Abstract:
OBJECTIVE:To evaluate a quality improvement protocol for venous thromboembolism prevention in postoperative gynecologic cancer patients. METHODS:On January 1, 2006, we initiated a universal protocol of dual prophylaxis with sequential compression devices and three times daily heparin (or daily low molecular weight heparin) until discharge in gynecologic cancer patients having major surgery. Patients with both malignancy and age over 60 years (or history of prior clot) were discharged on 2 weeks of anticoagulant. Before January 2006, all patients were given sequential compression devices starting before the induction of anesthesia, continuing until discharge from the hospital. Records of gynecologic cancer service patients admitted in 2005 and 2006 were reviewed, excluding patients with a history of heparin-induced thrombocytopenia or those admitted on an anticoagulant. Any pulmonary embolism or deep vein thrombosis diagnosed within 6 weeks of surgery was identified. We performed chi2 and Wilcoxon rank sum tests as well as multivariable regression analysis for confounders. RESULTS:Six of the 311 women meeting inclusion criteria in 2006 (1.9%) and 19 of 294 (6.5%) in 2005 had venous thromboembolism (odds ratio 0.33, 95% confidence interval 0.12-0.88, multivariable analysis adjusting for baseline differences between the groups). Heparin was given to 98.1% of patients in the hospital in 2006, and 91.1% of those meeting high-risk criteria were discharged on an anticoagulant. No differences in major bleeding complications were seen between years. CONCLUSION:A protocol of dual prophylaxis with prolonged prophylaxis in high-risk patients was successfully implemented and was associated with a significant reduction in the rate of venous thromboembolism without increasing bleeding complications. LEVEL OF EVIDENCE:II.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Einstein MH,Kushner DM,Connor JP,Bohl AA,Best TJ,Evans MD,Chappell RJ,Hartenbach EMdoi
10.1097/AOG.0b013e31818b1486subject
Has Abstractpub_date
2008-11-01 00:00:00pages
1091-7issue
5eissn
0029-7844issn
1873-233Xpii
112/5/1091journal_volume
112pub_type
临床试验,杂志文章abstract::Umbilical cord blood gases were measured as objective parameters of neonatal outcome in patients delivered by Silastic vacuum extractor and were compared with those values from patients delivered spontaneously, by forceps, or by sequential use of vacuum and forceps. The results demonstrated no clinically significant d...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:The clinical association of hemochromatosis and infertility is rare. Hemochromatosis may affect fertility through a variety of mechanisms. CASE:A 44-year-old man and his 36-year-old wife presented with primary infertility of 7 years' duration. The husband was diagnosed as having idiopathic hemochromatosis, ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00082-9
更新日期:1998-10-01 00:00:00
abstract::A well-woman visit provides an excellent opportunity to counsel patients about maintaining a healthy lifestyle and minimizing health risks. Given the shifting and complex landscape of care, in which many women may not receive all the recommended preventive services, obstetrician-gynecologists have an opportunity to co...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002898
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that preeclamptic women are more readily inducible than are nonpreeclamptic women, regardless of cervical condition. METHODS:One hundred eighty-three preeclamptic women and 461 nonpreeclamptic women requiring labor induction were studied prospectively. Patients were categorized by Bish...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/S0029-7844(97)00043-4
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:To assess pregnancy outcomes at 40, 41, and 42 weeks' gestation when labor induction is done routinely at 42 but not 41 weeks. METHODS:We reviewed all singleton pregnancies delivered at 40 or more weeks' gestation between 1988 and 1998 at Parkland Memorial Hospital, Dallas, Texas. We excluded women with hype...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)00862-0
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:To compare the pharmacokinetics of vaginal and oral administration of the prostaglandin E1 analogue, misoprostol. METHODS:Twenty women received 400-micrograms doses of misoprostol either orally or as tablets placed in the vagina. Serum levels of principal metabolite, misoprostol acid, were measured at 7.5, 1...
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(97)00111-7
更新日期:1997-07-01 00:00:00
abstract::Cell-mediated immunity was tested by coincubation of target cell line (2043) of human squamous cell carcinoma and peripheral blood leukocytes (PBL) of 22 patients with squamous cell neoplasia of the uterine cervix, 9 patients with other tumors, and 9 normal females. The percentage of cell reduction in mild dysplasia w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-06-01 00:00:00
abstract::The analgesic properties and motor effect of epidural 0.25% bupivacaine (8 mL) were compared with those of epidural morphine (2 mg in 10 mL saline) followed by 8 mL of 0.25% bupivacaine. The study was performed on two groups of parturients (30 in each group) in active labor. Pain relief in the morphine-bupivacaine gro...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198602000-00009
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVE:To compare the effects of single and repeated courses of corticosteroids on brain growth in fetal sheep. METHODS:Pregnant sheep were given intramuscular betamethasone (0.5 mg/kg) at 104 days' gestation followed at 111, 118, and 124 days by equivalent volumes of sterile normal saline (n = 12) or betamethasone...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00265-3
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:To identify neonatal complications associated with placenta previa. METHODS:This was a population-based, retrospective cohort study involving all singleton deliveries in Nova Scotia from 1988 to 1995. The study group consisted of all completed singleton pregnancies complicated by placenta previa; all other s...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00480-3
更新日期:1999-04-01 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:OBJECTIVE:To evaluate maternal parity, the sonographic measurement of cervical length, and the five components of the Bishop score to determine which factors best predict the length of latent-phase labor in women undergoing labor induction. METHODS:Cervical position, cervical consistency, cervical effacement, cervical...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(96)00321-3
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:To estimate the incidence of occult uterine sarcoma and leiomyosarcoma in hysterectomies for leiomyomas and the risk associated with their morcellation. METHODS:We conducted a population-based cohort study. All uterine sarcomas from 2006-2013 in an integrated health care system were identified. Age- and race...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001187
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:To compare the effect of depot medroxyprogesterone acetate (DMPA) and two types of oral contraceptives (OC) on bone mineral density (BMD) among women 18-33 years of age with those not using hormonal contraception. METHODS:Data from 155 women were analyzed. Depot medroxyprogesterone acetate was administered t...
