A protocol of dual prophylaxis for venous thromboembolism prevention in gynecologic cancer patients.


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.


Obstet Gynecol


Einstein MH,Kushner DM,Connor JP,Bohl AA,Best TJ,Evans MD,Chappell RJ,Hartenbach EM




Has Abstract


2008-11-01 00:00:00














  • Chronic pelvic pain and previous sexual abuse.

    abstract:OBJECTIVE:To determine whether there is an association between history of sexual abuse and development of chronic pelvic pain. METHODS:We studied 36 women with chronic pelvic pain, 23 with chronic low back pain, and 20 healthy women with reference to experience of sexual abuse, physical violence, and emotional neglect...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Lampe A,Sölder E,Ennemoser A,Schubert C,Rumpold G,Söllner W

    更新日期:2000-12-01 00:00:00

  • Human immunodeficiency virus type 1-related nucleic acids and papillomavirus DNA in cervicovaginal secretions of immunodeficiency virus-infected women.

    abstract:OBJECTIVE:To evaluate simultaneous human immunodeficiency virus (HIV)-related nucleic acids and human papillomavirus (HPV)-DNA in cervicovaginal secretions of HIV-seropositive women. METHODS:We collected 47 paired blood and cervicovaginal lavage samples from 124 known HIV-1-seropositive women. Proviral HIV-1 DNA, cell...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Spinillo A,Debiaggi M,Zara F,De Santolo A,Polatti F,Filice G

    更新日期:2001-06-01 00:00:00

  • Sickle-delta beta thalassemia: mild sickling disorder with serious morbidity in pregnancy.

    abstract::Two patients with sickle-delta gamma thalassemia are reported who experienced the typical complications of sickling disorders in the last 2 months of 4 pregnancies. The diagnosis, genetics, and management of pregnancy in this rare hematologic disease, which causes minimal morbidity in the nonpregnant woman, are discus...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Cohen AW,Russell MO,Mennuti MT

    更新日期:1981-07-01 00:00:00

  • Risk factors for fever in labor.

    abstract:OBJECTIVE:To identify risk factors for fever in labor. METHODS:A retrospective case-control study was conducted. Maternal sublingual temperature was measured every 2-4 hours during labor in 3109 of 3860 consecutive term parturients presenting from September 1992 through December 1993. Women who had fever (at least one...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Herbst A,Wølner-Hanssen P,Ingemarsson I

    更新日期:1995-11-01 00:00:00

  • Effect of human immunodeficiency virus treatment on maternal mortality at a tertiary center in South Africa: a 5-year audit.

    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 introduce...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Black V,Brooke S,Chersich MF

    更新日期:2009-08-01 00:00:00

  • Deaths from ectopic pregnancy, United States, 1979 to 1980.

    abstract::During the 1970s in the United States, the number of hospitalizations for ectopic pregnancy increased more than twofold, and ectopic pregnancy emerged as a leading cause of maternal mortality. All known deaths from ectopic pregnancy in the United States from January 1, 1979, to December 31, 1980, were investigated by ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Dorfman SF

    更新日期:1983-09-01 00:00:00

  • Bilateral radial nerve palsies from use of the standard birthing bar.

    abstract:BACKGROUND:Serious injury can result from improper use of the birthing bar. CASE:A 31-year-old woman delivered a neonate using a birthing bar for her entire second stage of labor. Shortly after delivery, she experienced bilateral upper extremity weakness from compression of the radial nerve. She was treated with physi...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Roubal PJ,Chavinson AH,LaGrandeur RM

    更新日期:1996-05-01 00:00:00

  • Labial adhesions presenting as urinary incontinence in postmenopausal women.

    abstract::Most discussion on labial adhesions is about the pediatric group. A case is presented of a postmenopausal woman whose main complaint was urinary incontinence. Etiology, symptoms, signs, and diagnosis are discussed. Guidelines for treatment and prevention are proposed. Because the number of postmenopausal women is stea...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Chuong CJ,Hodgkinson CP

    更新日期:1984-09-01 00:00:00

  • Contemporary Trends in Cesarean Delivery Utilization for Live Births Between 22 0/7 and 23 6/7 Weeks of Gestation.

    abstract:OBJECTIVE:In 2014, the Society for Maternal-Fetal Medicine, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists published an executive summary of a joint workshop to establish obstetric inter...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Rossi RM,Hall E,DeFranco EA

    更新日期:2019-03-01 00:00:00

  • DNA content as a prognostic factor in endometrial carcinoma.

    abstract::Two hundred thirty-three cases of endometrial carcinoma were analyzed for DNA content using flow cytometry of cell nuclei extracted from archival paraffin blocks. The median follow-up time for the cases was 8.7 years. Aneuploidy, present in 18% of tumors overall, was associated with adverse histologic type, high grade...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Newbury R,Schuerch C,Goodspeed N,Fanning J,Glidewell O,Evans M

    更新日期:1990-08-01 00:00:00

  • The role of endocervical curettage at cervical conization for high-grade dysplasia.

    abstract:OBJECTIVE:To quantify the risk of invasive cancer above the location where the conization specimen was taken in patients with an endocervical curettage (ECC) positive for dysplasia at conization for high-grade cervical intraepithelial neoplasia (CIN), and to determine if any pathologic features may influence this risk....

