Abstract:
OBJECTIVE:Our purpose was to compare operative vaginal and abdominal delivery rates in a large population before and after on-demand labor epidural analgesia became available. STUDY DESIGN:We retrospectively compared patients who gave birth during a 20-month period immediately before the introduction of an on-demand labor epidural analgesia service with those who gave birth during a 20-month period after the epidural usage rate had reached a plateau at approximately 60%. Operative vaginal and cesarean delivery rates were stratified according to parity and history of prior cesarean delivery. RESULTS:A total of 4859 women gave birth during the study period when on-demand epidural analgesia was available, and 4778 women gave birth in the study period before the availability of on-demand epidural analgesia. Comparisons between the women with and those without on-demand availability of epidural analgesia demonstrated no statistically significant differences in the rate of spontaneous vaginal delivery (69.5% vs 68.3%), the overall cesarean delivery rate (19.0% vs 19.4%), the primary cesarean delivery rate (13.2% vs 13.4%), or the operative vaginal delivery rate (11.1% vs 11.9%) between the 2 periods. There were no statistically significant differences in mean gestational age at the time of delivery between the 2 groups, whereas there were statistically significant increases in the proportion of nulliparous women and in mean birth weight during the on-demand epidural period. Analysis after substratification of the study groups according to parity also revealed no statistically significant differences in the primary cesarean delivery rate or the proportion of women undergoing vaginal delivery. The sample size was adequate to exclude a 2% increase in the primary cesarean delivery rate between the 2 periods with 80% power. Subgroup analysis of the population of women who gave birth while epidural analgesia was available on request demonstrated that nulliparous parturient women who requested epidural analgesia were almost twice as likely to require operative vaginal or cesarean delivery as women who did not request epidural analgesia, a finding suggesting that women who request labor epidural analgesia have an inherent propensity toward operative delivery. CONCLUSION:The introduction of an on-demand labor epidural analgesia service does not increase the rate of cesarean delivery or operative vaginal delivery.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Yancey MK,Pierce B,Schweitzer D,Daniels Ddoi
10.1016/s0002-9378(99)70213-9subject
Has Abstractpub_date
1999-02-01 00:00:00pages
353-9issue
2 Pt 1eissn
0002-9378issn
1097-6868pii
S0002-9378(99)70213-9journal_volume
180pub_type
杂志文章abstract::To study possible cellular antigonadotropic effects of danazol, monolayer cultures of anterior pituitary cells from immature female rats were treated with danazol. Measurements of luteinizing hormone release in response to 10(-8) mol/L gonadotropin-releasing hormone challenge and iodine 125-labeled gonadotropin-releas...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90673-3
更新日期:1986-02-01 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::Between October, 1969, and April, 1981, gynecologic oncologists at the University of Alabama Medical Center in Birmingham have performed 119 pelvic exenterations. One hundred fifteen of these patients had a concurrent supravesical urinary diversion. Fifty-six patients (48.7%) had an anterior exenteration and 59 patien...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32536-4
更新日期:1982-04-01 00:00:00
abstract::Matings between mice carrying the heterozygous autosomal gene Steel produce 25% homozygous Sl/Sld mutants having agametic gonads composed of somatic tissue alone. Mutants show a normal 1:1 male:female sex ratio and gonadal sex corresponds to genotypic sex. Gonads from both normal and mutant male and female fetuses wer...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)90319-8
更新日期:1983-02-15 00:00:00
abstract::An analysis of the medical records of 103 women with Crohn's disease points up the following observations. There is a slight increase in spontaneous abortions and a substantial degree of subfertility. The obstetric experience is the same as in the normal obstetric population and the effects of the disease on pregnancy...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90664-6
更新日期:1978-05-15 00:00:00
abstract:OBJECTIVE:The arcus tendineous fasciae pelvis (ATFP) provides support to the anterior vagina. The objective of this study was to determine the impact of menopause on the structural components of the ATFP. STUDY DESIGN:Biopsy specimens of the ATFP were obtained from 10 premenopausal, 5 postmenopausal, and 12 postmenopa...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2003.08.040
更新日期:2004-03-01 00:00:00
abstract::Tissue deficiency of folic acid, as measured by a red cell folate level below 150 ng. per milliliter, was present in 16 per cent of 110 sequential pregnant women at the time of their first prenatal visit to a municipal clinic. A further 14 per cent of subjects had red cell folate levels in the range "suggestive but no...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90523-2
更新日期:1975-09-15 00:00:00
abstract:OBJECTIVE:Photodynamic therapy is a technique in which tissue is irradiated with light after the use of a photosensitizing drug that produces singlet oxygen, which has a cytotoxic effect. The feasibility of using photodynamic therapy with photofrin II for endometrial ablation was studied. STUDY DESIGN:Fifty-eight rabb...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91787-b
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to compare surgical techniques for the primary repair of obstetric anal sphincter lacerations. STUDY DESIGN:Patients with complete third- or fourth-degree lacerations were recruited and randomly assigned to either an end-to-end or overlapping repair. Data collection included demogra...
