Abstract:
OBJECTIVE:To determine how pregnant women of varying ages, races, ethnicities, and socioeconomic backgrounds value procedure-related miscarriage and Down-syndrome-affected birth. METHODS:We studied cross-sectionally 534 sociodemographically diverse pregnant women who sought care at obstetric clinics and practices throughout the San Francisco Bay area. Preferences for procedure-related miscarriage and the birth of an infant affected by Down syndrome were assessed using the time trade-off and standard gamble metrics. Because current guidelines assume that procedure-related miscarriage and Down syndrome-affected birth are valued equally, we calculated the difference in preference scores for those two outcomes. We also collected detailed information on demographics, attitudes, and beliefs. RESULTS:On average, procedure-related miscarriage was preferable to Down syndrome-affected birth, as evidenced by positive differences in preference scores for them (time trade-off difference: mean = 0.09, median = 0.06; standard gamble difference: mean = 0.11, median = 0.02; P <.001 for both, one-sample sign test). There was substantial subject-to-subject variation in preferences that correlated strongly with attitudes about miscarriage, Down syndrome, and diagnostic testing. CONCLUSION:Pregnant women tend to find the prospect of a Down syndrome-affected birth more burdensome than a procedure-related miscarriage, calling into question the equal risk threshold for prenatal diagnosis. Individual preferences for those outcomes varied profoundly. Current guidelines do not appropriately consider individual preferences in lower-risk women, and the process for developing prenatal testing guidelines should be reconsidered to better reflect individual values.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Kuppermann M,Nease RF,Learman LA,Gates E,Blumberg B,Washington AEdoi
10.1016/s0029-7844(00)00969-8subject
Has Abstractpub_date
2000-10-01 00:00:00pages
511-6issue
4eissn
0029-7844issn
1873-233Xpii
S0029-7844(00)00969-8journal_volume
96pub_type
杂志文章abstract::A simple, inexpensive enzyme-linked immunosorbent assay using commercially available supplies is described. An examination of amniotic fluid alpha-fetoprotein (AFP) values for 15 to 20 weeks' gestation is presented. The interassay coefficient of variation was 12% (N = 40) at a level of 4.75 micrograms/mL. Repeat freez...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract::Terbutaline was administered to 50 women, all diagnosed as being in labor prior to 36 weeks' gestation. In 47, uterine activity was initially arrested with intravenous therapy. The infusion rate required to arrest uterine activity ranged from 10 to 80 microgram/min and 21 of the 50 patients (42%) required more than on...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-197804000-00001
更新日期:1978-04-01 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::Newborn screening is the largest genetic screening program in the United States, with approximately 4 million infants screened annually. Newborn screening is a mandatory state-based public health program that provides all newborns in the United States with testing and necessary follow-up health care for a variety of m...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000003246
更新日期:2019-05-01 00:00:00
abstract::There is growing recognition of the importance and potential benefit of information technology and electronic medical records in providing quality care for women. Incorporation of obstetrician-gynecologist-specific requirements by electronic medical record vendors is essential to achieve appropriate electronic medical...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181e1328c
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:To examine levels of serum tryptophan and its degradation product kynurenine in uncomplicated pregnancy, according to the week of pregnancy and the concentrations of neopterin. METHODS:Plasma was analyzed from 45 healthy pregnant women (15 in each trimester), 15 healthy puerperas, and 20 nonpregnant controls...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00084-1
更新日期:1996-07-01 00:00:00
abstract::In a randomized four-way crossover study, 32 women with primary dysmenorrhea were treated with transcutaneous electrical nerve stimulation (TENS) for two cycles, placebo (sham) TENS for one cycle, or ibuprofen 400 mg four times a day for one cycle. The TENS setting used was 100 pulses per second with 100-microsecond p...
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:1990-04-01 00:00:00
abstract::Suspected bowel adhesions are generally considered to be a contraindication to laparoscopy. Among 32 patients who were refused laparoscopy for that reason, only 1 patient was found to have adhesions at laparotomy. To attempt preoperative diagnosis of intraabdominal adhesions, needle laparoscopy was performed in 21 pat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:To develop a scoring system to predict the likelihood of vaginal birth in patients undergoing a trial of labor after previous cesarean delivery using factors known at the time of hospital admission. METHODS:Trial of labor was attempted in 5022 patients who were assigned randomly to score derivation and score...
