Abstract:
OBJECTIVE:There has been a gradual shift of the focus of prenatal diagnosis from genetics to ultrasonography. We assessed our primary genetics approach to determine what would be missed without the genetics component. STUDY DESIGN:We evaluated referral indications for patients with normal and abnormal prenatal findings from Jan. 1, 1990, to March 31, 1995, and categorized them according to type of fetal anomalies and genetic abnormalities found. Discordance among initial indication, identified risk factors, and observed abnormalities was assessed. RESULTS:The proportion of patients referred for very-high-risk indications increased over time; 13.5% of all patients (1992 of 14,725) had abnormalities. Abnormal outcomes were categorized as 26% chromosomal, 58% ultrasonographic dysmorphologic features, 11% biochemical or deoxyribonucleic acid disorders, 5% infectious, and 11% other. Of the cases of ultrasonographic dysmorphism (exclusive of the aneuploidies), 3.5% were ultimately determined to be syndromic and 2.5% to be discrepant, that is, having a different abnormality than the referred diagnosis. Including the whole spectrum of disorders seen, half of the abnormalities would not be detectable with even high-quality ultrasonography. CONCLUSION:A large number of abnormal findings were not consistent with initial indication for referral. Correct diagnosis depended on increased acuity provided by genetic pedigree analysis and recognition of syndromes. Diligence in the search for associated anomalies, aneuploidy, pedigree analysis, and syndromic abnormalities remain critical components in the differential diagnosis. The elucidation of unexpected findings suggests the advantages of early counseling and a genetics-based approach combined with tertiary rather than primary ultrasonography with counseling only when anomalies are detected.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Evans MI,Hume RF Jr,Johnson MP,Treadwell MC,Krivchenia EL,Zador IE,Sokol RJdoi
10.1016/s0002-9378(96)70230-2subject
Has Abstractpub_date
1996-06-01 00:00:00pages
1925-31; discussion 1931-3issue
6eissn
0002-9378issn
1097-6868pii
S0002-9378(96)70230-2journal_volume
174pub_type
杂志文章abstract:OBJECTIVES:Our objectives were to document the causes of fluid absorption during continuous flow hysteroscopy and to determine under which operative conditions fluid overload may occur. STUDY DESIGN:Fifteen patients underwent operative hysteroscopy with 2% ethanol solution for uterine distention. Absorption of fluid w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91417-3
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVE:Placenta growth factor is a potent angiogenic factor produced by the human placenta that has been implicated in the pathogenesis of preeclampsia and intrauterine growth restriction. Placenta growth factor belongs to the vascular endothelial growth factor family and is capable of inducing proliferation, migrat...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.107437
更新日期:2000-06-01 00:00:00
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::This study was designed to test the hypothesis that maternal marijuana smoking impairs placental oxygen transfer in late ovine pregnancy by disrupting perfusion balance between the maternal and fetal placental circulations. Placental hemodynamics were assessed in nine chronically prepared ewes 1 hour after exposure to...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90569-8
更新日期:1988-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to test the null hypothesis that the volume of exercise at different times during pregnancy has no effect on fetoplacental growth. STUDY DESIGN:Seventy-five women who exercised regularly were evaluated before pregnancy and randomly assigned at 8 weeks' gestation to one of 3 exer...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mob.2002.119109
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:The aims of this study were to assess the accuracy of uterine contraction palpation, determine whether the accuracy of palpation improves with experience, determine clinical factors that affect the accuracy of palpation, and evaluate the range of intrauterine pressure present when an observer notes the contra...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70397-6
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to test the hypothesis that severe placental insufficiency and a rise in fetal systemic venous pressure are associated with fetal myocardial cell damage, which in turn leads to increased neonatal troponin T levels. STUDY DESIGN:Sixty-six neonates born after uncomplicated pregnancy a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.106753
更新日期:2000-09-01 00:00:00
abstract::To characterize the effects of aminophylline and nifedipine on pregnant human myometrium, in vitro contractility studies were performed on myometrial strips obtained at cesarean section. The strips were stimulated with oxytocin (800 mU/L) to simulate labor and then were exposed to increasing concentrations of aminophy...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80373-3
更新日期:1987-07-01 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:The purpose of this study was to estimate US rates of postpartum intrauterine device (IUD) insertion and postpartum tubal sterilization. STUDY DESIGN:Data from the 2001-2008 Nationwide Inpatient Sample were used to identify delivery hospitalizations with IUD insertion or tubal sterilization procedure codes. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.08.004
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:Our goal was to evaluate whether active management of labor lowers cesarean section rates, shortens the length of labor, and overcomes any negative effects of epidural analgesia on nulliparous labor. STUDY DESIGN:We randomly assigned 405 low-risk term nulliparous patients to either an active management of la...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-9378(97)70152-2
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVES:Extraperitoneal approaches to removal of lymph nodes for staging in cervical cancer patients are numerous, and each has disadvantages. We developed a supraumbilical transverse incision to initiate irradiation within days of cervical cancer staging. STUDY DESIGN:Twenty patients with advanced stage IIB or III...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90080-3
更新日期:1993-08-01 00:00:00
abstract::In a double-blind controlled multicentric study involving 94 patients with an intrauterine fetal death, we investigated the efficacy and tolerance of mifepristone (RU 486), a steroid compound that antagonizes progesterone action at the receptor level. Success of treatment was defined as the occurrence of fetal expulsi...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/0002-9378(90)91193-g
