Abstract:
:Reductions in publicly funded prenatal care programs in 1981 to 1984 resulted in an increase in unregistered patient deliveries from 7.8% to 14.9% of births at University of California San Diego Medical Center. To assess the economic and perinatal impact of the increasing number of deliveries of women without prenatal care, 100 consecutive patients with fewer than three prenatal visits were studied. Each "no care" patient was matched by age, parity, and week of delivery with a control patient who received care in a state-funded perinatal project (Comprehensive Perinatal Program). Maternal antenatal risk factors were equally distributed between the two groups when maternal age, parity, history of substance abuse, prior preterm delivery, hypertension, and abortion were compared. Maternal obstetric outcomes were similar, including cesarean section rate and incidence of postpartum fever and hemorrhage. However, neonates delivered of women receiving no care experienced significantly greater morbidity than the neonates of women in the Comprehensive Perinatal Program, including an increased incidence of premature rupture of the membranes and preterm delivery (13% versus 2%, p less than 0.05), low birth weight (21% versus 6% less than 2500 gm, p less than 0.002), and intensive care unit admissions (24% versus 10%, p less than 0.005). When the total inpatient hospital charges were tabulated for each mother-baby pair, the cost of perinatal care for the group receiving no care ($5168 per pair) was significantly higher than the cost for patients in the Comprehensive Perinatal Program ($2974 per pair, p less than 0.001) including an antenatal charge of $600 in the Comprehensive Perinatal Program. The excess cost for delivery of 400 women receiving no care per year in the study hospital was $877,600. These results suggest that extension of prenatal care programs to medically indigent women is likely to result in a net reduction in perinatal morbidity and health care expenditures.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Moore TR,Origel W,Key TC,Resnik Rdoi
10.1016/0002-9378(86)90387-xsubject
Has Abstractpub_date
1986-01-01 00:00:00pages
29-33issue
1eissn
0002-9378issn
1097-6868pii
0002-9378(86)90387-Xjournal_volume
154pub_type
杂志文章abstract:OBJECTIVE:The objective of the study was to identify correlates of perceived risk of carrying a Down syndrome-affected fetus or experiencing a procedure-related miscarriage among a diverse group of pregnant women. STUDY DESIGN:We conducted a cross-sectional survey of 1081 English-, Spanish-, or Chinese-speaking women ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.09.045
更新日期:2008-03-01 00:00:00
abstract::This study compares fetal corticoid response from conventional dose (12.0 mg) intramuscular betamethasone to large dose (1,000 mg) intravenous cortisol administered to women in premature labor for acceleration of fetal lung maturity. To compare these two regimens, 14 women selected at random were treated in groups of ...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(76)90172-1
更新日期:1976-03-01 00:00:00
abstract::The pulsatile release of gonadotropin-releasing hormone and the consequent secretion of gonadotropins are regulated by a complex interplay of steroids, neuropeptides, catecholamines, and environmental factors. Estrogen and progesterone influence the amplitude and frequency of luteinizing hormone pulsatile secretion. T...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(90)91436-g
更新日期:1990-11-01 00:00:00
abstract::A retrospective chart review was performed on all patients undergoing trachelectomy in the Roanoke Valley between January 1, 1975 and April 30, 1987. During this period a total of 55 trachelectomies were performed. Fifty-three of the 55 trachelectomies (96%) were performed by the vaginal approach. Forty-seven of the 5...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(88)80042-5
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVES:Our goal was to determine the degree of shunting through the ductus venosus in the human fetus and its possible association with fetal growth. STUDY DESIGN:Blood flow in the umbilical vein and the fetal ductus venosus was measured in 197 low-risk pregnancies in a cross-sectional ultrasonographic study at a ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(00)70504-7
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare autologous versus cadaveric grafts in pubovaginal slings. STUDY DESIGN:Women who had pubovaginal slings from 1994 to 2003 completed history, questionnaires, prolapse staging, and cough stress testing. Failure was defined by recurrent urinary incontinence symptoms and ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.01.058
更新日期:2006-05-01 00:00:00
