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 labor (n = 200) or our usual care control protocol (n = 205). Patients who were undergoing active management of labor were diagnosed as being in labor on the basis of having painful palpable contractions accompanied by 80% cervical effacement, underwent early amniotomy, and were treated with high-dose oxytocin for failure to progress adequately in labor. RESULTS:The cesarean section rate in the active management of labor group was lower than that of controls but not significantly so (active management, 7.5%; controls, 11.7%; p = 0.36). The length of labor in the active management group was shortened by 1.7 hours (from 11.4 to 9.7 hours, p = 0.001). Fifty-five percent of patients received epidural analgesics; a reduction in length of labor persisted despite the use of epidural analgesics (active management 11.2 hours vs control 13.3 hours, p = 0.001). A significantly greater proportion of active management patients were delivered by 12 hours compared with controls (75% vs 58%, p = 0.01); this difference also persisted despite the use of epidural analgesics (66% vs 51%, p = 0.03). CONCLUSIONS:Patients undergoing active management had shortened labors and were more likely to be delivered within 12 hours, differences that persisted despite the use of epidural analgesics. There was a trend toward a reduced rate of cesarean section.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Rogers R,Gilson GJ,Miller AC,Izquierdo LE,Curet LB,Qualls CRdoi
10.1016/s0002-9378(97)70152-2subject
Has Abstractpub_date
1997-09-01 00:00:00pages
599-605issue
3eissn
0002-9378issn
1097-6868pii
S0002-9378(97)70152-2journal_volume
177pub_type
临床试验,杂志文章,随机对照试验abstract：:Spontaneous preterm birth is a heterogeneous phenotype. A multitude of pathophysiologic pathways culminate in the final common denominator of cervical softening, shortening, and dilation that leads to preterm birth. A precise description of specific microstructural changes to the cervix is imperative if we are to iden...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2012.05.015
更新日期：2012-11-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:In some women placental function may not be adequate to meet fetal growth requirements in late pregnancy or the additional demands during labor, thus predisposing these infants to intrapartum fetal compromise and subsequent serious morbidity and mortality. The objective of this study was to det...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ajog.2020.02.034
更新日期：2020-09-01 00:00:00
abstract：OBJECTIVE:This study reports the gynecologic conditions in postmenopausal women (intact uterus on enrollment) in the National Surgical Adjuvant Breast and Bowel Project (NSABP) study of tamoxifen and raloxifene (STAR)/P-2 trial. STUDY DESIGN:This study, with a median follow-up period of 81 months, evaluated the incide...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2011.06.067
更新日期：2011-12-01 00:00:00
abstract：OBJECTIVE:We wanted to test whether the recently described method of using the transferrin receptor system for fluorescence-activated cell-sorter enrichment of nucleated red blood cells can be used for prenatal diagnosis from maternal blood. STUDY DESIGN:Instead of the laborious, expensive fluorescence-activated cell-...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(92)91603-8
更新日期：1992-05-01 00:00:00
abstract：:Twenty-six pregnant women were given prophylactic heparin treatment because of previous thromboembolic complications. The mean duration of treatment was 25 weeks (range, 6 to 32 weeks). The amount of heparin was adjusted to a plasma concentration of 0.08 to 0.15 IU/ml, measured as anti-factor Xa activity. This effect ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(89)90535-8
更新日期：1989-08-01 00:00:00
abstract：:A case of Gordon's syndrome (short stature, defective dentition, hyperkalemic, hyperchloremic acidosis, and chronic hypertension) complicating pregnancy is presented. Rigid salt restriction with diuretic therapy not only controlled the hypertension but also reversed the metabolic abnormalities. This is the first case ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(87)90120-7
更新日期：1987-05-01 00:00:00
abstract：:A sensitive and specific double antibody radioimmunoassay for gonadotropin-releasing hormone (GnRH) has been developed for measurement in ethanol extracts of human plasma. Iodinated hormone was prepared with the use of the chloramine-T method, and antibodies were developed in rabbits over a six-month period with a GnR...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(76)90090-9
更新日期：1976-02-15 00:00:00
abstract：:Three large randomized controlled trials investigating the efficacy of universal cervical length screening and treatment with vaginal progesterone or cervical cerclage to prevent preterm delivery have been published over the past several years. None of these trials demonstrate proven efficacy for universal cervical le...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2012.04.021
更新日期：2012-08-01 00:00:00
abstract：OBJECTIVE:Our purpose was to determine the relation to infant birth weight of maternal fat and lean tissue during early and late pregnancy. DESIGN:Total and net maternal pregnancy weight, fat, and water were determined from measurements of total body water, body density, and bone mineral mass in 200 women, with the us...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(99)70181-x
更新日期：1999-01-01 00:00:00
abstract：OBJECTIVE:Prostaglandins reduce cervical resistance by reorganizing collagen fibrils. Proteoglycans are involved in collagen fibril organization and structure. We evaluated the changes in proteoglycan composition induced by prostaglandin E(2) (PGE(2)). STUDY DESIGN:Prostaglandins were administered intravaginally to in...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2007.11.024
更新日期：2008-05-01 00:00:00
abstract：:Placental pathology can be useful in a variety of ways including immediate diagnosis of important conditions affecting the mother or infant, identifying conditions that are likely to recur in subsequent pregnancies, separating clinical syndromes into distinct pathological phenotypes for further investigation, and unco...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2015.05.056
更新日期：2015-10-01 00:00:00
abstract：BACKGROUND:Chlamydia trachomatis infection is highly prevalent among young women in the United States. Prevention of long-term sequelae of infection, including tubal factor infertility, is a primary goal of chlamydia screening and treatment activities. However, the population-attributable fraction of tubal factor infer...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2017.05.026
更新日期：2017-09-01 00:00:00
