Abstract:
OBJECTIVE:To estimate whether excessive weight gain or obesity are risk factors affecting success for vaginal birth after cesarean (VBAC). METHODS:Patients attempting VBAC were identified by the International Classification of Diseases, 9th Revision, codes "VBAC" and "non-primary C-section" and by reviewing logbooks on labor and delivery. A chart review identified patients attempting VBAC who were eligible for inclusion. Exclusion criteria included multiple gestation, more than one previous cesarean delivery, previous classical uterine scar, delivery at less than 36 weeks of gestation, and incomplete information. Patients were divided into the following categories: underweight (body mass index [BMI] < 19.8), normal weight (BMI 19.8-26), overweight (BMI 26.1-29), and obese (BMI > 29). Excessive weight gain was defined as a weight gain of more than 40 lb. Variables of interest included diabetes, previous successful vaginal delivery or VBAC, and presence of recurrent indication for cesarean delivery. RESULTS:We identified 1,213 patients who met inclusion criteria. Overall, the VBAC success rate was 77.2%. The success rates for BMI less than 19.8, 19.8-26, 26.1-29, and greater than 29 were 83.1%, 79.9%, 69.3%, and 68.2%, respectively, P < .001. Obese patients were almost 50% less likely to have a successful VBAC when compared to underweight patients, odds ratio 0.53, 95% confidence interval 0.29-0.98, P = .043. Similarly, patients who gained more than 40 lb were almost 40% less likely to be successful at VBAC than those who gained less than that amount, odds ratio 0.63, 95% confidence interval 0.42-0.97, P = .034. They had a VBAC success rate of 66.8%, whereas patients who gained less than 40 lb were successful 79.1% of the time, P < .001. CONCLUSION:Excessive weight gain during pregnancy and obesity both decrease VBAC success. Proper patient selection will help increase the likelihood of successful VBAC.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Juhasz G,Gyamfi C,Gyamfi P,Tocce K,Stone JLdoi
10.1097/01.AOG.0000177972.32941.65subject
Has Abstractpub_date
2005-10-01 00:00:00pages
741-6issue
4eissn
0029-7844issn
1873-233Xpii
106/4/741journal_volume
106pub_type
杂志文章abstract::The nonstress test is a commonly used tool for fetal well-being assessment. The antenatal death rate using the nonstress test as a primary modality is significantly higher than that with the use of the contraction stress test. The nonstress test is commonly performed on a once-a-week basis. The rate of stillbirths wit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the usefulness of routine screening for other associated autoimmune endocrine disorders in patients with karyotypically normal spontaneous premature ovarian failure. METHODS:One hundred nineteen women with karyotypically normal spontaneous premature ovarian failure (FSH exceeding 40 mIU/mL) who d...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00077-x
更新日期:1997-05-01 00:00:00
abstract::We have reviewed the family histories of children with neural tube defects to determine which relatives are at sufficient risk to be offered amniocentesis for prenatal diagnosis. The recurrence risks for sibs was 6%; therefore, women with one affected child should be made aware of the availability of this test for mon...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVES:To compare satisfaction with and adherence to the contraceptive vaginal ring and a daily low-dose oral contraceptive pill (OCP) among college and graduate students using a novel method of electronic data collection. METHODS:We randomly assigned 273 women to the contraceptive vaginal ring (n=136) or OCP (n=1...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/AOG.0b013e3181cf45dc
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:To compare the success of external cephalic version using spinal analgesia with no analgesia among nulliparas. METHODS:A prospective randomized controlled trial was performed in a tertiary referral center delivery suite. Nulliparous women at term requesting external cephalic version for breech presentation w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.AOG.0000295605.38175.7b
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:The combination of severe uterovaginal prolapse and stress urinary incontinence in medically compromised patients in whom surgery is contraindicated is a difficult treatment dilemma. CASE:A 75-year-old woman with severe cardiac compromise and a history of pulmonary embolus presented with severe uterovaginal...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00260-3
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:To determine the influence of maternal smoking on fetal erythropoietin concentrations in health term pregnancies and test the correlation between cotinine, a biomarker of maternal smoking, and erythropoietin levels in fetuses. METHODS:We invited women with healthy term pregnancies to participate in the study...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00622-5
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:To determine whether severe preeclampsia is associated with genetic thrombophilic mutations or other types of thrombophilia. METHODS:A case-control study compared 63 consecutive women with severe preeclampsia evaluated at our institution between November 1997 and April 1999 with 126 control women matched for...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)00861-9
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the methodology of the cost-effectiveness and cost-benefit literature in obstetrics and gynecology. DATA SOURCES:We performed a MEDLINE search of the general and subspecialty obstetrics and gynecology journals for the years 1990 through 1996. METHODS OF STUDY SELECTION:Original investigations in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00679-0
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:To describe causes, courses, complications, and outcomes of patients with pregnancy-associated acute respiratory distress syndrome (RDS). METHODS:Twenty-eight women with ARDS during pregnancy or within a week postpartum formed the study population. Eight cases had been reported previously. Charts were abstra...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)01231-x
更新日期:2001-05-01 00:00:00
abstract::Over the past decades, the use of assisted reproductive technology (ART) has increased dramatically worldwide and has made pregnancy possible for many infertile couples. Although the perinatal risks that may be associated with ART and ovulation induction are much higher in multifetal gestations, even singletons achiev...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001636
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:To assess the utility of umbilical cord venous blood gas measures for prediction of umbilical artery pH and base deficit acidemia. METHODS:A retrospective cohort study was conducted of all singletons with valid paired arterial and venous cord gas samples delivered at our institution from January 2006 to Marc...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000517
