The Journal of reproductive medicine最新文献_第8页

Acute exacerbation of recurrent pelvic inflammatory disease. Laparoscopic findings in 141 women with a clinical diagnosis. 复发性盆腔炎的急性加重。141例临床诊断的女性腹腔镜检查结果。

The Journal of reproductive medicine Pub Date : 2001-05-01 DOI: 10.1097/00006254-200105000-00017

D. Cibula, D. Kužel, Z. Fučíková, K. Švabík, J. Živný

{"title":"Acute exacerbation of recurrent pelvic inflammatory disease. Laparoscopic findings in 141 women with a clinical diagnosis.","authors":"D. Cibula, D. Kužel, Z. Fučíková, K. Švabík, J. Živný","doi":"10.1097/00006254-200105000-00017","DOIUrl":"https://doi.org/10.1097/00006254-200105000-00017","url":null,"abstract":"OBJECTIVE\u0000To evaluate the accuracy of the clinical diagnosis of recurrent pelvic inflammatory disease (PID) and to determine the positive and negative predictive value of laboratory tests for the diagnosis of PID.\u0000\u0000\u0000STUDY DESIGN\u0000According to a prospective study design, 141 consecutively hospitalized patients with the clinical diagnosis of PID were evaluated. The basic inclusion criterion was a history of at least one episode of PID. Standard laboratory tests were performed, specimens for aerobic and anaerobic culture and for Chlamydia trachomatis isolation were obtained, and temperature was regularly monitored. All patients underwent laparoscopy under general anesthesia within 24 hours of admission.\u0000\u0000\u0000RESULTS\u0000The clinical diagnosis of PID was confirmed by laparoscopy in 30% of patients. In almost one-third of patients, at laparoscopy the pelvic organs were within normal limits. Adhesions without signs of PID were found in 16%. The third-most-frequent finding was endometriosis (14%). Neither the individual monitored parameters nor their combination reached satisfactory positive and negative predictive values for diagnosing PID.\u0000\u0000\u0000CONCLUSION\u0000Recurrent clinical symptoms and laboratory signs of PID should be an indication for confirming or excluding the clinical diagnosis by laparoscopy.","PeriodicalId":192418,"journal":{"name":"The Journal of reproductive medicine","volume":"121 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126278986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 15

Endometrial brush biopsy for the diagnosis of endometrial cancer. 子宫内膜刷活检诊断子宫内膜癌。

The Journal of reproductive medicine Pub Date : 2001-05-01 DOI: 10.1097/00006254-200109000-00014

G. Del Priore, R. Williams, C. B. Harbatkin, L. Wan, K. Mittal, G. Yang

{"title":"Endometrial brush biopsy for the diagnosis of endometrial cancer.","authors":"G. Del Priore, R. Williams, C. B. Harbatkin, L. Wan, K. Mittal, G. Yang","doi":"10.1097/00006254-200109000-00014","DOIUrl":"https://doi.org/10.1097/00006254-200109000-00014","url":null,"abstract":"OBJECTIVE\u0000To evaluate a new technique for processing endometrial cytology for the diagnosis and exclusion of endometrial cancer.\u0000\u0000\u0000STUDY DESIGN\u0000All women at risk for endometrial cancer with clinical indications for endometrial biopsy were evaluated by endometrial brush biopsy (Tao Brush, Cook OB-GYN, Bloomington, Indiana) and Pipelle (Cooper Surgical, Shelton, Connecticut) endometrial biopsies during one office visit. Patients were followed longitudinally for the development of endometrial cancer or until undergoing dilatation and curettage or hysterectomy. All comparisons were analyzed using the chi 2 or t test.\u0000\u0000\u0000RESULTS\u0000One hundred one women (mean age, 58; range, 35-86) had endometrial biopsies performed. Median follow-up was > 21 months (range, 3-29). Twenty-two had cancer or atypia, while the remaining had benign diagnoses. When correlated with the final diagnosis, the Tao Brush had 95.5% sensitivity and the Pipelle, 86% sensitivity. Both devices had 100% specificity, positive predictive value of 100% and negative predictive value of 98%. When the results of the two biopsy devices are considered together, the positive and negative predictive value for detecting or excluding endometrial cancer was 100%. Based on 1998 Medicare reimbursements, a simultaneous second office biopsy using the Tao brush could save approximately $67 per case as compared to a sonohistogram and much more when compared to dilatation and curettage.\u0000\u0000\u0000CONCLUSION\u0000Endometrial cancer can be reliably detected and excluded using these two distinct office biopsy devices simultaneously during one office visit. In patients with an indication for endometrial biopsy, no further diagnostic test may be necessary to exclude or diagnose endometrial cancer or atypia.","PeriodicalId":192418,"journal":{"name":"The Journal of reproductive medicine","volume":"163 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128791438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 41

Relative risk of high grade squamous intraepithelial lesion associated with prior abnormal Pap smears. 与既往异常巴氏涂片检查相关的高级别鳞状上皮内病变的相对风险。

The Journal of reproductive medicine Pub Date : 2001-02-01 DOI: 10.1097/00006254-200107000-00013