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/j.ajog.2004.11.045
更新日期:2005-05-01 00:00:00
abstract::With the induction of ovulation, clomiphene citrate and human menopausal gonadotropin have the potential to stimulate the endocervical glands. We have found that the degree of mucus production can occasionally be quite large and hence is detectable by sonographic evaluation as an anechoic cervical mass. The incidence ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80287-9
更新日期:1987-11-01 00:00:00
abstract::A chart for displaying neonatal survival data regarding low birth weight and early gestational age is presented. Survival data at two institutions for infants with low birth weight and early gestational age are compared. This format is useful for student and resident teaching, for counseling parents-to-be about potent...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90026-7
更新日期:1984-07-01 00:00:00
abstract::Fetal activity in multiple pregnancies, as expressed by maternal daily fetal movement recordings, was compared with that in singleton pregnancies. It was found that the mean fetal activity in 33 cases of twins, six cases of triplets, one case of quadruplets, and one case of quintuplets was generally higher than that o...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)91079-7
更新日期:1983-08-01 00:00:00
abstract:OBJECTIVE:We sought to assess the concurrent validity and interrater reliability of the cotton-tipped applicator (CTA) test as a screening tool for diagnosis of cutaneous allodynia in patients with viscerally related chronic pelvic pain (CPP). STUDY DESIGN:We performed a prospective cohort comparative observational st...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.11.005
更新日期:2013-01-01 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::Pelvic blood flow was serially determined in 19 pregnant ewes before and after the induction of one-kidney renal hypertension. The six twin gestations and 13 singleton gestations behaved similarly for all parameters, except renal blood flow. After the renal preparatory surgical procedure, there was a 19% increase in m...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32681-3
更新日期:1981-12-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate which factors affect the occurrence of neonatal ultrasonographic evidence of severe cerebral lesions in the presence of intrauterine infection. STUDY DESIGN:From a cohort of 567 singleton neonates who were born between 24.0 and 31.6 weeks of gestation, we identified ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.06.059
更新日期:2008-10-01 00:00:00
abstract::In many developing countries, services to prevent the mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) operate with limited contact with HIV care and treatment programs, despite significant advances in the accessibility of both services. There is a need to deliver more complex multidrug PMTCT...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2007.03.068
更新日期:2007-09-01 00:00:00
abstract::Knowledge of ureteric anatomy is essential for ureteric injury prevention in laparoscopic gynecologic surgery. Rates of injury increase with limited surgical experience and reduced surgical volume. Currently, there are no low-fidelity or high-fidelity simulation models for teaching and practicing ureteric dissection. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2017.07.004
更新日期:2017-10-01 00:00:00
abstract::The pulsatility index of the fetal umbilical arteries was evaluated in 14 high-risk pregnant patients delivered by cesarean section between 30 and 35 weeks of gestation. Transabdominal cord sampling by ultrasonic guidance was performed on 10 of these patients. Umbilical arterial and venous blood was obtained in all pa...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90418-8
更新日期:1988-11-01 00:00:00
abstract::Although genital condylomata worsen with pregnancy, we are unaware of any reports of fatal maternal laryngeal papillomatosis. A maternal death at 20 weeks' gestation of a patient with chronic laryngeal papillomatosis is described. Pregnant patients with a history of this disorder who have symptoms should be considered...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91662-t
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVE:To summarize the evidence on short-, mid-, and long-term results up to 5 years of uterine artery embolization in comparison to surgery. STUDY DESIGN:We searched the CENTRAL, MEDLINE and EMBASE databases for randomized clinical trials comparing uterine artery embolization with hysterectomy/myomectomy in preme...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ajog.2011.03.016
更新日期:2011-10-01 00:00:00
abstract::Rabbit fetuses were injected intramuscularly with 0.5 mg. of isoxsuprine on the twenty-eighth day of gestation. They were killed in utero four hours after the injection, and fetal pulmonary fluid (FPF) was collected through a tracheal catheter. The quantity of FPF and the lung weight/body weight ratio were both signif...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90744-x
更新日期:1977-09-15 00:00:00
abstract:OBJECTIVE:The objective of the study was to determine whether transversus abdominis plane (TAP) block reduces postoperative pain when compared with trocar site infiltration of bupivacaine in gynecological laparoscopy. STUDY DESIGN:This was a prospective, randomized, double-blinded clinical trial using patients as thei...
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.2014.07.049
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to examine the effect of first-trimester obstetric ultrasound (OBUS) on the measurement of the effect of complications ascribed to postterm pregnancies. STUDY DESIGN:We conducted a retrospective cohort study of all term, singleton pregnancies delivered at our institution who ha...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.03.034
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine the effect of perfusate flow or viscosity on release and action of nitric oxide in the human fetal-placental vasculature in vitro. STUDY DESIGN:Cotyledons from normal term placentas were perfused with Hanks' buffered saline solution gassed with 95% oxygen and 5% carbon dioxide, p...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90327-5
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate temporal correlations between maternal serum placenta growth factor levels and placental perfusion in early human pregnancies. STUDY DESIGN:Systolic umbilical artery Doppler blood flow velocity indices at fetal and placental insertion sites were measured between 7...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.01.012
更新日期:2006-06-01 00:00:00
abstract::This case report describes the antenatal diagnosis of a fetal pulmonary anomaly. Early detection afforded detailed parental counseling and prompt neonatal diagnosis and treatment. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90433-8
更新日期:1985-01-01 00:00:00
abstract::The cancer antigen CA 125 is manifest by serous cystadenocarcinoma of the ovary and to a lesser extent by other gynecologic and nongynecologic tumors. Its presence was screened for in normal human fetal tissues and fluids. Appreciable quantities of CA 125 were discovered in amniotic fluid by both a dot blot assay and ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90076-1
更新日期:1986-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the effect of methadone on fetal neurobehavioral functions and maternal physiologic indicators. STUDY DESIGN:Forty women attending a substance abuse treatment facility with otherwise uncomplicated pregnancies were evaluated at peak and trough methadone levels. Fet...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.02.075
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to determine whether estrogen increases the expression of the inducible nitric oxide synthase gene. STUDY DESIGN:An inducible nitric oxide synthase fusion gene was created with its promoter and the reporter gene, luciferase. COS cells were transfected transiently with the fusion ge...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.350
更新日期:2003-05-01 00:00:00