abstract：:Whereas peak bone mass is genetically determined, the skeletal growth, maturation, and maintenance required to reach this peak may be influenced by physical activity, ovarian function, and nutrition. Estrogen deficiency at menopause leads to increased skeletal remodeling and loss of bone mass, which can result in oste...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/0002-9378(92)91400-5
更新日期：1992-06-01 00:00:00
abstract：:Maternal, fetal, and neonatal results and complications were analyzed after 923 genetic amniocenteses. Maternal age of 35 years and beyond was associated with a 2.0% risk of fetal trisomy 21 and a 3.0% risk of all major chromosome abnormalities. Comparable rates for women aged 40 and beyond were 4.8% and 7.2%. Neural ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1983-05-15 00:00:00
abstract：OBJECTIVE:The International Federation of Gynecology and Obstetrics (FIGO) staging for cervical cancer is based on clinical examination. Previous studies have demonstrated significant upstaging with surgical staging. However, no randomized trial has ever shown a survival benefit when radiation combined with chemoradiat...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ajog.2015.05.026
更新日期：2015-10-01 00:00:00
abstract：:The mechanisms responsible for the onset and progression of preterm labor are poorly understood. In the present study a total of 115 amniotic fluid specimens were analyzed for a lipid that has not previously been detected in amniotic fluid. This glycolipid was identified as ceramide lactoside. It was found in two-dime...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(89)90508-5
更新日期：1989-08-01 00:00:00
abstract：:The Long-Acting Reversible Contraception (LARC) Program at the American College of Obstetricians and Gynecologists (ACOG) celebrated its 10th anniversary in 2018. This Viewpoint article reviews opportunities, challenges, and lessons learned by the ACOG LARC Program throughout the last decade. Housed within the largest...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2019.11.1269
更新日期：2020-04-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to evaluate the impact of an interconception antibiotic regimen on endometrial microbial flora and histologic type. STUDY DESIGN:This was a secondary analysis of a double-blind randomized placebo-controlled trial of prophylactic metronidazole plus azithromycin that was given to ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ajog.2007.01.014
更新日期：2007-03-01 00:00:00
abstract：OBJECTIVE:The objective of the study was to evaluate the association of depression, sleep disturbance, and menopausal symptoms with diminished libido. STUDY DESIGN:Data from a 2001-2002 baseline survey of 341 peri- and postmenopausal women, aged 45-55 years, participating in a randomized trial, was analyzed. Eligibili...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2007.03.008
更新日期：2007-06-01 00:00:00
abstract：:This study examines the use of episiotomy and the frequency of perineal lacerations in a primary care maternity center staffed by certified nurse midwives (Booth Maternity Center) and a tertiary care teaching hospital where deliveries were performed by physicians (Thomas Jefferson University Hospital). The study sampl...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(89)90158-0
更新日期：1989-05-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to determine whether fetuses with a congenital heart defect demonstrate changes in cerebrovascular impedance. STUDY DESIGN:Fetal echocardiograms from January 2001 to May 2005 were reviewed. Cases had sonographically diagnosed congenital heart defects; control subjects were gesta...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2006.05.045
更新日期：2006-09-01 00:00:00
abstract：:The source of amniotic fluid prolactin was investigated with the use of amnion, chorion, placenta, and decidual tissue taken from term human pregnancy. Decidua alone of these tissues contained significant quantities of prolactin. The release of decidual prolactin was affected by the presence or absence of oxygen and p...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(16)33248-3
更新日期：1977-01-15 00:00:00
abstract：:Unrecognized assay drift that may occur during low-volume (fewer than 500 specimens per week) maternal serum alpha-fetoprotein testing could result in either underestimation or overestimation of the number of pregnant women who are at increased risk of fetal malformations and genetic anomalies. Quality control softwar...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(91)90502-i
更新日期：1991-03-01 00:00:00
abstract：:Epidural analgesia in labor is generally accepted as safe and effective and therefore has become increasingly popular. However, little is known regarding the effect of epidural analgesia on the incidence of cesarean section for dystocia in nulliparous women. During the first 6 months of 1987 we studied 711 consecutive...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(89)90377-3
更新日期：1989-09-01 00:00:00
abstract：:Clinical research has shown that prostaglandins (PGs) play an important role in every phase of human reproduction. The logical consequence of early basic biological research into PGs is the current interest in clinical evaluation of PGs as agents to induce labor and abortion and to stimulate menstruation. This is a ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(72)90467-x
更新日期：1972-05-01 00:00:00
abstract：BACKGROUND:A rapid increase in restrictive abortion legislation in the United States has sparked renewed interest in self-managed abortion as a response to clinic access barriers. Yet little is known about knowledge of, interest in, and experiences of self-managed medication abortion among patients who obtain abortion ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2020.02.026
更新日期：2020-08-01 00:00:00
abstract：OBJECTIVE:The purpose of our study was to explore the urinary responses of the ovine fetus to indomethacin levels comparable with those used therapeutically in the human fetus. STUDY DESIGN:After a 1-hour control period, chronically catheterized ovine fetuses between 125 and 139 days of gestation were given an intrave...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(92)91767-5
更新日期：1992-12-01 00:00:00
abstract：:This article presents a review of 902 tubal sterilizations performed in an 18 1/2-year period at a predominantly private teaching service. 803 (89%) of the sterilizations were puerperal, generally performed within 48 hours of delivery or with cesarean section. The Pomeroy technique (often modified) was used in 97.2%...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1967-02-15 00:00:00
abstract：:The current resolution of antenatal ultrasonography permits the sonologist to visualize and critically evaluate the cerebellum and cisterna magna. Abnormalities in the size and shape of these structures will assist the sonologist in the detection of the majority of central nervous system malformations. ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(91)90686-l
更新日期：1991-05-01 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