更新日期:2014-11-01 00:00:00
abstract::A case of ovarian carcinoma with bilateral metastases to the breasts is presented. This is the first report of simultaneous involvement of both breasts presenting as an inflammatory tumor. Axillary lymph node enlargement preceded breast involvement. The related literature is reviewed briefly, and the unpredictable inv...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198003001-00029
更新日期:1980-03-01 00:00:00
abstract::We report the first known case of Chediak-Higashi syndrome in human pregnancy. This rare autosomal recessive disorder is characterized by partial oculocutaneous albinism, decreased leukocyte chemotaxis, susceptibility to infection, and death in childhood. Pathognomonic giant cytoplasmic granules are postulated to be d...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVE:To estimate the relation between undercoiling and overcoiling of the umbilical cord and adverse pregnancy outcome. METHODS:Umbilical cords and hospital records of 885 patients were studied in a cross-sectional study design. The umbilical coiling index was determined as the number of complete coils divided by...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000209197.84185.15
更新日期:2006-05-01 00:00:00
abstract::This article, for the "To the Point" series prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, supplies educators with a review of best practices regarding incorporation of the electronic medical record (EMR) into undergraduate medical education. The uniqu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0000000000001004
更新日期:2015-09-01 00:00:00
abstract::Anterior sacral meningocele is a rare abnormality. Only 14 cases of it have been reported in association with pregnancy. Of those 14 patients, three died as a result of rupture of the meningocele during labor and postpartum. A new case is presented; the clinical presentation, the diagnosis, and treatment are discussed...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-03-01 00:00:00
abstract:OBJECTIVE:To compare hCG levels, obtained by biologic and immunologic means, in women with normal pregnancies and women with preeclampsia. METHODS:Peripheral blood samples from women in the third trimester with preeclampsia (n = 30) or normal pregnancies (n = 30) were assayed for immunoactive and bioactive hCG (mouse ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01463-6
更新日期:2001-09-01 00:00:00
abstract::The weights of 101 neonates delivered within 72 hours of real-time ultrasound examination were compared with the weight calculated from the ultrasonically measured biparietal diameter and abdominal circumference. A high degree of correlation (4 = .9624) was found between actual and calculated weights. This method of w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-06-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of depressive symptoms among women of reproductive age attending family planning clinics across southeast Texas in addition to demographic and reproductive characteristics associated with these symptoms. METHODS:A retrospective, self-reported, paper-and-pencil survey designed to as...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.obstetgynecol.2003.08.012
更新日期:2003-12-01 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::Uterine activity monitoring to detect preterm contractions and thus to manage patients in active labor is valuable to the clinician. Uterine activity measured by external devices using the guard ring principle or by standard tocodynamometers has been shown to be accurate concerning the frequency of uterine activity as...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract::: Accurate dating of pregnancy is important to improve outcomes and is a research and public health imperative. As soon as data from the last menstrual period, the first accurate ultrasound examination, or both are obtained, the gestational age and the estimated due date should be determined, discussed with the patien...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000454932.15177.be
更新日期:2014-10-01 00:00:00
abstract::Sixteen isoimmunized pregnancies at risk for erythroblastosis fetalis were managed by serial amniocenteses for bilirubin delta optical density at 450 nm (delta OD450). Before amniocentesis each fetus was evaluated ultrasonically and the fetal liver size, the abdominal circumference, and the umbilical vein diameter, in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-08-01 00:00:00
abstract:OBJECTIVE:To evaluate whether quality of peer review and reviewer recommendation differ based on reviewer subspecialty in obstetrics and gynecology and to determine the role of experience on reviewer recommendation. METHODS:We performed a retrospective cohort study of reviews submitted to Obstetrics & Gynecology betwe...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001852
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy and safety of routine electronic fetal monitoring (EFM) of labor with intermittent auscultation, using the results of published randomized controlled trials (RCTs). DATA SOURCES:We identified RCTs by searching the MED-LINE data base for the period 1966-1994, contacting experts, and re...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract::A case of endometrioid carcinoma arising in endometriosis of the fallopian tube is described. One case of tubal endometrioid carcinoma has been reported previously, but the entity has not hitherto been recognized among primary fallopian tube tumors. The clinical presentations, histopathology, and pathogenesis of this ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-07-01 00:00:00
abstract::Immediate postpartum long-acting reversible contraception (LARC) has the potential to reduce unintended and short-interval pregnancy. Women should be counseled about all forms of postpartum contraception in a context that allows informed decision making. Immediate postpartum LARC should be offered as an effective opti...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001583
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To compare last menstrual period and ultrasonography in predicting delivery date. METHODS:We used ultrasound to scan 17,221 nonselected singleton pregnancies at 8-16 completed weeks. The last menstrual period (LMP) was considered certain in 13,541 and uncertain in 3680 cases. The duration of pregnancy from t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)01131-5
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to examine the human teratogenic risk of the protease inhibitor, nelfinavir mesylate, used to treat human immunodeficiency virus. METHODS:This study used a subset of data from the Antiretroviral Pregnancy Registry, which was designed to monitor prenatal exposures to antiretrov...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000127440.68730.23
更新日期:2004-06-01 00:00:00