of abnormal fatty acid oxidation in preeclampsia by comparing plasma carnitine levels betwee...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000125699.60416.03
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE:To establish nomograms of fetal ear measurements. Newborns with trisomies have smaller ears than the normal population. This observation led us to believe that ear measurements might be useful in the antenatal prediction of fetuses with abnormal karyotypes. METHODS:Fetal ear length and width were obtained ul...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract::A double-blind randomized trial of antibiotic prophylaxis was performed with 49 patients undergoing extended pelvic surgery for adenocarcinoma of the endometrium. In this series infections of the Hemovac drain site(s) were most common (8 of 10 infections); only 1 serious infection, pelvic cellulitis, occurred. Short-t...
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:1982-03-01 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 review our experience with antenatal detection and subsequent neonatal outcome of fetuses with a persistent right umbilical vein. METHODS:In a prospective observational study, 33 cases of persistent right umbilical vein were detected during 15,237 obstetric ultrasound examinations performed after 15 weeks...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract::To address the question of when to perform an appendectomy in the surgical treatment of endometriosis, a series of 500 consecutive appendectomies was reviewed. In 104 patients with pelvic endometriosis who were undergoing appendectomy, the appendix was a relatively common (13%) extragenital site of endometriosis. Gros...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-04-01 00:00:00
abstract::In order to evaluate changes in hemoglobin A1 levels during nondiabetic pregnancy, 19 pregnant women were followed by determination of hemoglobin A1 with a two to four week interval. There was an early decrease in the hemoglobin A1 level already between the 12th and 16th weeks of pregnancy, with a further decrease in ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-12-01 00:00:00
abstract::This study reviewed 20 cases of extensive squamous carcinoma in situ of the vulva and posterior perineum. Two patients had concurrent, overt invasive carcinoma of the vulva, 14 patients had concurrent extensive vulvar carcinoma in situ, three patients had previous skinning vulvectomy for carcinoma in situ, and one pat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the response rate and toxicity of alternating weekly therapy with etoposide-methotrexate-dactinomycin/cyclophosphamide-vincristine for women with high-risk gestational trophoblastic disease. METHODS:Twenty-two women with gestational trophoblastic disease received 126 cycles of the study regimen. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of clinical trials registries in published obstetrics and gynecologic systematic reviews and meta-analyses. METHODS:We performed a metaepidemiologic study of systematic reviews between January 1, 2007, and December 31, 2015, from six obstetric and gynecologic journals (Obstetrics & Gyneco...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001204
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:To explore the relationship between race and depression symptoms among participants in an early pregnancy loss clinical trial. METHODS:We performed a planned secondary analysis of a randomized trial by comparing treatments for medical management of early pregnancy loss. We hypothesized that Black participant...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004212
更新日期:2021-01-01 00:00:00
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::Ten cases of malignant tumors arising in foci of gonadal and extragonadal endometriosis are reported and added to 195 previously reported cases from the English literature. The ovary was the primary site in 165 (78.7%) of the cases, whereas extragonadal sites represented 44 (21.3%). Endometrioid adenocarcinomas accoun...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1990-06-01 00:00:00
abstract:OBJECTIVE:To report labor, delivery, and neonatal outcomes in a cohort of women delivering neonates who had undergone fetoscopic neural tube defect repair. METHODS:We conducted a retrospective cohort study from April 2014 to January 2018. All patients met Management of Myelomeningocele Study eligibility criteria. We i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002577
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To determine the incidence, features, and surgical treatment of vulvovaginal lesions in toxic epidermal necrolysis. METHODS:Acute genital lesions were studied retrospectively in 40 women hospitalized for toxic epidermal necrolysis in a dermatologic intensive care unit. A questionnaire was sent to evaluate se...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00596-6
更新日期:1998-02-01 00:00:00
abstract::The risk of a first episode of pelvic inflammatory disease resulting in extensive surgery was examined in relation to duration of intrauterine device (IUD) use in a case-control study. Extensive surgery for pelvic inflammatory disease was defined as hysterectomy or bilateral adenexal surgery, with pelvic inflammatory ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-02-01 00:00:00
abstract:OBJECTIVE:To compare the representation of women in obstetrics and gynecology department-based leadership to other clinical specialties while accounting for proportions of women in historical residency cohorts. METHODS:This was a cross-sectional observational study. The gender of department-based leaders (chair, vice ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001290
更新日期:2016-03-01 00:00:00