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Kobak WH,Roman LD,Felix JC,Muderspach LI,Schlaerth JB,Morrow CP

    更新日期:1995-02-01 00:00:00

  • The reliability and predictive value of an amniotic fluid scoring system in severe second-trimester oligohydramnios.

    abstract::Sixty-two cases of oligohydramnios diagnosed by ultrasound between 13-28 weeks' gestation were reviewed. Three experienced ultrasonographers used a subjective scale to rate the oligohydramnios as mild, moderate, severe, or anhydramniotic. Interobserver reliability was excellent (intraclass correlation coefficient 0.81...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Moore TR,Longo J,Leopold GR,Casola G,Gosink BB

    更新日期:1989-05-01 00:00:00

  • The management of severe toxemia in patients at less than 36 weeks' gestation.

    abstract::Fifty-five patients at less than 36 weeks' gestation with severe toxemia were treated conservatively. The pregnancies were continued for a mean duration of 19.2 days and the mean gestation at delivery was 35.2 weeks. Fifty-three percent of the deliveries were by cesarean section. Of the neonates, 56.5% showed severe i...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Martin TR,Tupper WR

    更新日期:1979-11-01 00:00:00

  • Learning curve in ultrasonographic screening for selected fetal structural anomalies in early pregnancy.

    abstract:OBJECTIVE:To assess the value of first trimester screening by ultrasonography in detecting structural anomalies of the fetus in a general obstetric population. METHODS:During 1993-1998, 20,465 consecutive pregnant women who resided in a defined geographic area participated in ultrasonographic screening for major malfo...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Taipale P,Ammälä M,Salonen R,Hiilesmaa V

    更新日期:2003-02-01 00:00:00

  • Committee opinion no. 515: Health care for urban American Indian and Alaska Native women.

    abstract::Sixty percent of American Indian and Alaska Native women live in metropolitan areas. Most are not eligible for health care provided by the federal Indian Health Service (IHS). The IHS partly funds 34 Urban Indian Health Organizations, which vary in size and services. Some are small informational and referral sites tha...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Committee on American Indian\/Alaska Native Women's Health.,Committee on Health Care for Underserved Women.

    更新日期:2012-01-01 00:00:00

  • Postoperative Opioid Consumption After Scheduled Compared With Unscheduled Cesarean Delivery.

    abstract:OBJECTIVE:To identify characteristics associated with high inpatient daily opioid consumption after cesarean delivery. METHODS:This is a retrospective cohort study of all cesarean deliveries performed under neuraxial anesthesia with neuraxial morphine, at a single institution from January 1, 2015, to December 31, 2015...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Prabhu M,Dolisca S,Wood R,James K,Bateman BT,Barth WH Jr,Wylie BJ

    更新日期:2019-02-01 00:00:00

  • Cordocentesis for the diagnosis and treatment of human fetal parvovirus infection.

    abstract::Human parvovirus B-19 infection was diagnosed by DNA hybridization in blood obtained by cordocentesis from two hydropic fetuses at 22 and 26 weeks' gestation; B-19-specific immunoglobulin M (IgM) in fetal blood was negative in both cases. Hematologic studies demonstrated severe anemia, which was treated by intravascul...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Peters MT,Nicolaides KH

    更新日期:1990-03-01 00:00:00

  • Determinants of postoperative outcomes of female genital fistula repair surgery.

    abstract:OBJECTIVE:To determine predictors of fistula repair outcomes 3 months postsurgery. METHODS:We conducted a multicountry prospective cohort study between 2007 and 2010. Outcomes, measured 3 months postsurgery, included fistula closure and residual incontinence in women with a closed fistula. Potential predictors include...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,多中心研究


    authors: Barone MA,Frajzyngier V,Ruminjo J,Asiimwe F,Barry TH,Bello A,Danladi D,Ganda SO,Idris S,Inoussa M,Lynch M,Mussell F,Podder DC

    更新日期:2012-09-01 00:00:00

  • Forecasting the prevalence of pelvic floor disorders in U.S. Women: 2010 to 2050.

    abstract:OBJECTIVES:To estimate the number of women who will have symptomatic pelvic floor disorders in the United States from 2010 to 2050. METHODS:We used population projections from the U.S. Census Bureau from 2010 to 2050 and published age-specific prevalence estimates for bothersome, symptomatic pelvic floor disorders (ur...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Wu JM,Hundley AF,Fulton RG,Myers ER

    更新日期:2009-12-01 00:00:00

  • The prognostic value of antinuclear antibodies in women with recurrent pregnancy losses: a prospective controlled study.

