Abstract:
OBJECTIVE:To estimate the incidence, mortality, and risk factors for pregnancy-related stroke in the United States. METHODS:The Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, for the years 2000-2001 was queried for International Classification of Diseases, 9th Revision, codes for stroke among all pregnancy-related discharges. RESULTS:A total of 2,850 pregnancy-related discharges included a diagnosis of stroke for a rate of 34.2 per 100,000 deliveries. There were 117 deaths or 1.4 per 100,000 deliveries. Twenty-two percent of survivors were discharged to another facility. The risk of stroke increased with age, particularly ages 35 years and older. African-American women were at a higher risk, odds ratio (OR) 1.5 (95% confidence interval [CI] 1.2-1.9). Medical conditions that were strongly associated with stroke included migraine headache, OR 16.9 (CI 9.7-29.5), thrombophilia, OR 16.0 (CI 9.4-27.2), systemic lupus erythematosus, OR 15.2 (CI 7.4-31.2), heart disease, OR 13.2 (CI 10.2-17.0), sickle cell disease, OR 9.1 (CI 3.7-22.2), hypertension, OR 6.1(CI 4.5-8.1) and thrombocytopenia, OR 6.0 (CI 1.5-24.1). Complications of pregnancy that were significant risk factors were postpartum hemorrhage, OR 1.8 (CI 1.2-2.8), preeclampsia and gestational hypertension, OR 4.4 (CI 3.6-5.4), transfusion OR 10.3 (CI 7.1-15.1) and postpartum infection, OR 25.0 (CI 18.3-34.0). CONCLUSION:The incidence, mortality and disability from pregnancy related-stroke are higher than previously reported. African-American women are at an increased risk, as are women aged 35 years and older. Risk factors, not previously reported, include lupus, blood transfusion, and migraine headaches. Specific strategies, not currently employed, may be required to reduce the devastation caused by stroke during pregnancy and the puerperium. LEVEL OF EVIDENCE:II-2.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
James AH,Bushnell CD,Jamison MG,Myers ERdoi
10.1097/01.AOG.0000172428.78411.b0subject
Has Abstractpub_date
2005-09-01 00:00:00pages
509-16issue
3eissn
0029-7844issn
1873-233Xpii
106/3/509journal_volume
106pub_type
杂志文章abstract:OBJECTIVE:Preoperative evaluation for pregnancy at our institution lacked standardization among individual health care providers and surgical services. This pilot project aimed to improve assessment for pregnancy before scheduled outpatient gynecologic surgical procedures. The Pregnancy Reasonably Excluded Guide incorp...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002917
更新日期:2018-11-01 00:00:00
abstract::We report a case in which maternal serum alpha-fetoprotein (MSAFP) screening of a low-risk patient led to the antepartum detection of an asymptomatic and previously undetected stage Ia immature teratoma of the ovary. It is widely accepted that MSAFP screening is valuable in the antepartum diagnosis of neural tube defe...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
abstract::This study was undertaken to compare the outcome of pregnancy in patients treated for some type of infertility problem to that of a control group of patients from the same obstetric unit and also to the reported literature. Reported are the primary outcomes of 122 pregnancies in 104 patients treated for infertility an...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-02-01 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of intrauterine local anesthesia in reducing pain associated with outpatient gynecologic procedures. DATA SOURCES:We searched online databases PubMed or MEDLINE, Embase, Google Scholar, and Clinicaltrials.gov and hand-searched reference lists from reviews evaluating pain-control m...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0b013e3182639ab5
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To compare risk of reintervention, long-term clinical outcomes, and health care utilization among women who have bulk symptoms from leiomyoma and who underwent the following procedures: hysterectomy, myomectomy, uterine artery embolization, and magnetic resonance-guided, focused ultrasound surgery. METHODS:T...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002331
更新日期:2017-11-01 00:00:00
abstract::Cerebral hemodynamics were studied in eight nonpregnant women and 24 women in late pregnancy by internal carotid artery velocimetry with a 3.5-MHz continuous-wave Doppler system. Criteria for supine hypotensive syndrome were a mean blood pressure decrease of 15 mmHg and a 2-minute sustained increase in pulse of 20 bea...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::Endometriosis of the sciatic nerve is rare but must be included in the differential diagnosis of sciatic pain. Patients present with typical signs and symptoms of sciatica, which are cyclic in nature. Electromyography and computed tomographic scanning are useful in diagnosis. At laparoscopy or laparotomy, a characteri...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1988-03-01 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::The effect of reporting therapeutic abortions in Maryland from 1968-1970 to assess the impact of the new abortion law, which was a liberalization of the previous law, is discussed. All hospitals in the state were required to report on all abortions performed. In fiscal year 1969, 2134 abortions were performed, while...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1972-06-01 00:00:00
abstract::Pain management should be provided whenever medically indicated. The American Society of Anesthesiologists (ASA) and the American College of Obstetricians and Gynecologists (ACOG) believe that women requesting epidural analgesia during labor should not be deprived of this service based on their insurance or inadequate...
