Abstract:
OBJECTIVE:Posttraumatic stress disorder (PTSD) is a serious anxiety disorder triggered by the experience of trauma. One in 4 individuals exposed to trauma will develop PTSD. Victims of trauma are frequent users of health care, but screening is rarely done and most sequelae remain undetected. Our objectives were 1) to document the prevalence of a trauma history among women seeking routine gynecologic care and 2) to evaluate a 4-item screening instrument for PTSD for triaging women with a trauma history for further evaluation. METHODS:We conducted a cross-sectional survey of women presenting to the University of North Carolina outpatient gynecology clinic for an annual examination. Written surveys included medical history and health status, trauma history (including type), and PTSD symptoms using the screening instrument. Patients with trauma who agreed to further participation received a structured clinical interview to diagnose PTSD. RESULTS:Seventy-six percent of patients (N = 292) completed the survey, and 88 (30%) reported a history of 1 or more traumatic event or events. Thirty-two of the 88 completed the psychiatric assessment, and 25 of 32 (78%) met Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for PTSD. Mean age was 34 years, 49% were African American, and 46% were unmarried. Compared with the structured clinical interview, the screening instrument performed with a sensitivity of 72% (95% confidence interval [CI] 0.51-0.88) and a specificity of 71% (95% CI 0.29-0.96), corresponding to a positive likelihood ratio of 2.52 (95% CI 0.76-8.34) and a negative likelihood ratio of 0.39 (95% CI 0.18-0.86). CONCLUSION:Trauma was common in this population. Including a screening instrument for trauma and PTSD on clinic intake surveys has promise for use as a triage tool. Use of such an instrument could meaningfully increase detection of PTSD among women receiving routine preventive care. LEVEL OF EVIDENCE:III
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Meltzer-Brody S,Hartmann K,Miller WC,Scott J,Garrett J,Davidson Jdoi
10.1097/01.AOG.0000140683.43272.85subject
Has Abstractpub_date
2004-10-01 00:00:00pages
770-6issue
4eissn
0029-7844issn
1873-233Xpii
104/4/770journal_volume
104pub_type
杂志文章abstract::A negative oxytocin challenge test has been considered a very reassuring finding in managing pregnancies in which the fetus is at risk from uteroplacental insufficency. In the case described here a fetal death in utero occurred 4 days after a negative oxytocin challenge test in a Class D diabetic patient, but in that ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-02-01 00:00:00
abstract::The management of a patient with an ovarian cyst weighing 71.1 kg is described. Preoperative paracentesis did not improve the condition of the patient and should be avoided. Supine hypotension from vena caval occlusion, technically difficult surgery, massive blood replacement, prolonged postoperative ventilatory failu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-08-01 00:00:00
abstract::The maternal serum alpha-fetoprotein (AFP) in 6161 women in routine pregnancy [2771 in a hospital obstetric clinic (group 1) and 3390 in private practices (group 2)] was studied. Group 1 studies enabled the delineation of the normal range of serum AFP, whereas group 2 represented a true screening experience. In group ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract:OBJECTIVE:To estimate detection rates for aneuploidy by first-trimester and sequential screening. METHODS:The study included women with singleton pregnancies who participated in the California Prenatal Screening Program with estimated delivery dates from August 2009 to December 2012 who had first- or first- and second...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001040
更新日期:2015-10-01 00:00:00
abstract::A case of twin pregnancy with a fetus in each horn of a uterus didelphys is reported. During labor that resulted in the term birth of 1 fetus, contractions occurred temporarily in the other horn and subsided 2 hours after delivery. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::Maternal and infant health is critical to our nation's health. Disparities remain unacceptably high, particularly in the areas of prematurity and infant mortality. In 2012, traditionally distant partners such as federal and state governments, Medicaid and commercial payers, patients, public health and private clinicia...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000320
更新日期:2014-07-01 00:00:00
abstract::Twelve women with tubal pregnancies were treated with intratubal transvaginal methotrexate injection (1 mg/kg body weight). Serum beta-hCG levels decreased in all patients, and the resolution time from injection to undetectable beta-hCG levels was 14-120 days. In spite of declining serum beta-hCG and unruptured tubal ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND:The management of an abnormally invaded placenta presents a challenging obstetric problem. Recent reports have suggested that a conservative approach to the treatment of this condition is appropriate in selected cases. We present the courses of two women with suspected placenta percreta who were managed cons...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181794727
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:Pregnancy-induced hemolytic anemia is a rare maternal complication that occurs during pregnancy and resolves soon after delivery. The mechanism is unclear, and the disease is often referred to as unexplained hemolytic anemia associated with pregnancy. CASE:We report a case of life-threatening hemolytic anem...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000287292.74846.f2
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:To determine whether planned vaginal or elective cesarean delivery is better for singleton term breech infants. DATA SOURCES:Articles that included singleton term pregnancies with breech presentation published in English between 1966 and September 1992 were searched through the Index Medicus, Oxford Database...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1993-10-01 00:00:00
abstract::Laparoscopic radiofrequency ablation of uterine leiomyomas with a new Federal Drug Administration (FDA)-approved device, a device that delivers radiofrequency energy, is a novel procedure that aims to meet patient and physician demand for effective, minimally invasive leiomyoma treatment. However, as a new procedure, ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000914
