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21. |
HydramniosAnomaly Prevalence and Sonographic Detection |
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Obstetrics & Gynecology,
Volume 100,
Issue 1,
2002,
Page 134-139
Jodi Dashe,
Donald McIntire,
Ronald Ramus,
Rigoberto Santos-Ramos,
Diane Twickler,
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摘要:
OBJECTIVETo characterize the prevalence and ultrasound detection of fetal anomalies in pregnancies with hydramnios, and to estimate anomaly and aneuploidy risks when no sonographic abnormality is noted.METHODSThis was a retrospective cohort study of singleton pregnancies with hydramnios. Hydramnios was categorized as mild, moderate, or severe based on greatest amniotic fluid index of 25.0–29.9 cm, 30.0–34.9 cm, or 35.0 cm or more, respectively. Antenatal anomaly detection was compared with assessment in the immediate neonatal period. Aneuploidy and fetal deaths were analyzed separately.RESULTSHydramnios was diagnosed in 672 pregnancies, and 77 (11%) of neonates had one or more anomalies. Though more severe hydramnios was associated with higher likelihood of anomaly (P< .001), sonographic anomaly detection (79%) did not differ according to degree of hydramnios (P= .4). Of anomalies which eluded sonographic diagnosis, cardiac septal defects, cleft palate, imperforate anus, and tracheoesophageal fistula were the most frequent. If sonographic evaluation was normal, the risk of a major anomaly was 1% with mild hydramnios, 2% with moderate hydramnios, and 11% with severe hydramnios (P< .001). Aneuploidy was present in 10% of fetuses with sonographic anomalies and 1% without apparent sonographic anomalies. The fetal death rate was 4% in the setting of hydramnios; 60% of these cases had anomalies.CONCLUSIONThe anomaly detection rate in pregnancies with hydramnios was nearly 80%, irrespective of the degree of amniotic fluid increase. Residual anomaly risk after normal sonographic evaluation was 2% or less if hydramnios was mild or moderate and 11% if severe.
ISSN:0029-7844
出版商:OVID
年代:2002
数据来源: OVID
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22. |
Inhibin‐A Levels and Severity of Hypertensive Disorders Due to Pregnancy |
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Obstetrics & Gynecology,
Volume 100,
Issue 1,
2002,
Page 140-144
Gerda Zeeman,
James Alexander,
Donald McIntire,
William Byrd,
Kenneth Leveno,
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摘要:
OBJECTIVETo evaluate the use of 3rd trimester inhibin-A levels as an adjunct to assess severity of hypertensive disorders due to pregnancy in women evaluated for preeclampsia.METHODSSerum inhibin-A concentration was measured in a consecutive series of women evaluated for preeclampsia in the third trimester of pregnancy.RESULTSInhibin-A levels were significantly associated with the severity of proteinuric hypertensive disease due to pregnancy. Women with gestational hypertension or those with chronic hypertension without superimposed preeclampsia had levels comparable with normotensive women. The sensitivity to detect proteinuric hypertension was 16%.CONCLUSIONAlthough inhibin-A levels rise with increasing severity of disease, due to considerable overlap of normal and abnormal serum levels in women with and without preeclampsia, inhibin-A is not a useful adjunct for the classification of hypertensive disorders due to pregnancy.
ISSN:0029-7844
出版商:OVID
年代:2002
数据来源: OVID
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23. |
Vulvar Disease |
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Obstetrics & Gynecology,
Volume 100,
Issue 1,
2002,
Page 145-163
David Foster,
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摘要:
Unique embryologic and immunologic aspects of the vulva contribute to the diagnostic and therapeutic challenges of managing vulvar problems. Individual variations in care of the genital region, defined by personal and societal “norms,” may at times exacerbate vulvar problems. Three dimensions are considered in the evaluation of a vulvar problem: 1) lesion type, 2) lesion location, and 3) associated systemic and laboratory findings. This review of vulvar disease highlights a number of common and problematic vulvar conditions. Treatment options for vulvar conditions are covered with an expanded discussion of newer immune response modifiers.
ISSN:0029-7844
出版商:OVID
年代:2002
数据来源: OVID
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24. |
Rising Rates of Labor InductionPresent Concerns and Future Strategies |
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Obstetrics & Gynecology,
Volume 100,
Issue 1,
2002,
Page 164-167
William Rayburn,
Jun Zhang,
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摘要:
The rate of labor induction nationwide increased gradually from 9.5% to 19.4% between 1990 and 1998. Reasons for this doubling of inductions relate to widespread availability of cervical ripening agents, pressure from patients, conveniences to physicians, and litigious constraints. The increase in medically indicated inductions was slower than the overall increase, suggesting that induction for marginal or elective reasons has risen more rapidly. Data to support or refute the benefits of marginal or elective inductions are limited. Many trials of inductions for marginal indications are either nonexistent or retrospective with small sample sizes, thereby limiting definitive conclusions. Until prospective clinical trials can better validate reasons for the liberal use of labor induction, it would seem prudent to maintain a cautious approach, especially among nulliparous women. Strategies are proposed for developing evidence-based guidelines to reduce the presumed increase in health care costs, risk of cesarean delivery for nulliparas, and overscheduling in labor and delivery.
ISSN:0029-7844
出版商:OVID
年代:2002
数据来源: OVID
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25. |
“Not Just Another Business”Medicine's Struggle to Preserve Professionalism in a Commercialized World |
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Obstetrics & Gynecology,
Volume 100,
Issue 1,
2002,
Page 168-169
Jordan Cohen,
Barbara Gabriel,
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PDF (43KB)
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ISSN:0029-7844
出版商:OVID
年代:2002
数据来源: OVID
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26. |
Medical Professionalism in the New MillenniumA Physician Charter |
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Obstetrics & Gynecology,
Volume 100,
Issue 1,
2002,
Page 170-172
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ISSN:0029-7844
出版商:OVID
年代:2002
数据来源: OVID
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27. |
Recurrent Pregnancy Loss With Antiphospholipid AntibodyA Systematic Review of Therapeutic Trials |
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Obstetrics & Gynecology,
Volume 100,
Issue 1,
2002,
Page 173-174
Marianne Empson,
Marissa Lassere,
Jonathan Craig,
James Scott,
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ISSN:0029-7844
出版商:OVID
年代:2002
数据来源: OVID
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28. |
Race, Adolescent Contraceptive Choice, and Pregnancy at Presentation to a Family Planning Clinic |
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Obstetrics & Gynecology,
Volume 100,
Issue 1,
2002,
Page 174-175
Tina Raine,
Cynthia Harper,
Maarit Paukku,
Philip Darney,
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PDF (56KB)
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ISSN:0029-7844
出版商:OVID
年代:2002
数据来源: OVID
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29. |
Correction |
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Obstetrics & Gynecology,
Volume 100,
Issue 1,
2002,
Page 175-175
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PDF (51KB)
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ISSN:0029-7844
出版商:OVID
年代:2002
数据来源: OVID
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