L. Collins, J. Niloff, L. Burke, G. Abu-Jawdeh, H. Wang

{"title":"Relative risk of high grade squamous intraepithelial lesion associated with prior abnormal Pap smears.","authors":"L. Collins, J. Niloff, L. Burke, G. Abu-Jawdeh, H. Wang","doi":"10.1097/00006254-200107000-00013","DOIUrl":"https://doi.org/10.1097/00006254-200107000-00013","url":null,"abstract":"OBJECTIVE\u0000Pap smear frequency remains controversial, especially for women with consecutive negative smears. We undertook the current study to ascertain the association of high grade squamous intraepithelial lesions (HSIL) and prior abnormal Paps.\u0000\u0000\u0000STUDY DESIGN\u0000Women with biopsy-proven HSIL (cervical intraepithelial neoplasia 2 and 3) diagnosed between September 1996 and December 1997 and age-matched controls with a negative Pap obtained during the same time period were selected.\u0000\u0000\u0000RESULTS\u0000Sixty-three cases (mean age = 32 years) of HSIL and 69 controls (mean age = 33 years) constituted the study population. Any prior abnormal diagnosis conferred a 15-fold increased risk of HSIL on the current Pap (50/63 vs. 14/69, P < .0001). When limited to the 60 women with at least three prior Paps, the odds ratio for HSIL on the current Pap with any prior abnormal was 18 (28/31 vs. 10/29, P < .0001). Three cases had at least three consecutive negative Paps prior to the diagnosis of HSIL.\u0000\u0000\u0000CONCLUSION\u0000Women with one or more prior negative Pap smears had a significantly decreased risk of HSIL on the current Pap. Consecutive negative Paps did not appear to further decrease the risk; 10% of HSIL patients had had three or more consecutive prior negative Paps. To detect HSIL at its earliest stage, women should be advised to continue annual Pap screening in spite of consecutive negative results.","PeriodicalId":192418,"journal":{"name":"The Journal of reproductive medicine","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122568710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Metronidazole for bacterial vaginosis. A comparison of vaginal gel vs. oral therapy. 甲硝唑治疗细菌性阴道病。阴道凝胶与口服治疗的比较。

The Journal of reproductive medicine Pub Date : 2000-11-01 DOI: 10.1097/00006254-200103000-00014

Jane M. Hanson, James A. McGregor, Sharon L. Hillier, D. Eschenbach, A. Karen Kreutner, Rudolph P. Galask, Mark Martens

{"title":"Metronidazole for bacterial vaginosis. A comparison of vaginal gel vs. oral therapy.","authors":"Jane M. Hanson, James A. McGregor, Sharon L. Hillier, D. Eschenbach, A. Karen Kreutner, Rudolph P. Galask, Mark Martens","doi":"10.1097/00006254-200103000-00014","DOIUrl":"https://doi.org/10.1097/00006254-200103000-00014","url":null,"abstract":"OBJECTIVE\u0000To compare the efficacy and safety of 0.75% metronidazole vaginal gel with oral metronidazole for the treatment of bacterial vaginosis (BV).\u0000\u0000\u0000STUDY DESIGN\u0000Nonpregnant women with BV were enrolled in a multicenter, randomized, investigator-blind treatment trial. Patients were randomly assigned to either 0.75% metronidazole vaginal gel (5 g twice daily for five days) or oral metronidazole (500 mg twice daily for seven days). Follow-up visits occurred approximately two and five weeks after initiation of therapy.\u0000\u0000\u0000RESULTS\u0000BV was clinically eliminated at the first follow-up visit in 83.7% (36/43, 95% CI 72.3-95.1%) of the intravaginal group and 85.1% (40/47, 95% CI 74.6-95.6%) of the oral group. At the final visit, BV was eliminated in 70.7% (29/41, 95% CI 56.3-85.1%) of the intravaginal group and 71.1% (32/45, 95% CI 57.4-84.8%) of the oral group. Significantly more patients in the oral treatment group (51.8%) reported gastrointestinal complaints as compared to the intravaginal treatment group (32.7%, P = .04).\u0000\u0000\u0000CONCLUSION\u0000The efficacy of 0.75% metronidazole vaginal gel twice daily for five days in treating BV was similar to that of standard oral metronidazole treatment and was associated with fewer gastrointestinal complaints.","PeriodicalId":192418,"journal":{"name":"The Journal of reproductive medicine","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131840194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 78

Fetal abdominal circumference measurements of 35 and 38 cm as predictors of macrosomia. A risk factor for shoulder dystocia. 胎儿腹围35和38厘米作为巨大儿的预测指标。肩难产的危险因素。

The Journal of reproductive medicine Pub Date : 2000-11-01 DOI: 10.1097/00006254-200106000-00007