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)01495-8
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:Burkitt lymphoma during pregnancy is a rare event, and outcomes have been poor. However, few patients were treated by current standards, with nearly half receiving single-agent cyclophosphamide or no chemotherapy. CASE:A patient with Burkitt lymphoma presenting at 11 6/7 weeks' gestation was treated with su...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0029-7844(98)00282-8
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:To evaluate whether myo-inositol supplementation, an insulin sensitizer, reduces the rate of gestational diabetes mellitus (GDM) and lowers insulin resistance in obese pregnant women. METHODS:In an open-label, randomized trial, myo-inositol (2 g plus 200 micrograms folic acid twice a day) or placebo (200 mic...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/AOG.0000000000000958
更新日期:2015-08-01 00:00:00
abstract::Patient care emergencies may occur at any time in any setting, particularly the inpatient setting. It is important that obstetrician-gynecologists prepare themselves by assessing potential emergencies, establishing early warning systems, designating specialized first responders, conducting emergency drills, and debrie...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/01.AOG.0000444442.04111.c6
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Postpartum renal failure in previously healthy subjects is associated most often with preeclampsia and/or hypertension; hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, hemolytic uremic syndrome; or thrombotic thrombocytopenic purpura. Transient oliguria associated with preeclampsia is comm...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00196-3
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:To investigate the interaction of exogenous adenosine 5'-triphosphate (ATP), a P2 receptor agonist, with prostaglandin F(2alpha) (PGF(2alpha)) on pregnant women in labor as well as on isolated human pregnant uterus preparations. METHODS:For an in vitro study, myometrial samples were obtained from 27 women un...
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.0000161314.50808.dd
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the accuracy of the diagnosis of presumed ectopic pregnancy. METHODS:This was a retrospective cohort analysis at a tertiary care medical center. The patient population was composed of 1) clinically stable pregnant women with human chorionic gonadotropin (hCG) above 2000 mIU/mL and no evidence of ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)02142-7
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:Many serum markers have been proposed to aid in the identification of an ectopic pregnancy, but few have been validated. Most studies have been limited by sample size and design. The goal of this study was to assess putative markers to identify which can be optimally combined. METHODS:We conducted a case-con...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1097/AOG.0b013e31820b3c61
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:As cesarean deliveries increase, so does placenta accreta. There is little evidence regarding management of patients with known or suspected abnormal placentation seeking abortion. CASE:A medically complicated patient with evidence of placenta increta on magnetic resonance imaging presented for pregnancy te...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318194258c
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To compare 12-hour and 72-hour expectant management of premature rupture of membranes (PROM) in singleton term pregnancies. METHODS:In a prospective, nonrandomized study, 566 low-risk women with singleton term pregnancies presenting with PROM were assigned to either 12-hour or 72-hour expectant management. P...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00031-l
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:Pelvic vein thrombosis may occur in nonpuerperal patients with hypercoagulable conditions and have significant sequelae. The purpose of this report is to describe a nonpuerperal woman with factor V Leiden mutation who developed acute pelvic pain secondary to pelvic varix thrombosis. CASE:A multiparous woman...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01589-7
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:To assess treatment outcomes associated with an obstetric hypertensive emergency quality improvement intervention instituted in a tertiary care women's emergency department. METHODS:We conducted a cohort study of pregnant (20 weeks of gestation or greater) and postpartum (6 weeks of gestation or less) women ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002809
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To evaluate whether peptides given to adult mice with Down syndrome prevent learning deficits, and to delineate the mechanisms behind the protective effect. METHODS:Ts65Dn mice were treated for 9 days with peptides D-NAPVSIPQ (NAP)+D-SALLRSIPA (SAL) or placebo, and wild-type animals were treated with placebo...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182051ca5
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:There are various causes of shortness of breath in a young, pregnant woman. The importance of entertaining a broad differential diagnosis is highlighted in this case. CASE:A young, pregnant African-American woman presented in her third trimester with acute onset of shortness of breath. A team approach by di...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000267318.56856.2a
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:The secreted form of ADAM12 is a metalloprotease that may be involved in placental and fetal growth. We examined whether the concentration of ADAM12 in first-trimester maternal serum could be used as a marker for preeclampsia. METHODS:We developed a semiautomated, time-resolved, immunofluorometric assay for...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000165829.65319.65
更新日期:2005-07-01 00:00:00
abstract::A review of 3600 cases of laparoscopy sterilization at the John Hopkins Hospital, between the years 1968-1972, is presented. Technics, complications and failure rate are discussed. The criteria for sterilization were: 1) that the patient be 21 years old (unless mentally retarded or unless the patient was a teenager ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1973-11-01 00:00:00
abstract::To determine whether planned anterior vaginotomy is a logical and safe means of avoiding a uterine scar with term abdominal delivery. I recorded the complications of the technique and whether vaginal birth after anterior vaginotomy occurred. Thirteen anterior vaginotomies were done when the vagina had advanced during ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00209-8
更新日期:1996-09-01 00:00:00