journal_title:Obstetrics and gynecology
pub_type: 指南,杂志文章,实务指引
doi:
更新日期:2004-07-01 00:00:00
abstract::A new method to replace fetal membranes that have prolapsed through an incompetent cervix, which includes overfilling of the urinary bladder, was successful in four consecutive patients who presented with this clinical entity. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-09-01 00:00:00
abstract:OBJECTIVE:To estimate the rate of early-onset group B streptococcal (GBS) neonatal sepsis with combined maternal and neonatal chemoprophylaxis. METHODS:Since 1995, GBS chemoprophylaxis at our institution has consisted of intrapartum antibiotic prophylaxis to all women with identified risk factors. In addition, a singl...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182592451
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of an outcomes-management program designed to provide high-quality patient care, generate data for outcomes research, and decrease costs in a managed-care environment. METHODS:An outcomes-management program was launched in June 1994, based on the elimination of wasteful or ineff...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/S0029-7844(97)00008-2
更新日期:1997-04-01 00:00:00
abstract::A simple, inexpensive enzyme-linked immunosorbent assay using commercially available supplies is described. An examination of amniotic fluid alpha-fetoprotein (AFP) values for 15 to 20 weeks' gestation is presented. The interassay coefficient of variation was 12% (N = 40) at a level of 4.75 micrograms/mL. Repeat freez...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVE:To evaluate changes over the past decade in the mode of delivery and second-stage duration in nulliparous women. METHODS:We conducted a retrospective cohort study at a single institution of nulliparous women reaching complete cervical dilation with singleton gestations 36 weeks or greater from January 1, 201...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000872
更新日期:2015-07-01 00:00:00
abstract::Short-term oral steroid therapy was used to treat a capillary hemangioma of the vagina and urethra in a young child. After 8 weeks of prednisolone therapy (40 mg every other day decreasing to 2.5 mg every other day), vaginal bleeding has not recurred. At 2 years and 8 months, the patient presented with severe hematuri...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1989-05-01 00:00:00
abstract:OBJECTIVE:To determine if scores from first attempts at the United States Medical Licensure Examination step 1 correlated with obstetrics-gynecology examination scores and identified students at risk of failure. METHODS:All students in obstetrics-gynecology clerkships at the University of Illinois at Chicago from July...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00477-9
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVES:Use of prostaglandins, including sulprostone (an E2 analog), is recommended for second-line uterotonic treatment of atonic postpartum hemorrhage and might be considered as an indicator of quality of care in severe atonic postpartum hemorrhage management. Our objective was to estimate whether sulprostone was ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/AOG.0b013e3182255335
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:To assess health and neurodevelopmental outcome at 3 years of age in neonatal intensive care unit (NICU)-surviving children who were born at 26 or fewer weeks of gestation in a geographically defined region of Belgium from 1999 through 2000. METHODS:The study included a clinical examination and a standardize...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000284447.43442.55
更新日期:2007-10-01 00:00:00
abstract::A single-transducer mechanical sector scanner was used to examine the first-trimester fetus. Fifty-six examinations of 31 patients demonstrated an orderly developmental progression of fetal activity beginning with beating of the fetal heart (7 weeks), progressing to fetal trunk movement (8 weeks), and culminating in i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:To determine the relationship between the change in amniotic fluid index (AFI) and the volume of fluid removed at amnioreduction. METHODS:In a prospective study of 20 twin and 19 singleton pregnancies undergoing amnioreduction for severe polyhydramnios, AFI was measured immediately before and after the proce...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00356-6
更新日期:1997-10-01 00:00:00
abstract::Over a 3-year period at the Long Beach Women's Hospital, where electronic FHR (fetal heart rate) monitoring was routine, there were 8622 live births, including 41 infants born with major congenital malformations. The neonatal death rate in these malformed infants was 44%; 17 were delivered by cesarean section, 11 of w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-06-01 00:00:00
abstract::Unilateral jaw and ovarian Burkitt's lymphoma occuring in an adult American female is reported. The patient was treated with a combination of surgery, radiation, and chemotherapy. The diagnosis, treatment, prognosis, and relapse patterns are briefly reviewed as they relate to the specialty of gynecology. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-07-01 00:00:00
abstract::In the period 1950 through 1966, 357 patients with cancer metastatic to the ovaries were treated at the Mayo Clinic. The majority of primary tumors arose in the gastrointestinal tract. Factors influencing survival included the site of the primary cancer, histologic grade of the neoplasm, menstrual status, and the type...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1975-04-01 00:00:00
abstract::Conjoined twins occur with a frequency of 1/50,000--1/100,000 deliveries. The cephalothoracopagus variety is particularly rare. This paper presents a case report of cephalothoracopagus (Janiceps) twinning, with a detailed pathologic analysis, as well as an historical review and discussion of diagnostic modalities. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract:OBJECTIVE:The purposes of this prospective investigation were to determine the frequency of glove perforation during obstetric and gynecologic procedures and to assess the value of double gloving in preventing damage to the inner glove. METHODS:During a 2-month period, surgeons in the Department of Obstetrics and Gyne...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVE:To identify risk factors for febrile morbidity after hysterectomy for nonmalignant indications. METHODS:We performed a retrospective cohort study of 686 women who had a hysterectomy between January and September 1997 by abdominal (n = 408), laparoscopic-assisted vaginal (n = 90), or vaginal (n = 188) approac...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000109219.24211.30
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:To compare the prevalence of large-for-gestational-age (LGA) newborns across categories of body mass index (BMI) in five racial and ethnic groups. METHODS:This cohort study examined 7,468 women with gestational diabetes mellitus (GDM) who delivered a live newborn between 1995 and 2006 at Kaiser Permanente No...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318291b15c
更新日期:2013-06-01 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:OBJECTIVE:To test the performance characteristics of a new DNA probe designed for the rapid identification of heavy colonization of the genital tract with group B streptococci. METHODS:Vaginal and combined vaginal-perianal samples were collected from 193 pregnant women and cultured on colistin-nalidixic acid agar plat...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0029-7844(95)00199-2
更新日期:1995-10-01 00:00:00