更新日期:1990-08-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to examine routine cervical cancer screening diagnoses and outcomes on an age-specific basis in a US population. STUDY DESIGN:We conducted an observational cohort study using 1997-2002 health plan administrative and laboratory data for women enrolled at Kaiser Permanente Northwest (...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.01.043
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:We sought to use an innovative tool that is based on common biologic pathways to identify specific phenotypes among women with spontaneous preterm birth (SPTB) to enhance investigators' ability to identify and to highlight common mechanisms and underlying genetic factors that are responsible for SPTB. STUDY ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2015.06.011
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:Before parturition are there useful and valid predictors of successful or unsuccessful vaginal birth after previous cesarean birth that could be used to enhance the obstetric care of a patient and her pregnancy? STUDY DESIGN:The clinical course and outcome of all patients who attempted vaginal birth after ce...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91572-r
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND:Transgender, nonbinary, and gender-expansive people who were assigned female or intersex at birth experience pregnancy and have abortions. Scarce data have been published on individual abortion experiences or preferences of this understudied population. OBJECTIVE:This study aimed to fill existing evidence g...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2020.09.035
更新日期:2020-09-25 00:00:00
abstract:OBJECTIVES:Our purpose was to determine whether systemic hypotension induced by rapid withdrawal of fetal blood would induce periventricular leukomalacia in the brain of premature fetal sheep. STUDY DESIGN:At 113 days' gestation, systemic hypotension (mean blood pressure <30 mm Hg) was induced by withdrawing approxima...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70519-3
更新日期:1999-09-01 00:00:00
abstract::This letter was written in response to the article by P.G. Brooks et al ( 113: 104, 1972) in which the use of the peritoneoscope for removal of extruded intrauterine contraceptive devices (IUCD) with fluoroscopy to aid localization was recommended. In recent experiences of the authors of this letter and of R.R. MacD...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(72)90884-8
更新日期:1972-12-15 00:00:00
abstract:BACKGROUND:Routine cesarean delivery has been shown to decrease mother-to-child-transmission of HIV in women with high viral load greater than 1000 copies/mL; however, women presenting late in pregnancy may not have viral load results before delivery. OBJECTIVE:Our study investigated the costs and outcomes of using a ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2019.06.021
更新日期:2019-09-01 00:00:00
abstract::Prostaglandin E2 is a powerful oxytocic agent that reliably initiates labor, even in the presence of an unripe cervix. The low incidence of fetomaternal complication contributes to its universal use. We report a rare case of uterine rupture after intracervical application of prostaglandin E2 gel. Thus far no prostagla...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90094-8
更新日期:1991-08-01 00:00:00
abstract::We investigated the ability of a single, random, urinary pregnanediol-3 alpha-glucuronide level to differentiate early intrauterine from ectopic pregnancy. Thirty-four patients with intrauterine gestations were compared with 60 patients with ectopic pregnancies. Urinary pregnanediol-3 alpha-glucuronide was measured by...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90589-3
更新日期:1988-12-01 00:00:00
abstract:OBJECTIVE:The purpose of our study was to examine the neuronal outcome after a standardized period of umbilical cord occlusion. STUDY DESIGN:The umbilical cord was clamped for 10 minutes in nine experimental and four control chronically instrumented fetal sheep. Three days later the animals were killed for histologic ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91728-1
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:The process of childbirth is one of the most crucial events in the future health and development of the offspring. The vulnerability of parturients and fetuses during the delivery process led to the development of intrapartum monitoring methods and to the emergence of alternative methods of delivery. However...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2020.05.025
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:Our purpose was to compare the accuracy of ultrasonographic and manual cervical examinations for the prediction of preterm delivery. STUDY DESIGN:One hundred two singleton pregnancies at high risk for preterm delivery were followed up prospectively from 14 to 30 weeks with both serial cervical ultrasonograph...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)70259-x
更新日期:1997-10-01 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:OBJECTIVE:Although most methods for selecting the sex of offspring by sorting spermatozoa are ineffective at shifting the ratio of Y- to X-containing cells, some commercial sources continue to offer such services. Our objective was to evaluate commercially "sorted" samples with use of dual-color fluorescence in situ hy...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)70331-4
更新日期:1997-06-01 00:00:00
abstract::Plasma prolactin (hPRL) concentration was measured in four nursing mothers during 24 hour periods. Blood was collected via indwelling catheters and sleep and nursing periods were recorded. Elevated hRPL levels and amenorrhea were seen for as long as 13 months post partum in mothers whose infants nursed frequently. One...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90594-x
更新日期:1978-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this analysis was to study the relationship between an increasing cesarean delivery rate and term neonatal seizures and peripartum deaths. STUDY DESIGN:This was a retrospective analysis of annually collated institutional data on cesarean delivery and perinatal outcome. RESULTS:Of 77,350 women...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.06.102
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:The pathogenesis of the HELLP (hemolysis, enzyme liver, low platelets) syndrome is unknown. Recently soluble endoglin (sEng) was identified as a cause of the appearance of schistocytes and liver pathology in an animal model of preeclampsia (PE). STUDY DESIGN:We explored the value of sEng in 82 women who deli...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.03.006
更新日期:2010-06-01 00:00:00