Abstract:
OBJECTIVE:Maternal anal sphincter tears after vaginal delivery are frequently not diagnosed clinically and are associated with subsequent fecal incontinence. This study examined whether diagnosis of these tears by ultrasonography, followed by immediate surgical repair, reduces the occurrence of incontinence. METHODS:We conducted a randomized trial involving 752 primiparous women without a clinically evident anal sphincter tear to evaluate the benefit of adding endoanal ultrasonography immediately after vaginal delivery to the standard clinical examination of the perineum. When a sphincter tear was diagnosed, the perineum was surgically explored and the sphincter sutured. The main outcome evaluated was fecal incontinence 3 months postpartum graded by the Wexner incontinence scale, which measures incontinence to flatus and liquid or solid stools, need to wear a pad, and lifestyle alterations. RESULTS:Among women assessed by ultrasonography, 5.6% had a sphincter tear. Severe incontinence was reported 3 months after childbirth by 3.3% of women in the intervention group compared with 8.7% in the control group (risk difference -5.4%; 95% confidence interval -8.9 to -2.0; P = .002). The benefit of the intervention persisted 1 year after delivery, with 3.2% severe incontinence in the intervention group compared with 6.7% in the control group (risk difference -3.5%; 95% confidence interval -6.8% to -0.3%; P = .03). Ultrasonography needs to be performed in 29 women to prevent 1 case of severe fecal incontinence. CONCLUSION:Ultrasound examination of the perineum after childbirth improves the diagnosis of anal sphincter tears, and their immediate repair decreases the risk of severe fecal incontinence. LEVEL OF EVIDENCE:I.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Faltin DL,Boulvain M,Floris LA,Irion Odoi
10.1097/01.AOG.0000165273.68486.95subject
Has Abstractpub_date
2005-07-01 00:00:00pages
6-13issue
1eissn
0029-7844issn
1873-233Xpii
106/1/6journal_volume
106pub_type
临床试验,杂志文章,随机对照试验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:OBJECTIVE:To review cases of anti-c isoimmunization and determine the most appropriate management strategies. METHODS:We performed a review of 102 pregnancies managed at The Ohio State University from 1967 to 2001 for anti-c isoimmunization. Of these, 55 had complete data and are included in this report. Information c...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000109206.22354.2C
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:To compare blood loss, operative time, postoperative pain medication requirements, and complication rates in patients undergoing vaginal hysterectomy who were randomly assigned to receive preoperative intracervical vasopressin or no intracervical injection. METHODS:Fifty-eight women undergoing vaginal hyster...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/AOG.0b013e3181954c44
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To evaluate whether cesarean delivery is a risk factor for emergent postpartum hysterectomy. METHODS:We performed a case-control study of patients who delivered at Women & Infants Hospital between January 1989 and February 2000. Fifty cases of emergent postpartum hysterectomy performed within 14 days of deli...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(03)00404-6
更新日期:2003-07-01 00:00:00
abstract::Marketing of genetic testing, although similar to direct-to-consumer advertising of prescription drugs, raises additional concerns and considerations. These include issues of limited knowledge among patients and health care providers of available genetic tests, difficulty in interpretation of genetic testing results, ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0b013e31817d250e
更新日期:2008-06-01 00:00:00
abstract::Methods to prevent perineal trauma during childbirth include avoiding episiotomy and forceps delivery and slowing delivery of the head to allow the perineum time to stretch. Each intervention can lengthen the second stage of labor and change the biophysical stresses on infants and the pelvic floor. Available evidence ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00609-2
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:In patients with a prior uterine septum resection, uterine rupture during pregnancy has been reported with the use of energy sources or when complicated by perforation. CASE:A woman was found to have a uterine abnormality during her first pregnancy. After delivery, a septum was diagnosed and hysteroscopical...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)02099-9
更新日期:2002-11-01 00:00:00
abstract::Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension; severe diastolic hypertension; or both require urgent antihypertensive th...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000002019
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:To explore the shared experiences of miscarriage using a qualitative analysis of social media posts on Instagram. METHODS:We performed this qualitative study by collecting text, photos, hashtags, and emoji from 200 Instagram posts on five arbitrarily selected days in 2019. Key eligibility criteria included p...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003621
更新日期:2020-01-01 00:00:00
abstract::Thirty-eight cases of nonimmune hydrops fetalis were evaluated by detailed real-time ultrasonography and two-dimensional echocardiography. Before ultrasound evaluation, all mothers had a complete blood count, titers for toxoplasmosis, rubella, cytomegalovirus, and herpes (TORCH screen), serum albumin, and a Kleihauer-...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:Resistance to thyroid hormone manifests as high serum levels of free thyroxine and free triiodothyronine, with nonsuppressed thyroid stimulating hormone (TSH) levels. We report a case series of three patients with this condition, the changes in thyroid function tests during their pregnancies, and their obste...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181809e3a
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:To assess the potential role of childhood and adulthood physical and sexual abuse and complaints of chronic pain in accounting for psychiatric symptomatology in adult women. METHODS:We assessed sexual abuse, physical abuse, depression, anxiety, and somatization in 64 women with chronic pelvic pain, 42 women ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVE:To estimate the effect of prolonged vaginal distention and anal sphincter transection on contractile properties of the external anal sphincter. METHODS:Young female virgin rats were randomly assigned to four treatment groups (sham, vaginal distention, transection of anal sphincter plus repair, or combined di...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318162f6a7
