Abstract:
OBJECTIVE:Our purpose was to determine the safety and tolerance of levonorgestrel contraceptive implants (Norplant, Wyeth-Ayerst, Philadelphia) when inserted immediately post partum, to document the effects on weight and blood pressure, and to determine the side effects. STUDY DESIGN:After vaginal delivery, 250 women were randomized to receive Norplant within 48 hours of delivery (study group) or at the 4- to 6-week postpartum visit (control group). Baseline measurements were recorded and compared with those obtained at the 4- to 6-week follow-up visit. A diary was maintained by patients who recorded bleeding and side effects. Statistical analysis was performed with t test and chi 2 analysis. RESULTS:There were no episodes of acute postpartum hemorrhage or clinically significant bleeding. Compared with the control group, the immediate group reported significantly more bleeding days (p < 0.01). There was no significant difference between the two groups in the hemoglobin values obtained at 4 to 6 weeks post partum. The immediate insertion group reported significantly more headaches (p < 0.01) and acne (p = 0.01). CONCLUSION:Norplant is well tolerated and should be available for interested patients immediately post partum. :During June 1992-February 1993, physicians in Charlotte, North Carolina, randomly assigned 250 women who had delivered vaginally at the Carolinas Medical Center to receive the contraceptive implant Norplant either before being discharged from the hospital on postpartum day 1, 2, or 3 or 4-6 weeks later at the scheduled postpartum follow-up visit. They wanted to ascertain whether insertion of Norplant in the immediate postpartum period was safe and well-tolerated. 26 women were lost to follow-up. 11 of these women were in the delayed insertion group, so they did not receive Norplant or an alternative contraceptive method, placing them at risk of pregnancy. Another 34 women in the same group returned for their follow-up visit but did not receive Norplant. The mean interval from delivery to insertion stood at 1.7 days for the immediate insertion group and 34.3 days for the delayed insertion group. No one in either group experienced acute postpartum hemorrhage. The immediate insertion group had much more bleeding and spotting than did the delayed insertion group (17 vs. 13.6 days, p 0.01, and 11.1 vs. 8.8 days, p = 0.03, respectively; 28.2 vs. 22.4 days for both spotting and bleeding, p 0.01). Since hemoglobin values of the two groups did not differ (12.9 vs. 12.7), the increased bleeding was not clinically significant. Women in the immediate insertion group were more likely than those in the delayed insertion group to have headaches on at least seven days between insertion and study follow-up (15.1% vs. 2.8%; p 0.01). They also were more likely to have acne during at least three days (18.9% vs. 6.4%; p 0.01). They were just as likely as the delayed insertion group to report nausea, hair loss, and hirsutism. 40% of the women in both groups had sexual intercourse before their 4-6 week follow-up visit. These findings show that Norplant can be safe and well-tolerated if inserted in the immediate postpartum period.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Phemister DA,Laurent S,Harrison FN Jrdoi
10.1016/0002-9378(95)90109-4subject
Has Abstractpub_date
1995-01-01 00:00:00pages
175-9issue
1 Pt 1eissn
0002-9378issn
1097-6868pii
0002-9378(95)90109-4journal_volume
172pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVE:The objective of the study was to investigate whether knowledge of human papillomavirus (HPV) deoxyribonucleic acid test results increases sensitivity of guided cytology screening for the detection of cervical intraepithelial neoplasia (CIN)-2 or higher-grade cervical lesions. STUDY DESIGN:This was a prospec...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/j.ajog.2011.06.101
更新日期:2011-12-01 00:00:00
abstract::The study of different morphometric parameters in 17 placentas collected between 22 and 40 weeks of gestation has shown that, from mid-gestation to term, two stages are clearly discernible in the development of the human placenta. The first stage of growth, which terminates at approximately 36 weeks of gestation, is c...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(80)90696-1
更新日期:1980-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the effectiveness of a human immunodeficiency virus (HIV) rapid testing (RT) program. STUDY DESIGN:From April 13, 2004, to April 13, 2005, pregnant women at 2 high-risk maternity hospitals with no or incomplete HIV testing results (negative tests at <34 weeks, none t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2007.09.005
更新日期:2008-02-01 00:00:00
abstract::A 35-year-old woman underwent exploratory laparotomy for ovarian enlargement, massive ascites, and intestinal obstruction. Sclerosing peritonitis associated with florid mesothelial hyperplasia, ovarian fibromatosis, and endometriosis were diagnosed postoperatively. We add to the literature this new association of bila...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)70581-7
更新日期:1997-03-01 00:00:00