abstract::Crude glycosaminoglycan preparations were isolated from acetone-powder of first-, second-, and third-trimester human placentas. Glycosaminoglycan composition was examined by electrophoresis and densitometric scanning before and after treatment with testicular hyaluronidase and chondroitinase ABC. Hexosamines were dete...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32733-8
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVE:Pertussis causes significant morbidity among adults, children, and especially infants. Since 2006, pertussis vaccination has been recommended for women after delivery. We conducted a prospective, controlled evaluation of in-hospital postpartum pertussis vaccination of birth mothers from October 2009 through J...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.09.043
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the relationship between gestational age and outcomes of outborn versus inborn preterm infants. STUDY DESIGN:Multivariable logistic regression analysis was used to examine gestational age-specific, risk-adjusted outcomes of 2962 singleton infants who were born at <32 ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.139
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the normal beta-human chorionic gonadotropin change within 24 hours after a medical abortion. Because a medical abortion creates a "miscarriage," these data can represent the serum beta-human chorionic gonadotropin changes that would occur with a complete spontaneous...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-9378(96)70463-5
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:Our aim was to determine the fate of mandatory resident research projects with regard to subsequent presentation and publication. STUDY DESIGN:In this retrospective descriptive study required research projects were assessed for frequency of presentation at regional and national meetings or publication in med...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70281-0
更新日期:1994-03-01 00:00:00
abstract::Normal fetal growth is a critical component of a healthy pregnancy and influences the long-term health of the offspring. However, defining normal and abnormal fetal growth has been a long-standing challenge in clinical practice and research. We review various references and standards that are used widely to evaluate f...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2009.10.889
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:Our purpose was to compare the effectiveness, women's views of the termination procedure, and success of umbilical cord culture for vaginal and oral misoprostol versus intra-amniotic prostaglandin PGF(2alpha) for second-trimester pregnancy termination (STPT). STUDY DESIGN:We randomized 217 women, 15 to 24 we...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.ajog.2003.09.037
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to examine risk factors for bacterial vaginosis (BV) during pregnancy among African American women. STUDY DESIGN:As part of a study of preterm birth, African American women residing in Baltimore, MD, were recruited from prenatal care sites. Women enrolled prenatally (between 22...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2007.03.085
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess the risk of neonatal death and morbidity in vertex-nonvertex second twins according to the mode of delivery and birth weight. STUDY DESIGN:Data from a retrospective cohort study that was based on all twin births in the United States (1995-1997) were used. RESULTS:A to...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.09.132
更新日期:2005-03-01 00:00:00
abstract::Partial mole is distinguishable from complete mole with coexisting normal twin after delivery by DNA polymorphysm analysis. Our patient had chorionic villus sampling of a molar-appearing placenta with coexisting fetus at 12.3 weeks. Absent maternal alleles confirmed a diandrogenetic complete mole. Prenatal DNA diagnos...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.151
更新日期:2003-04-01 00:00:00
abstract::This study was undertaken to determine the significance of the changes in nonsuppressible insulin-like activity as measured by the fat pad assay and by the levels of immunoreactive somatomedin C, growth hormone, and human placental lactogen in sera of term normal pregnant women, mothers who delivered prematurely, and ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90087-0
更新日期:1985-10-15 00:00:00
abstract:BACKGROUND:The current recommendation regarding the management of a term newborn delivered of a mother with an intrapartum fever or a diagnosis of clinical chorioamnionitis is that the neonate should have baseline laboratory work drawn along with blood cultures and be universally treated with antibiotics until culture ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2017.02.022
更新日期:2017-06-01 00:00:00
