American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Sep 2001
The Preterm Prediction Study: toward a multiple-marker test for spontaneous preterm birth.
The Preterm Prediction Study evaluated 28 potential biologic markers for spontaneous preterm birth in asymptomatic women at 23 to 24 weeks gestational age. This analysis compares those markers individually and in combination for an association with spontaneous preterm birth at <32 and <35 weeks gestational age. ⋯ Overlap among the strongest biologic markers for spontaneous preterm birth is small. This suggests that the use of tests such as maternal serum alpha-fetoprotein, alkaline phosphatase, and granulocyte colony-stimulating factor as a group or adding their results to fetal fibronectin test and cervical length test results may enhance our ability to predict spontaneous preterm birth and that the development of a multiple-marker test for spontaneous preterm birth is feasible.
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Am. J. Obstet. Gynecol. · Aug 2001
Scheduled cesarean delivery and the prevention of human immunodeficiency virus transmission: a survey of practicing obstetricians.
To characterize practice patterns among obstetrician-gynecologists with respect to delivery for human immunodeficiency virus (HIV)-seropositive women, following publication of the 1999 American College of Obstetricians and Gynecologists (ACOG) Committee Opinion regarding scheduled cesarean delivery for HIV-infected patients. ⋯ There is considerable disagreement among practicing obstetricians with respect to the 1999 ACOG Committee Opinion recommendation to offer cesarean delivery to all HIV-seropositive women. Most physicians use viral load detection to assist with the counseling in delivery options for HIV-infected pregnant women.
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Am. J. Obstet. Gynecol. · Jul 2001
Assessing symptoms before hysterectomy: is the medical record accurate?
Our purpose was to evaluate the agreement between the documentation of symptoms leading to hysterectomy and the assessment of those symptoms by the patient. ⋯ Physician overestimation of symptoms could lead to overuse of hysterectomy, whereas underestimation could result in underuse. Our results suggest that both underestimation and overestimation occur for patients with abnormal bleeding, pain, or both. If physicians accurately assess symptoms but fail to document them, examinations of appropriateness will be faulty unless patients are interviewed.
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Am. J. Obstet. Gynecol. · Jul 2001
Randomized Controlled Trial Clinical TrialA randomized controlled trial of fentanyl for abortion pain.
Our aim was to find out whether intravenous fentanyl was effective in reducing the pain of first-trimester abortion. ⋯ Fentanyl, when compared with the placebo, reduced abortion pain by 1.0 point on an 11-point scale. This reduction was of questionable clinical significance and was less than desired by the women included in the study.
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Am. J. Obstet. Gynecol. · Jul 2001
Hormonal and barrier contraception and risk of upper genital tract disease in the PID Evaluation and Clinical Health (PEACH) study.
Among women diagnosed with pelvic inflammatory disease, we examined the associations between hormonal or barrier methods of contraception and upper genital tract infection or inflammation. ⋯ No hormonal or barrier contraceptive method was related to a reduction in upper genital tract disease among women with clinical pelvic inflammatory diseases.