Abstract:
OBJECTIVE:An infrequent clinical dilemma arises when a patient with uterine prolapse that is best treated vaginally is discovered to have coexisting endometrial cancer. Often the underlying cancer is only discovered intraoperatively or postoperatively. We have reviewed our experience in this situation in an effort to evaluate efficacy of treatment, strategies to avoid late postoperative discovery of cancer, and general guidelines for optimal treatment. STUDY DESIGN:At the Mayo Clinic from 1950 to 1993, 54 patients with coexisting endometrial carcinoma underwent vaginal hysterectomy with repairs for uterine prolapse. RESULTS:We have retrospectively reviewed these cases for relevant data and survival analysis. Complete follow-up is available for 53 patients, and there were four recurrences. In 19 patients bilateral oophorectomy was not performed for multiple reasons, and one of these patients had a recurrence. Twenty-five percent of all patients had disease confined to the endometrium, and 80% overall had low-grade lesions with superficial or no myometrial invasion. Of the four recurrences, three would have been considered low risk of extrauterine spread, and it is doubtful that an abdominal approach would have yielded additional useful information. No patient required reoperation for recurrent pelvic relaxation. CONCLUSION:We believe that for certain selected patients vaginal surgery for uterine prolapse is adequate treatment in the presence of endometrial cancer. We discuss the selection strategies, exclusion criteria, and general guidelines to optimize care for these challenging patients.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Cliby WA,Dodson MK,Podratz KCdoi
10.1016/0002-9378(95)91399-8subject
Has Abstractpub_date
1995-06-01 00:00:00pages
1675-80; discussion 1680-3issue
6eissn
0002-9378issn
1097-6868pii
0002-9378(95)91399-8journal_volume
172pub_type
杂志文章,评审abstract:OBJECTIVE:This retrospective study was conducted to determine whether predischarge survival and morbidity of very-low-birth weight infants varied according to the principal pregnancy complication that led to preterm delivery. STUDY DESIGN:The hospital records of 535 consecutive live-born singleton infants who weighed ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90288-t
更新日期:1993-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the association between preeclampsia and 3 relatively common mutations that are important in the development of vascular disease and thrombosis; these are similar to conditions observed in pregnancies complicated by preeclampsia. STUDY DESIGN:Deoxyribonucleic acid wa...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.110411
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:To analyze the effects of preconception maternal height and weight on the risk of preterm singleton and twin births resulting from in vitro fertilization (IVF). STUDY DESIGN:We performed a retrospective cohort analysis of the incidence of very early preterm birth (VEPTB), early preterm birth (EPTB), and pret...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.05.052
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine whether the combined distribution of a panel of cellular messenger RNA markers can detect preeclampsia long before onset. STUDY DESIGN:We compared blood at 10-14 weeks from 11 women who ultimately experienced preeclampsia with 88 matched control subjects. After mult...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.07.043
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to determine whether the presence of a dilated internal os (funneling or beaking) alters the outcome of patients with a short cervix documented by transvaginal ultrasound in the second trimester. STUDY DESIGN:Between January 1998 and May 2004, all singleton pregnancies with a short ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.01.076
更新日期:2005-04-01 00:00:00
abstract::This study examines some potential factors that are associated with occasional readmission soon after discharge for laparoscopic sterilization--a generally innocuous outpatient procedure. Thirty-six early readmissions among 22,000 cases of laparoscopic sterilization (an incidence rate of 1.6 per 1,000 procedures) in a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(84)80077-0
更新日期:1984-02-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to assess the reliability and validity of an objective structured assessment of technical skills (OSATS) for repair of fourth-degree obstetric lacerations on a surgical model. STUDY DESIGN:Three blinded judges reviewed recordings of 20 junior and 20 senior obstetrics-gynecolog...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.07.054
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine whether a wet mount preparation of endocervical secretions from obstetric patients can accurately rule out the presence of gonococci and Chlamydia trachomatis. STUDY DESIGN:Gravid patients were screened for gonococci and C trachomatis with a deoxyribonucleic acid pr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70549-1
更新日期:1999-08-01 00:00:00
abstract::Percutaneous umbilical blood sampling (cordocentesis) provides direct access to the fetal circulation in the second and third trimesters of pregnancy. Seventeen patients underwent this procedure between December 1985 and December 1986 for evaluation of a variety of clinical situations, including nonlethal fetal abnorm...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90795-8
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine the maternal blood glucose response to food throughout pregnancy. STUDY DESIGN:Forty-five normal, healthy primiparous women with singleton pregnancies were studied longitudinally throughout pregnancy. Blood glucose levels were determined at each stage of pregnancy after a standar...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90460-x
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to provide a viable alternative to routine postpartum hematocrit measurement, by a determination of the clinical risk factors that identify patients with anemia and an examination of the resulting cost savings. STUDY DESIGN:In this retrospective review, cases (postpartum hematoc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.121255
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to compare the birth outcomes of a multifetal pregnancy reduction population with those of other patients delivered at Hutzel Hospital, Detroit, and to determine the fiscal impact of the multifetal pregnancy reduction program. STUDY DESIGN:In a retrospective review patients who were...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.106856
