Abstract:
:Women who present with pain and bleeding in the first trimester are at risk for ectopic pregnancy, a life-threatening condition. Conditions that predispose a woman to ectopic pregnancy are damaged fallopian tubes from prior tubal surgery or previous pelvic infection, smoking, and conception using assisted reproduction. Many women without risk factors can develop an ectopic pregnancy. A diagnostic algorithm that includes the use of transvaginal ultrasonography, human chorionic gonadotropin (hCG) concentrations, and, sometimes, uterine curettage can definitively diagnose women at risk in a timely manner. The absence of an intrauterine pregnancy above an established cut point of hCG is consistent with an abnormal pregnancy but does not distinguish a miscarriage from an ectopic pregnancy. When the initial hCG value is low, serial hCG values can be used to determine whether a gestation is potentially viable or spontaneously resolving. The minimal rise in hCG for a viable pregnancy is 53% in 2 days. The minimal decline of a spontaneous abortion is 21-35% in 2 days, depending on the initial level. A rise or fall in serial hCG values that is slower than this is suggestive of an ectopic pregnancy. Women diagnosed with an unruptured ectopic pregnancy are potential candidates for medical management with methotrexate. Intramuscular injection with methotrexate can be used to safely treat an ectopic pregnancy with success rates, tubal patency rates, and future fertility that are similar to those obtained with conservative surgery. Success rates using methotrexate are inversely rated to baseline hCG values and are higher using "multidose" compared with "single-dose" regimens. Surgical treatment may be conservative or definitive and should be attempted in most cases via laparoscopy.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Seeber BE,Barnhart KTdoi
10.1097/01.AOG.0000198632.15229.besubject
Has Abstractpub_date
2006-02-01 00:00:00pages
399-413issue
2 Pt 1eissn
0029-7844issn
1873-233Xpii
107/2/399journal_volume
107pub_type
杂志文章,评审abstract::We evaluated the recovery of fertility and the relief of pain symptoms in a long-term follow-up of 42 women undergoing repetitive conservative surgery for recurrent endometriosis. The mean age of the patients was 31.1 +/- 4.3 years. At the time of their second operation the disease was stage IV in 14 women, stage III ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract::At puberty, a patient with an imperforate hymen typically presents with a vaginal bulge of thin hymenal tissue with a dark or bluish hue caused by the hematocolpos behind it. Other findings that may be present include an abdominal mass, urinary retention, dysuria, constipation, and dyschezia. On evaluation, the goal i...
journal_title:Obstetrics and gynecology
pub_type: 评论,杂志文章
doi:10.1097/AOG.0000000000003284
更新日期:2019-06-01 00:00:00
abstract::beta-Adrenergic agents are used to inhibit preterm labor and glucocorticoids to accelerate fetal pulmonary maturation. A study was designed to investigate the metabolic effects of intravenous infusion of ritodrine (150 to 100 microgram/min) or isoxsuprine (200 to 150 microgram/min) in a series of 28 patients with gest...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-197803000-00007
更新日期:1978-03-01 00:00:00
abstract:OBJECTIVE:To examine the association of body mass index (BMI) and operative time and perioperative morbidity after hysterectomy and determine whether the association varies among abdominal, laparoscopic, and vaginal approaches. METHODS:Data abstracted from the American College of Surgeons National Safety and Quality I...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000698
更新日期:2015-03-01 00:00:00
abstract::There are several obstetric, medical, and surgical disorders that share many of the clinical and laboratory findings of patients with severe preeclampsia-hemolysis, elevated liver enzymes, and low platelets syndrome. Imitators of severe preeclampsia-hemolysis, elevated liver enzymes, and low platelets syndrome are lif...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000258281.22296.de
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:To assess the predictability and accuracy of a simplified approach--the cough stress test and single-channel cystometry--in the diagnosis of genuine stress incontinence (GSI) by comparing these tests to the more complex multichannel cough urethral pressure profile and urethrocystometry. Conversely, we assesse...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-03-01 00:00:00
abstract::Fetal macrosomia (birthweight equal to or in excess of 4500 g) in a study of 110 affected infants was associated with excessive maternal weight, prolonged gestation, white race, multiparity, maternal diabetes, male fetus, and a previous macrosomic infant. The two most common obstetric complications associated with fet...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-10-01 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::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 assess the value of the early diastolic notch and color Doppler imaging of the uterine arteries at 24 weeks' gestation in a two-stage Doppler screening test for preeclampsia. METHODS:Two thousand fifty-eight unselected women had an initial screening study with continuous-wave Doppler at 18-22 weeks' gesta...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVE:To determine whether stage of disease and treatment patterns account for mortality differences between black and white women with cervical cancer. METHODS:Using data obtained from the Surveillance, Epidemiology, and End Results (SEER) Program for 1988-1994, we determined the associations between race and sta...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00334-8
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the relationship among gestational age at elective cesarean delivery, neonatal intensive care unit (NICU) admission, and whether the presence of pre-cesarean delivery labor or ruptured membranes affected the incidence of neonatal respiratory distress. METHODS:A chart review was performed of all e...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31816736e7
更新日期:2008-04-01 00:00:00
abstract::Two cases of Listeria monocytogenes chorioamnionitis are presented in which transabdominal amniocentesis was used to confirm the diagnosis and to obtain reliable intrauterine culture material free from lower genital tract contamination. The mechanisms of infection with Listeria monocytogenes in the pregnant patient ar...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198003001-00002
更新日期:1980-03-01 00:00:00
abstract:OBJECTIVE:To develop a curriculum for residents in obstetrics and gynecology that also provides training in family medicine. METHODS:We designed a 5-year curriculum with 36 months of obstetrics and gynecology, 12 of which are as chief resident, with a 4-month rotation through family medicine to meet the primary care r...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1999-08-01 00:00:00
abstract::A case of intravenous leiomyomatosis with cardiac extension was treated successfully with a two-stage operation: resection of the intracardiac and intracaval mass for the first stage and total hysterectomy with bilateral salpingo-oophorectomy for the second. Tumors were located either within or in continuity to dilate...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:To examine the effectiveness of lidocaine spray compared with conventional lidocaine submucosal injection during a loop electrosurgical excision procedure (LEEP). METHODS:Women undergoing LEEP for any degrees of cervical intraepithelial neoplasia were invited to participate. The participants were randomly as...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/AOG.0b013e31829d888e
更新日期:2013-09-01 00:00:00
abstract::A prospective randomized study was undertaken in 100 patients undergoing cesarean section to evaluate the efficacy of cefotaxime when given as a single-dose versus the more traditional triple-dose regimen for prophylaxis. Analysis of the results demonstrated no significant differences in febrile morbidity (14 versus 2...