abstract::Value-based care, best clinical outcome relative to cost, is a priority in correcting the high costs for average clinical outcomes of health care delivery in the United States. Hysterectomy represents the most common and identifiable nonobstetric major surgical procedure among women. Surgical approaches to hysterectom...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2018.11.124
更新日期:2019-03-01 00:00:00
abstract::FloSeal hemostatic matrix has been reported to be effective for the control of intraoperative bleeding in various surgeries. We report 3 patients who experienced a possible allergic response to FloSeal with the formation of excessive granulation tissue and fibrosis that were associated with early postoperative pelvic ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.10.052
更新日期:2009-04-01 00:00:00
abstract::Effect of irradiation alone and irradiation after 5-fluorouracil (5-FU), paclitaxel, or cisplatin (CDDP) was investigated in human cervical cell lines (CaSki, ME180, SiHa, and C33A). High-risk human papillomavirus (HPV) (+) CaSki and SiHa cells were the most resistant to CDDP, 5-FU, and radiation treatments. Radiation...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.12.045
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to describe obstetric outcomes after surgical abortion at > or = 20 weeks, and to identify risk factors for subsequent spontaneous preterm birth. STUDY DESIGN:Patients who had surgical abortion at > or = 20 weeks' gestation from 1996 to 2003 and received subsequent prenatal care...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.05.078
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:Recent randomized trials comparing total laparoscopic hysterectomy (TLH) and vaginal hysterectomy (VH) have produced conflicting results. The role of TLH in women suitable for VH remains uncertain. STUDY DESIGN:This study was a metaanalysis of randomized studies comparing TLH and VH for benign disease. Poole...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ajog.2010.12.059
更新日期:2011-05-01 00:00:00
abstract::An analysis of United States birth certificate records for the calendar year 1977 indicated that women who failed to seek prenatal care were at increased risk of delivery of a low-birth weight infant, even after social factors were considered. However, the strength of association, as well as the population impact, bet...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)90681-6
更新日期:1983-04-01 00:00:00
abstract::In mothers with anti-Ro-positive antibodies whose previous pregnancies have ended in deliveries of infants with congenital heart block, prophylactic therapeutic strategies are used to try to diminish the production and passage into fetal circulation of autoantibodies. Intravenous gamma globulin was given at 14 and 18 ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90362-u
更新日期:1991-11-01 00:00:00
abstract::Plasma levels of estrogen were measured daily by radioimmunoassay for 28 consecutive days in 12 healthy euthyroid women and 15 thyrotoxic women (10 with hypomenorrhea and 5 with amenorrhea) before commencement of therapy (except in one case) in an effort to increase understanding of the relationship between the thyroi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90732-2
更新日期:1975-08-01 00:00:00
abstract:OBJECTIVE:The mechanism underlying myometrial quiescence during pregnancy is unknown. Our group has previously shown that during pregnancy myometrial cyclic guanosine monophosphate content rises to several hundred times the nonpregnant levels, only to abruptly decline days before the onset of labor. Cyclic guanosine mo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.107462
更新日期:2000-12-01 00:00:00
abstract::Metformin is everywhere. Originally introduced in clinical practice as an antidiabetic agent, its role as a therapeutic agent is expanding to include treatment of prediabetes mellitus, gestational diabetes mellitus, and polycystic ovarian disease; more recently, experimental studies and observations in randomized clin...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2017.06.003
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:Because there is a dearth of literature, we developed an ethical framework to guide decision making about the management of pregnancy of patients with schizophrenia. STUDY DESIGN:We review pertinent literature on schizophrenia and pregnancy, including information on maternal and fetal risks and outcomes, and...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.125767
更新日期:2002-09-01 00:00:00
abstract::Providing reliable prenatal screening performance estimates is critical for patient counseling and policy-making. Women who choose prenatal screening for aneuploidy are likely to be concerned not only with the common aneuploidies but with all causes of intellectual disability and serious birth defects. Sequential pren...
journal_title:American journal of obstetrics and gynecology
pub_type: 社论
doi:10.1016/j.ajog.2016.06.046
更新日期:2016-11-01 00:00:00