更新日期:2008-02-01 00:00:00
abstract::Human trafficking is a widespread problem with estimates ranging from 14,000 to 50,000 individuals trafficked into the United States annually. This hidden population involves the commercial sex industry, agriculture, factories, hotel and restaurant businesses, domestic workers, marriage brokers, and some adoption firm...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182310d06
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:To study the state of erythrocyte adhesiveness/aggregation in the peripheral blood of women with pregnancy-induced hypertension as well as in matched controls using a simple slide test and image analysis. METHODS:We recruited 25 women with pregnancy-induced hypertension. Twenty-five age- and gestational age-...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01458-2
更新日期:2001-08-01 00:00:00
abstract::We sought to assess the signal consistency and accuracy of a long-duration fetal heart rate (FHR) recorder (a 1-MHz ultrasonic Doppler transducer composed of six miniprobes and an autocorrelation technique) in active, full-term pregnant women. The FHR data of 15 normal full-term fetuses were obtained every 250 millise...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-02-01 00:00:00
abstract::Major advances have been made in understanding the epidemiology and biology of the hepatitis B virus. Two particular developments--hepatitis B immune globulin and a new hepatitis B virus vaccine--are of special interest to obstetricians, gynecologists, and others who provide health care to women. The appropriate use o...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of transcervical Foley catheter alone (Foley) to transcervical Foley catheter with extraamniotic saline infusion for labor induction and cervical ripening in women with an unfavorable cervix. METHODS:This was a multicenter, randomized, controlled trial of women presenting for labor in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/01.AOG.0000278077.30890.87
更新日期:2007-09-01 00:00:00
abstract::The preoperative clinical and radiologic findings and staging were compared with the operative and pathological findings and surgical staging in 62 consecutive patients with endometrial carcinoma. Overall, the tumor grade was changed in 33.8% of the patients, and the histologic type of tumor was changed in 27.4% of th...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract::This study covers 20 years' experience in the treatment of carcinoma of the cervix. Improved results and a decreased rate of major complications are seen as a result of a cooperative approach in treatment planning and careful dosimetry. Comparisons are made with large treatment centers as well as with national surviva...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-10-01 00:00:00
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
doi:
更新日期:1975-03-01 00:00:00
abstract:OBJECTIVE:To assess the risk of Bartholin gland carcinoma in postmenopausal women. METHODS:A referral patient population from a tertiary care cancer center and a hospital-based regional tumor registry was used in a case-control and retrospective cohort study. We searched for data on any discharge diagnosis or procedur...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00404-1
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the degree to which prenatal knowledge of fetal anomalies and sociodemographic characteristics determined outcome of 53,000 pregnancies. METHODS:Pregnancies were consecutively evaluated at a university hospital between 1984 and 1997. The severity of anomalies was graded by using an ordinal scale,...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01673-8
更新日期:2002-02-01 00:00:00
abstract::Women who develop preeclampsia during pregnancy excrete less calcium than healthy pregnant women. Whether this reduction in calcium excretion precedes or follows hypertension is unknown. We prospectively measured urinary calcium excretion in 103 consecutive nulliparous women at risk for preeclampsia and presenting for...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVE:To determine whether glucagon has relaxant effects on the spontaneous contractions of term pregnant human uterine smooth muscle in an isolated preparation. METHODS:Myometrial specimens were excised from the upper incisional surface of the lower uterine segment in seven women during elective cesarean delivery...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00283-9
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the ultrasonographic findings of ovarian ectopic pregnancies. METHODS:The ultrasonographic reports, videotapes, medical records, and operative summaries were reviewed for all women with a confirmed diagnosis of an ovarian ectopic pregnancy. Examinations were personally conducted by a physician wh...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000148271.27446.30
更新日期:2005-01-01 00:00:00
abstract::In order to ascertain the usefulness of urinary 17-ketosteroids (17-KS) in the evaluation of hirsutism, 28 paired determinations of 17-KS and serum androgens were performed in 26 hirsute women before (control) and after (post Dex) 7 days of dexamethasone (Dex) administration. Upper normal control and post Dex urinary ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-04-01 00:00:00
abstract::Despite earlier studies, there remain unanswered questions regarding urinary calculi in pregnancy. The authors studied 11 cases in 11,292 deliveries over 5 years. Eight previous studies were also studied and data were compiled from 96 cases in 138,296 patients. The incidence of urinary calculi in pregnancy is approxim...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-10-01 00:00:00
abstract::Thirty-eight women with stage I epidermoid carcinoma of the vulva were studied retrospectively in an attempt to define the criteria for conservative therapy in early invasive vulvar cancer. Among the 38 women, 23 met the 6 criteria established for early invasive carcinoma of the vulva. In those 23 women, there were no...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1982-06-01 00:00:00
abstract:OBJECTIVE:To estimate the effectiveness against early-onset group B streptococcal (GBS) disease of intrapartum antibiotic prophylaxis among term and preterm deliveries, deliveries with fewer than 4 hours of antibiotics, and deliveries receiving clindamycin regimens. METHODS:We performed a secondary analysis of the Bir...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318280d4f6
更新日期:2013-03-01 00:00:00