journal_title: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/s0029-7844(97)00531-0
更新日期:1997-12-01 00:00:00
abstract::The use of assisted reproductive technology (ART) for treating the infertile couple is increasing in the United States. The purpose of this paper is to review the short-term outcomes after ART. Pregnancy rates after ART have shown nearly continuous improvement in the years since its inception. A number of factors affe...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000194207.06554.5b
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:To assess outcomes and costs associated with around-the-clock point-of-care intrapartum group B streptococcus (GBS) polymerase chain reaction (PCR) screening. METHODS:Intrapartum PCR screening was implemented in 2010. Intrapartum PCR was compared with antenatal culture screening in an uncontrolled, single in...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1097/AOG.0000000000003057
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to evaluate the value of neural network-directed review of smears determined to contain atypical squamous (glandular) cells of undetermined significance to identify those cases most likely to be associated with cervical intraepithelial neoplasia. METHODS:One hundred sixty smea...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00017-9
更新日期:1998-04-01 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::Inherited thrombophilias are associated with an increased risk of venous thromboembolism and also have been linked to adverse outcomes in pregnancy. However, there is limited evidence to guide screening for and management of these conditions in pregnancy. The purpose of this document is to review common thrombophilias...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181d9d82d
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:To estimate the incidence of gestational diabetes mellitus (GDM) according to The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria and the pregnancy complications in women fulfilling these criteria but who are not considered diabetic according to the Canadian Diabetes Ass...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31826994ec
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of delaying colposcopy in women with negative Papanicolaou smears and positive speculoscopy results. METHODS:This was a prospective study of asymptomatic women ages 13-60 years, regularly scheduled for pelvic examinations. All women had Papanicolaou smears and magnified visual examinat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00515-3
更新日期:2000-03-01 00:00:00
abstract::Cervical pregnancy was diagnosed at 12 weeks' gestation in a young nulliparous woman presenting with vaginal bleeding. Initial treatment with methotrexate was unsuccessful. The patient was ultimately treated by internal iliac artery ligation, hysterotomy, and intracervical balloon tamponade. Nineteen months after surg...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the usefulness of routine screening for other associated autoimmune endocrine disorders in patients with karyotypically normal spontaneous premature ovarian failure. METHODS:One hundred nineteen women with karyotypically normal spontaneous premature ovarian failure (FSH exceeding 40 mIU/mL) who d...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00077-x
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:To evaluate a possible correlation between a new variable-persistent breech presentation-and the success rate of external cephalic version (ECV). METHODS:This was a retrospective study of ECVs performed from January 2008 through January 2019 in an Israeli tertiary care hospital. The study group included all ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004231
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVE:To examine whether there are: 1) regional differences in three perinatal interventions that reflect active treatment among periviable gestations and 2) racial-ethnic differences in the receipt of these perinatal interventions after accounting for hospital region. METHODS:We conducted a retrospective study on...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003747
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To determine the relationships among the pregnancy outcomes of growth-retarded fetuses, Doppler flow velocimetry of the fetomaternal circulation, and pathologic changes in the placenta. METHODS:Forty-seven fetuses confirmed to be growth-retarded by ultrasonographic biometry were monitored during pregnancy in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVE:To determine which of three different approaches increased women's understanding of risk of pregnancy associated with different contraceptive methods. METHODS:We randomly assigned 461 reproductive-age women to one of three tables presenting pregnancy risk (Food and Drug Administration table with numbers, Wor...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0029-7844(03)00662-8
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:To describe the relations between body mass index (BMI; kg/m(2)), weight gain, and incident urinary incontinence in middle-aged women. METHODS:This was a prospective study in the Nurses' Health Study II. Participants reported their weight at age 18 years, and current weight and height in 1989; weight was upd...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000270121.15510.57
更新日期:2007-08-01 00:00:00
abstract::Karyotypes of chorionic villi have been said to be less accurate than karyotypes of amniocytes. Karyotypic differences between placental and fetal tissue and maternal-cell contamination could potentially complicate clinical management. We compared cytogenetic results obtained by chorionic villus sampling and amniotic ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00
abstract::A rare case of a paraganglioma (extraadrenal pheochromocytoma) that complicated both pregnancy and the puerperium is described. The patient presented a confusing clinical picture simulating pregnancy-induced hypertension, which, after delivery, masqueraded as intractable fever of unknown origin. Computed tomography pr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1982-06-01 00:00:00
abstract::Fetal activity acceleration determination (FAD) was performed 462 times on a total of 410 patients for the evaluation of fetal reserve. Simultaneous oxytocin challenge test (OCT) was performed 324 times to evaluate the correlation between the two tests. In 308 instances, FAD was positive and OCT was either negative or...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-07-01 00:00:00
abstract::In 21 pregnant women (seven in the first trimester and 14 in the second trimester), laminaria tents inserted for induction of elective abortion were removed after dilatation had been achieved, but upon the patient's request, the abortion was not carried out. Four patients again changed their minds and had uncomplicate...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract::The group A streptococcus is capable of producing exotoxins that have been linked to a toxic shock-like syndrome. Streptococcal toxic shock is a rapidly progressive disease associated with injury to multiple organ systems and a 30-60% mortality rate. We present a case of a 40-year-old woman who developed group A strep...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-09-01 00:00:00
abstract::Two cases of Listeria monocytogenes chorioamnionitis are presented in which transabdominal amniocentesis was used to confirm the diagnosis and to obtain reliable intrauterine culture material free from lower genital tract contamination. The mechanisms of infection with Listeria monocytogenes in the pregnant patient ar...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198003001-00002
更新日期:1980-03-01 00:00:00
abstract::The effectiveness of the carbon dioxide laser was evaluated in the treatment of penile, anorectal, and urethral condylomata acuminata in 40 men. All but six cases of urethral condylomata were prior conventional treatment failures. Postlaser follow-up ranged between one and two years, with an average of 16 months. No p...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-05-01 00:00:00