    abstract::Because autoimmune diseases are suspected of causing some cases of recurrent pregnancy loss, we sought clinical and serologic evidence of such diseases in a group of 277 women with recurrent pregnancy loss. Using HEp-2 cells as targets for an indirect immunofluorescence test for antinuclear antibodies, we compared the...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Harger JH,Rabin BS,Marchese SG

    更新日期:1989-03-01 00:00:00

  • Pituitary response to a new analog of luteinizing hormone releasing factor during the menstrual cycle.

    abstract::A new analog of luteinizing-hormone-releasing factor, (Des-Gly-NH-2-10, Pro-ethylamide-9)-LHRF, was tested in healthy women with regular menstrual cycles. This synthetic nonapeptide amide was injected intravenously in a dose of 200 mug into 15 normal female volunteers in the follicular, preovulatory, and luteal phases...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Nakano R,Takekida H,Kotsuji F,Tojo S

    更新日期:1975-03-01 00:00:00

  • Persistent tubal pregnancy.

    abstract::Persistent tubal pregnancy may be manifest by either acute symptoms or a persistent or rising beta-hCG titer following conservative surgery. This condition is a relatively new complication, related to the recent practice of conservative surgical management of tubal pregnancy. Much has been written on the identificatio...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Stock RJ

    更新日期:1991-02-01 00:00:00

  • Using Three-Dimensional Printing to Fabricate a Tubing Connector for Dilation and Evacuation.

    abstract:BACKGROUND:This is a proof-of-concept study to show that simple instrumentation problems encountered in surgery can be solved by fabricating devices using a three-dimensional printer. The device used in the study is a simple tubing connector fashioned to connect two segments of suction tubing used in a surgical procedu...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Stitely ML,Paterson H

    更新日期:2016-02-01 00:00:00

  • Relation of mild idiopathic polyhydramnios to perinatal outcome.

    abstract::The relation between clinically obvious polyhydramnios and poor perinatal outcome has been described. Much less is known about mild, unexplained polyhydramnios, which usually is initially suggested by sonographic examination late in gestation. The purpose of the present investigation was to relate mild idiopathic poly...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Smith CV,Plambeck RD,Rayburn WF,Albaugh KJ

    更新日期:1992-03-01 00:00:00

  • Ascending herpetic endometritis.

    abstract::Two cases of herpetic endometritis are reported. In both patients, the disease developed from documented herpetic cervicitis via transcervical ascension. One patient recovered spontaneously. Generalization and death occurred in the other patient, a renal transplant recipient treated with immunosuppressive agents. The ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Schneider V,Behm FG,Mumaw VR

    更新日期:1982-02-01 00:00:00

  • Postpartum Rh immunoprophylaxis.

    abstract::The postpartum dose of Rh immune globulin varies according to an individual laboratory estimation of fetal red blood cells in each mother's peripheral blood. In the United States, a four-step procedure determines the postpartum dose (number of vials of 300 micrograms; 1,500 international units) of Rh immune globulin (...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审


    authors: Sandler SG,Gottschall JL

    更新日期:2012-12-01 00:00:00

  • Histomorphometric changes in the skeleton of postmenopausal women with low bone mineral density treated with percutaneous estradiol implants.

    abstract:OBJECTIVE:To identify the effects of percutaneous estradiol (E2) implants on bone histology and bone mass of postmenopausal women with low bone mineral density. METHODS:Sixteen postmenopausal women with low bone mineral density were treated with 75-mg E2 implants. Each had iliac crest bone biopsies performed, followin...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Holland EF,Chow JW,Studd JW,Leather AT,Chambers TJ

    更新日期:1994-03-01 00:00:00

  • Pulse pressure and risk of preeclampsia: a prospective study.

    abstract:OBJECTIVE:To find whether pulse pressure, a measure of arterial compliance, is associated early in pregnancy with increased risk of developing preeclampsia. METHODS:In a prospective cohort of 576 nulliparas, we examined blood pressures throughout pregnancy and at 6-8 weeks postpartum. Measurements during weeks 7-15, 1...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Thadhani R,Ecker JL,Kettyle E,Sandler L,Frigoletto FD

    更新日期:2001-04-01 00:00:00

  • Second-Trimester Fetal Loss in a Patient With Hyperemesis Gravidarum Complicated by Refeeding Syndrome.

    abstract:BACKGROUND:Refeeding syndrome is a rare constellation of electrolyte abnormalities after reintroduction of glucose during an adaptive state of starvation and malnutrition, resulting in fluid shifts, end-organ damage, and, potentially, death. We present a case of fetal death in a patient with hyperemesis gravidarum comp...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Mayer KH,McGill AL

    更新日期:2019-06-01 00:00:00

  • Uterine rupture associated with recent antepartum cocaine abuse.

    abstract:BACKGROUND:The diagnosis of uterine rupture is aided by the identification of risk factors, such as oxytocin administration. In several experiments, cocaine has been shown to stimulate uterine contractility. Complications from cocaine abuse during pregnancy have increased dramatically in the United States, and cocaine ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Iriye BK,Bristow RE,Hsu CD,Bruni R,Johnson TR

    更新日期:1994-05-01 00:00:00