更新日期:2000-06-01 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:OBJECTIVE:Our purpose was to examine the hypothesis that the relaxant response to corticotropin-releasing factor is endothelium dependent and changes during pregnancy. STUDY DESIGN:Relaxant responses to cumulative concentrations of corticotropin-releasing hormone were measured in rings of thoracic aorta, precontracted...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)80042-7
更新日期:1997-01-01 00:00:00
abstract::Despite the widespread use of tetracycline for treatment of dermatologic disorders and sexually transmitted diseases, the pharmacodynamics of oral contraceptive use in the presence of tetracycline has not been studied. Seven normal women ingested an oral contraceptive containing ethinyl estradiol 35 micrograms and nor...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90617-z
更新日期:1991-01-01 00:00:00
abstract::Influenza virus infection complicating pregnancy remains a matter of concern because of the frequency of these infections and possible associated increased maternal and perinatal risks. Influenza A/Bangkok (H3N2) infection occurred in a gravid woman in association with fever, chills, and uterine tenderness and contrac...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90604-5
更新日期:1984-08-15 00:00:00
abstract:OBJECTIVE:Amniotic fluid embolism syndrome is a fatal disease in pregnant women. The exact role of platelets and neutrophils in amniotic fluid embolism syndrome is not clear. We examined whether amniotic fluid could affect platelet-neutrophil aggregation and activation and the possible mechanisms. STUDY DESIGN:Blood s...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.01.012
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Recommendations on preventing primary cesarean delivery removed the previously defined time limits for latent labor (defined as ending at 6 cm) and urged clinicians to avoid cesarean delivery for labor abnormalities in the latent phase. However, relatively little is known about the implications of labor curv...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2019.05.041
更新日期:2019-11-01 00:00:00
abstract::If the parents do not want to take the 50% chance that a male fetus will be involved with an x-linked disease, it is desirable to predict fetal sex early enough to safely terminate pregnancy. Slides obtained from midcervical smears of 20 consecutive patients at different stages of gestation were stained with .5% aque...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(73)90541-3
更新日期:1973-03-15 00:00:00
abstract::Nine cases of fetuses with pleural effusions are presented in which the diagnosis was made by ultrasound before the thirtieth week of gestation. A ratio of lung span to hemithorax diameter was calculated and ranged from 0.44 to 0.77 (mean 0.60). At autopsy, pulmonary hypoplasia was confirmed in all cases by criteria b...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80304-6
更新日期:1987-11-01 00:00:00
abstract::Pelvic floor disorders are common, with 1 in 4 US women reporting moderate to severe symptoms of urinary incontinence, pelvic organ prolapse, or fecal incontinence. Given the high societal burden of these disorders, identifying potentially modifiable risk factors is crucial. Physical activity is one such potentially m...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2015.08.067
更新日期:2016-02-01 00:00:00
abstract::One hundred forty-eight menstrual cycles were studied in 52 women, and in each cycle various parameters were measured to determine an objective means of assessing the syndrome. Daily mood assessment, body weight, plasma 17 beta-estradiol levels, and plasma progesterone levels were measured. The abdominal dimensions we...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(84)80016-2
更新日期:1984-09-15 00:00:00
abstract:OBJECTIVE:The study was undertaken to assess the validity of vaginal fetal fibronectin assay as a screening test for spontaneous preterm delivery in asymptomatic patients who have undergone multifetal pregnancy reduction (MFPR). STUDY DESIGN:A historic cohort of 63 patients who underwent MFPR between 10 and 14 weeks o...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2003.07.027
更新日期:2004-01-01 00:00:00
abstract::A 31-year-old nulligravid patient presented with irregular menses, severe hirsutism, and infertility. Evaluation revealed marked increases of serum androstenedione and testosterone levels and a possible ovarian mass. At operation a cystic teratoma was removed from the left ovary and bilateral wedge resection revealed ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90706-4
更新日期:1986-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine whether hysteroscopy improves the detection and extraction of endometrial polyps in postmenopausal women. This method was compared with curettage complemented by Randall polyp forceps. STUDY DESIGN:In a prospective study hysteroscopy was performed before and after curet...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.108332
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the presence and frequency of antegrade late diastolic arterial blood flow (ALDAF) in the fetus and to determine its contribution to cardiac output. STUDY DESIGN:We evaluated the presence of ALDAF in 457 fetal and 21 postnatal echocardiograms. The timing of ALDAF to t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.02.053
更新日期:2013-06-01 00:00:00
abstract::The placentas of five mothers with severe preeclampsia who gave birth to moderately growth-retarded term infants were compared to a group of placentas collected from mothers who had uncomplicated pregnancies and normal term infants who were appropriate for gestational age. This study demonstrated that, on a quantitati...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(85)80170-8
更新日期:1985-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess the validity of vaginal fetal fibronectin as a screening test for spontaneous preterm birth in patients with cervical cerclage. STUDY DESIGN:A historic cohort of 117 patients who underwent cervical cerclage placement between 1996 and 2002 were identified. All patients ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/s0002-9378(03)00656-2
更新日期:2003-11-01 00:00:00
abstract::Despite current recommendations against its use, activity restriction remains a common intervention used to prevent preterm birth in multiple clinical settings. Hypertensive disorders of pregnancy, preterm premature rupture of membranes, multiple gestations, vaginal bleeding, short cervical length, placenta previa, an...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1016/j.ajog.2020.04.031
更新日期:2020-08-01 00:00:00
abstract::The relationship between intermittent partial occlusion of the umbilical circulation and fetal acid base status, brain function, and neuropathologic outcome was assessed in nine control and nine experimental singleton fetal lambs to determine if transient episodes of partial cord occlusion play a role in antenatal bra...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(88)80118-2
更新日期:1988-08-01 00:00:00