abstract::In this series of gonadoblastomas it appeared that the germ cells were the motivating force underlying either tumor proliferation or regression. The ultrastructural morphology confirmed the presence of undifferentiated gonadal cells with active steroid synthesis by the interstitial cells. The Call-Exner-like bodies wh...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90359-8
更新日期:1976-06-15 00:00:00
abstract::Report of a study of Rh antibody titers in the amniotic fluids from 42 Rh-negative sensitized pregnancies is presented. Amniocentesis was performed in the pregnant Rh-negative women having serum Rh antibody titers (indirect Coombs) ranging from 1/64 to 1/4,096. Spectrophotometric analysis was done on the antiRh-D ti...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1969-12-15 00:00:00
abstract::We provide a justification for preventive ethics in obstetric practice. Four clinical guides to resolving ethical conflicts between pregnant women and their physicians can be identified: (1) informed consent as an ongoing dialogue between the pregnant woman and her physician, (2) negotiation as a clinical strategy, (3...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90374-g
更新日期:1990-02-01 00:00:00
abstract::Sound pressure in amniotic fluid was created by application of either an electronic artificial larynx or a standard audiometric earphone to the abdominal surface of pregnant ewes. Sound transmission was assessed with a hydrophone placed near the ear of the fetus within the intact amnion. Sound pressures produced by th...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90526-1
更新日期:1988-07-01 00:00:00
abstract::Plasma amino acid analyses on 27 amino acids in serial samples from 15 pregnancies in 14 patients are reported. Variations of amino acid levels with gestational age are reported both for absolute amino acid levels and for levels normalized to total amino acids, with a t test used to determine which amino acids vary si...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90108-4
更新日期:1978-07-01 00:00:00
abstract:OBJECTIVE:We determined developmental and labor-related changes in 11beta-hydroxysteroid (HSD) 1 and 2 expression in baboon placentas during the final third of gestation and labor. We examined whether maternal glucocorticoid administration alters placental 11beta-HSD 2 expression. STUDY DESIGN:Maternal and fetal plasm...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.62
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:This study investigates the association of allelic variation in angiogenic pathway genes and preeclampsia. STUDY DESIGN:Data for cases with preeclampsia and term control subjects were collected prospectively. Maternal DNA was extracted, and 124 tagging single nucleotide polymorphisms in 6 genes (vascular end...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.01.040
更新日期:2010-05-01 00:00:00
abstract::The purpose of this study is to clarify fetal cardiovascular effects of four popular analgesics administered to a maternal animal model. Clinical doses of aspirin (14 mg/kg), acetaminophen (14 mg/kg), ibuprofen (6 mg/kg), or indomethacin (0.7 mg/kg) were administered orally to near-term rats. At 1, 4, 8, or 24 hours l...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90042-6
更新日期:1990-05-01 00:00:00
abstract::A 13-year-old patient with an ovarian abscess caused by Salmonella paratyphi C1-7 had positive stool cultures for the same organism. She recovered after surgical removal of the abscess and intravenous antibiotics. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90118-3
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVE:We sought to determine whether midpregnancy antioxidant levels are associated with preeclampsia, overall and by timing of onset. STUDY DESIGN:We carried out a case-control study, nested within a cohort of 5337 pregnant women in Montreal, Quebec, Canada. Blood samples obtained at 24-26 weeks were assayed for ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2015.07.027
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to find out whether the effects of thermal stress on plasma catecholamines and plasma renin activity are altered by pregnancy. STUDY DESIGN:Nonpregnant (n = 15) and pregnant (13 to 14 weeks, n = 23; 36 to 37 weeks, n = 23) healthy women were examined. Samples were taken before t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91590-7
更新日期:1992-09-01 00:00:00
abstract::This study was designed to re-evaluate neonatal condition at birth following elective cesarean section performed with epidural anesthesia and a modified technique of general anesthesia. Two groups of 20 patients were studied. Twenty received epidural anesthesia with 2 per cent lidocaine-carbon dioxide-epinephrine, and...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90404-6
更新日期:1979-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to describe the outcome of peripartum cardiomyopathy in patients cared for in a community hospital. STUDY DESIGN:The cases of peripartum cardiomyopathy treated at Central Baptist Hospital in Lexington, Kentucky, from January 1, 1992, to December 31, 1998, were reviewed. RESULTS...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.105402
更新日期:2000-05-01 00:00:00