更新日期:2015-08-01 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:BACKGROUND:Cyclic vomiting syndrome is a condition that consists of recurrent episodes of vomiting occurring between periods of normal health, with no apparent organic cause of vomiting. We report the sentinel case of pregnancy complicated by preexisting cyclic vomiting syndrome. CASE:A primigravida presented at 8 wee...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181a458e0
更新日期:2009-08-01 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 determine whether serum vascular endothelial growth factor is an independent prognostic factor in ovarian cancer patients. METHODS:We measured vascular endothelial growth factor in pretreatment serum samples of 60 women with International Federation of Gynecology and Obstetrics stages I to IV epithelial o...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00190-2
更新日期:1998-09-01 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 compare stage distribution, tumor characteristics, and survival outcome in pregnancy-associated and non-pregnancy-associated breast cancer, and to evaluate pregnancy as a risk factor for mortality in breast cancer. METHODS:The California Cancer Registry (1991-1999) was linked with the California Patient D...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31817c4ebc
更新日期:2008-07-01 00:00:00
abstract::A double-blind prospective study of 99 patients undergoing vaginal and abdominal hysterectomy was performed at North Carolina Baptist Hospital of the Bowman Gray School of Medicine at Wake Forest University. The study indicated that low-dose intravenous carbenicillin begun preoperatively and continued for 24 hours res...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1978-07-01 00:00:00
abstract::Twenty-three patients with premature uterine contractions occurring between the 27th and 35th weeks of pregnancy were treated in a prospective and randomized study with intravenous ritodrine in a 0.1 wt/vol% solution of isotonic saline (N = 12) or isotonic glucose (N = 11). The aim of the study was to record the effec...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1981-09-01 00:00:00
abstract::Rates of perforation for different types of IUDs vary from 1 per 150 insertions with the bow to 1 per 2500 with the loop. Incidence of perforation varies with insertion technic. Not all perforations occur at the time of insertion but most do. These perforations may be partial or complete, with or without symptoms, ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1972-08-01 00:00:00
abstract:OBJECTIVE:To determine the correlation between the maximal urethral closure pressure and the stress leak-point pressure in patients with genuine stress incontinence, and to define a critical stress leak-point pressure value to detect patients with a low-pressure urethra, as defined by a maximal urethral closure pressur...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00014-i
更新日期:1995-05-01 00:00:00
abstract::A nearly unique case is presented of pleural and peritoneal endometriosis with bloody pleural effusion and 4700 cc of bloody ascites. Theories of pathogenesis, differential diagnosis, and treatment are discussed. This represents another of the protean manifestations of endometriosis to complement the many others descr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVE:To quantify physician prescribing patterns and patient opioid use in the 2 weeks after hysterectomy at an academic institution and to determine whether patient factors predict postsurgical opioid use and pain recovery. METHODS:We conducted a prospective quality initiative study by recruiting all English-spea...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002344
更新日期:2017-12-01 00:00:00
abstract::The obstetric hospitalist and the obstetric and gynecologic hospitalist evolved in response to diverse forces in medicine, including the need for leadership on labor and delivery units, an increasing emphasis on quality and safety in obstetrics and gynecology, the changing demographics of the obstetric and gynecologic...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0000000000001235
更新日期:2016-02-01 00:00:00
abstract::The effect of norethisterone on bone mineral metabolism was examined in 43 postmenopausal women. A significant decline in serum calcium, phosphate, and alkaline phosphatase in urinary calcium/creatinine ratio and in tubular maximum reabsorption of phosphate was demonstrated. There was no alteration in urinary hydroxyp...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1985-12-01 00:00:00
abstract::A case of fetal bradycardia associated with severe maternal hypothermia (92.9F) is reported. Until maternal temperature was corrected, the baseline fetal heart rate (FHR) remained between 90-110 beats per minute without other evidence of fetal distress and despite normal maternal blood pressure and pulse. With rewarmi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::The overwhelming majority of morbidity and mortality attributable to pertussis infection occurs in infants who are 3 months and younger. Infants do not begin their own vaccine series against pertussis until approximately 2 months of age. This leaves a window of significant vulnerability for newborns, many of whom cont...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000002293
更新日期:2017-09-01 00:00:00
abstract::Human placental cord blood contains a large number of hematopoietic progenitor cells, which could be used as a source of stem cells for the treatment of hematologic disorders and malignancies. Advantages of cord blood use include noninvasive collection, low risk for viral infection, and immunologic naivete. Cord blood...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/S0029-7844(96)00436-X
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVE:Previous studies that compared outcomes of infants born outside tertiary care centers (outborn) with those born in tertiary care centers (inborn) did not account for admission illness severity and perinatal risks. The objective of this study was to examine whether outborn status is associated with higher mort...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01438-7
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Monoamniotic twins with ultrasonographic evidence of umbilical cord entanglement present a management challenge in the antepartum period. CASES:We report two pregnancies with monoamniotic twins and ultrasonographic evidence of cord entanglement in which longitudinal Doppler flow velocity waveforms of the um...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00210-i
更新日期:1995-10-01 00:00:00