摘要:

&NA;We sought to determine by what amount the frequency of low birth weight (LBW) could be reduced by eliminating its known, preventable risk factors. Based on the prevalence of risk factors such as cigarette smoking (exposure) in a population, and the degree of association (relative risk) between the risk factors and the outcome of LBW, we estimated the percentage of LBW in the United States attributable to the risk factors (population‐attributable risk percentage). We found the following associations with known preventable LBW: Cigarette smoking accounts for 9.6%; alcohol consumption during pregnancy, 2.3%; low pre‐pregnancy weight (less than 54 kg), 6.3%; urinary tract infections, 1.3%;Chlamydia trachomatisgenital infections, 4.8%; and narcotics addiction, 3.8%;. Because these risk factors are not mutually exclusive, eg, narcotics addicts may be addicted to both narcotics and cigarettes, the maximum preventable population‐attributable risk percentage for LBW is less than the sum of the individual risk factors, which is 28.1% (9.6% [cigarette smoking] + 2.3% [alcohol consumption] + 6.3% [low pre‐pregnancy weight] + 1.3% [urinary tract infection] + 4.8% [Chlamydia] + 3.8% [narcotics addiction] = 28.1%). Given the current state of knowledge about preventable risk factors, LBW can be reduced—in an idealized model—from only 6.9 to 5.0% of all births. In a more realistic model, we estimate that LBW can be reduced from only 6.9 to 6.3% of all births. Therefore, a national effort is indicated to identify unknown preventable causes of LBW.(Obstet Gynecol 1994;83:1056‐9)

ISSN:0029-7844    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

&NA;To improve the exposure of the left retroperitoneum, a peritoneal incision is made in the left paracolic gutter up to the splenic flexure. By elevating and medially displacing the left colon, the avascular plane between this and the prerenal fascia is entered and developed caudally to the aorta bifurcation, and cranially 3‐4 cm beyond the left renal pedicle. Thus, the left kidney, its pedicle, the ureter, the ovarian vessels, and the aorta are adequately exposed. In 81 patients with gynecologic tumors who underwent the modified lymphadenectomy, the median number of aortic nodes removed was 29 (range 21‐56). The median duration of left dissection was 35 minutes (range 25‐50) and of the entire aortic lymphadenectomy 70 minutes (range 50‐120). No major intraoperative injuries occurred. The frequency and type of postoperative complications were not affected by this modification. This new approach provides better exposure of the left retroperitoneum, thus permitting safe and complete dissection of the nodes left of the aorta without increased morbidity. If aortic dissection can be limited to the left side, this technique makes it possible to avoid opening the right retroperitoneum.(Obstet Gynecol 1994;83:1060‐4)

ISSN:0029-7844    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

&NA;Massive vaginal prolapse in ten post‐hysterectomy women was treated by expanded polytetrafluoroethylene graft along the course of the round ligaments to anchor the vaginal vault to the lateral abdominal wall. Concurrent enterocele repair was done as well as other indicated abdominal or vaginal operations. Satisfactory coitus was reported in all cases. The procedure is technically simple and provides an alternative to sacral suspension or sacrospinous ligament suspension of the prolapsed vaginal vault.(Obstet Gynecol 1994;83: 1064‐6)

ISSN:0029-7844    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:1994

数据来源: OVID