abstract::Estrogen receptors and progesterone receptors were measured in tumors from patients with previously untreated endometrial carcinoma before and after a 5-day course of tamoxifen citrate. On initial biopsy, 13 of 25 tumors (52%) were progesterone receptor-positive, whereas 21 of 25 tumors (84%) were progesterone recepto...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90187-x
更新日期:1984-05-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the antenatal umbilical cord coiling index obtained during the fetal anatomic survey in the second trimester as a predictor of adverse pregnancy outcome. STUDY DESIGN:Four hundred twenty-five consecutive women who had a fetal anatomic survey between 18 to 23 weeks of...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.12.092
更新日期:2005-08-01 00:00:00
abstract::The possibility of controlling fertility by antibodies inactivating key reproductive hormones has been amply demonstrated by active and passive immunization in primates. Four birth control vaccines directed against human chorionic gonadotropin are currently in early clinical trials. The nature of these vaccines and th...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9378(87)80135-7
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVE:Our purpose was to assess the impact of new consensus guidelines issued by the Centers for Disease Control and Prevention, The American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics to prevent perinatal group B streptococcal disease. STUDY DESIGN:We performed a descriptiv...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.110308
更新日期:2001-03-01 00:00:00
abstract::The daily symptom records of 150 untreated women with a convincing history of the premenstrual syndrome were investigated qualitatively and quantitatively by means of time series analysis in the form of Trigg's technique for trends. Symptoms were monitored with use of a modified menstrual distress questionnaire. Analy...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90808-2
更新日期:1986-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine if the ability to increase maximum urethral closure pressure (MUCP) with a pelvic muscle contraction is impaired in women without pubococcygeal muscle (PCM). STUDY DESIGN:This was a cross-sectional study of continent women comparing those with (n=28) and those witho...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.03.082
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to define the rate of neoplasia in prophylactic surgical specimens with the use of a careful surgical and pathologic protocol in a prospective study of high-risk women who were undergoing risk-reducing salpingo-oophorectomy. Outcomes of interest were neoplasia that was identified...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.03.006
更新日期:2006-06-01 00:00:00
abstract::Three hundred forty-three cases of early invasive carcinoma of the uterine cervix were analyzed. Depth of infiltration and lateral extension of the tumors varied between 0.2 and 9.0 mm and 0.4 and 17.2 mm and were found to be of no prognostic importance. A multivariate statistical analysis revealed several risk factor...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)91043-8
更新日期:1983-05-15 00:00:00
abstract:OBJECTIVES:The purpose of this study was to provide a morphometric profile of endometrial granulated lymphocytes and to investigate qualitative and quantitative differences in leukocyte subsets in precisely timed luteal phase endometrial biopsies. STUDY DESIGN:Endometrial biopsies were obtained from 24 normal fertile ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91568-3
更新日期:1992-09-01 00:00:00
abstract::After the adoption of the use of umbilical artery and middle cerebral artery peak systolic velocity in high-risk pregnancies and in pregnancies that are at risk of having an anemic fetus, the main focus of Doppler ultrasonography in obstetrics today is intrauterine growth-restricted fetuses. What is most needed at thi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.10.054
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:The antepartum course and short-term neonatal outcome for patients with premature rupture of membranes between 26 and 33 weeks' gestation with positive cervical cultures for group B streptococcus or Neisseria gonorrhoeae were reviewed. STUDY DESIGN:A retrospective analysis of 182 patients managed expectantly...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91369-l
更新日期:1992-03-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine the efficacy of transvaginal electrical stimulation in treating genuine stress incontinence. STUDY DESIGN:This was a multicenter, prospective, randomized, double-blind, placebo-controlled 15-week trial comparing the use of an active pelvic floor stimulator with a sham device. Thi...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/0002-9378(95)90172-8
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVE:This study is a survey of the determinants of refractoriness to the pressor effects of angiotensin II during normal pregnancy. STUDY DESIGN:In 25 normal pregnant women, the effective angiotensin II pressor dose was determined 88 times from the twenty-fifth to the thirty-second week of gestation. Immediately ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)90617-6
更新日期:1992-04-01 00:00:00