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:1985-02-01 00:00:00
abstract::An unusual myxoid and vascular appearing neoplasm of the vulva, termed an aggressive angiomyxoma, is described in a 36-year-old Hispanic woman. The clinical presentation and recurrence pattern were typical for previously described neoplasms of the same cellular pattern. The histopathology, difficulties in determining ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract::A new fetal scalp electrode applicator system uses a guide tube with increased curvature and a plunger mechanism to advance, rotate, and release the spiral electrode. Results of a preliminary survey among house staff who used the system in 51 patients indicated a favorable impression, with 96.1% of the applications ra...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract::To determine if intraabdominal irrigation with normal saline at cesarean delivery is associated with increased maternal morbidity. One hundred ninety-six women undergoing routine cesarean delivery at at least 37 weeks' gestation were prospectively randomized to receive 500-1000 mL of normal saline intraabdominal irrig...
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(02)02466-3
更新日期:2003-01-01 00:00:00
abstract::An unbalanced translocation, 46,XX,der(5)t(5;11) (p15;q25)mat was ascertained by prenatal diagnosis. The mother previously had a liveborn child with cri du chat syndrome. The subtlety of the chromosome rearrangement in this case illustrates the need for the most detailed cytogenetic investigations in cri du chat cases...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:Postoperative bleeding may be complicated by failure to identify the site of bleeding, multiple bleeding points, and persistent hemorrhage despite surgical intervention. CASE:Activated recombinant factor VII was used successfully in a patient with life-threatening postsurgical bleeding after resection of tw...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:2003-06-01 00:00:00
abstract::The Acyclovir in Pregnancy Registry was established to gather data on prenatal exposure to acyclovir. Exposed pregnancies are tracked prospectively to ascertain exposure, risk factors, and pregnancy outcome. Through June 30, 1990, 312 acyclovir-exposed pregnancies had been reported and followed. Of these, 239 were exp...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::The cardiovascular effects of ritodrine tocolytic therapy were assessed by noninvasive simultaneous recordings of indirect carotid pulse, electrocardiogram (ECG), phonocardiogram, and M-mode echocardiogram in 12 patients in preterm labor. The study was performed before and during infusion, and afterward when the patie...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-10-01 00:00:00
abstract::This month, we focus on current research in postpartum hemorrhage. Dr. Rouse discusses five recent publications, and each is concluded with a "bottom line" that is the take-home message. The complete reference for each can be found in on this page, along with direct links to the abstracts. ...
journal_title:Obstetrics and gynecology
pub_type: 评论,杂志文章
doi:10.1097/AOG.0b013e3182a2c357
更新日期:2013-09-01 00:00:00
abstract::The diagnosis of premature ovarian failure was made in 35 women (ages 17 to 40) with increased concentrations of follicle-stimulating hormone and luteinizing hormone. Three had primary amenorrhea, 29 had secondary amenorrhea (less than one to 15 years), and three had irregular menstrual intervals of less than six mont...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVE:To estimate the association between vaginal birth after cesarean delivery (VBAC) rates and primary cesarean delivery rates in California hospitals. METHODS:Hospital VBAC rates were calculated using birth certificate and discharge data from 2009, and hospitals were categorized by quartile of VBAC rate. Multiv...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182a91e0f
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:A regimen including interferon-alpha has become the standard of care in the treatment of chronic hepatitis C over the last decade. One rare adverse effect associated with the use of interferon-alpha is a granulomatous pulmonary reaction. CASE:A unique case of uterine sarcoidosis associated with the use of i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000157764.44292.aa
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:To examine preterm births among African-American and Hispanic women who delivered at an inner-city public hospital in the context of contemporaneously increasing rates in the United States. METHODS:The rates of preterm birth, defined as birth before 37 weeks of gestation, for singleton neonates with birth we...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318195e257
更新日期:2009-03-01 00:00:00
abstract::The endocervical strip biopsy instrument obtains strips of endocervical epithelium with attached cervical stroma without excessive bleeding or discomfort to the patient. The intact specimen allows a precise histologic evaluation of endocervical disease processes in patients with abnormal cervical cytology or endometri...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-11-01 00:00:00