J. Gilby, M. Williams, W. Spellacy

{"title":"Fetal abdominal circumference measurements of 35 and 38 cm as predictors of macrosomia. A risk factor for shoulder dystocia.","authors":"J. Gilby, M. Williams, W. Spellacy","doi":"10.1097/00006254-200106000-00007","DOIUrl":"https://doi.org/10.1097/00006254-200106000-00007","url":null,"abstract":"OBJECTIVE\u0000To determine if ultrasound measurements of fetal abdominal circumference (AC) can be used to predict macrosomic infants.\u0000\u0000\u0000STUDY DESIGN\u0000Using a computer database, 1,996 women at > or = 36 weeks' gestation, delivering a singleton infant and having an ultrasound examination within one week of delivery were studied. Fetal AC was evaluated to determine if it was useful in predicting the birth of a macrosomic infant, > 4,000 or > 4,500 g.\u0000\u0000\u0000RESULTS\u0000AC predicted infants > 4,500 g better than those > 4,000 g. Almost all macrosomic infants > 4,500 g had an AC of > or = 35 cm (68/69, or 99%), but many nonmacrosomic infants were also in this group (683). AC of > or = 38 cm occurred in 99 infants, and 37 of the 69 (53.6%) weighing > 4,500 g were identified. Most infants (78%) with AC > or = 38 cm weighed > 4,000 g.\u0000\u0000\u0000CONCLUSION\u0000Fetal AC was very helpful in identifying potential macrosomic infants. If AC was < 35 cm, the risk of infant birth weights > 4,500 g was < 1%. If AC was > or = 38 cm, the risk was 37% (37/99), and > 50% of these infants were identified (37/69, or 53.6%).","PeriodicalId":192418,"journal":{"name":"The Journal of reproductive medicine","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127259108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 43

Trends in vulvar neoplasia. Increasing incidence of vulvar intraepithelial neoplasia and squamous cell carcinoma of the vulva in young women. 外阴肿瘤的发展趋势。年轻女性外阴上皮内瘤变和鳞状细胞癌的发病率增加。

The Journal of reproductive medicine Pub Date : 2000-08-01 DOI: 10.1097/00006254-200101000-00016

E. Joura, Alexander L??sch, Maria-Gabriela Haider-Angeler, G. Breitenecker, Sepp Leodolter

{"title":"Trends in vulvar neoplasia. Increasing incidence of vulvar intraepithelial neoplasia and squamous cell carcinoma of the vulva in young women.","authors":"E. Joura, Alexander L??sch, Maria-Gabriela Haider-Angeler, G. Breitenecker, Sepp Leodolter","doi":"10.1097/00006254-200101000-00016","DOIUrl":"https://doi.org/10.1097/00006254-200101000-00016","url":null,"abstract":"OBJECTIVE\u0000To determine trends in the epidemiology of vulvar intraepithelial neoplasia (VIN) and squamous cell carcinoma (SCC) of the vulva in a Central European sample during the last decade.\u0000\u0000\u0000STUDY DESIGN\u0000A total of 366 women with VIN 2 and 3 (n = 128) or vulvar SCC (n = 238) presented within two four-year periods separated by one decade (1985-1988 and 1994-1997). We performed a retrospective analysis of the clinicopathologic records of the cohorts.\u0000\u0000\u0000RESULTS\u0000The number of women with high grade VIN (n = 29 vs. 99) tripled during the last decade, while the incidence of vulvar SCC remained stable. In women < or = 50 years old, the incidence of high grade VIN increased by 392% (n = 12 vs. 59) and of invasive vulvar cancer by 157% (n = 7 vs. 18). In the earlier cohort there were 7/126 (5%) women with invasive vulvar SCC under the age of 50 and, in the latter cohort, 18/112 (16%, P < .01).\u0000\u0000\u0000CONCLUSION\u0000Over the past decade a striking increase occurred in the incidence of VIN and an increase in invasive vulvar SCC in young women.","PeriodicalId":192418,"journal":{"name":"The Journal of reproductive medicine","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114597831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 242

Umbilical artery Doppler velocimetry in pregnancies complicated by oligohydramnios. 妊娠合并羊水过少的脐动脉多普勒测速。

The Journal of reproductive medicine Pub Date : 2000-07-01 DOI: 10.1097/00006254-200104000-00004

B. C. Carroll, J. Bruner

{"title":"Umbilical artery Doppler velocimetry in pregnancies complicated by oligohydramnios.","authors":"B. C. Carroll, J. Bruner","doi":"10.1097/00006254-200104000-00004","DOIUrl":"https://doi.org/10.1097/00006254-200104000-00004","url":null,"abstract":"OBJECTIVE\u0000To determine the role of umbilical artery Doppler velocimetry in the management of oligohydramnios.\u0000\u0000\u0000STUDY DESIGN\u0000In a retrospective chart review covering a two-year period, pregnancies with oligohydramnios evaluated by Doppler velocimetry of the umbilical artery were identified. Those patients with ruptured membranes and complex congenital anomalies were excluded from analysis. In the remainder, various measures of perinatal morbidity, including delivery of a small-for-gestational-age infant, preterm delivery, hyperbilirubinemia, requirement for blood transfusion, and other cardiovascular or pulmonary complications, were correlated with recorded values of the systolic/diastolic (S/D) ratio.\u0000\u0000\u0000RESULTS\u0000Seventy-six subjects were identified for study. Forty-six had normal S/D ratios; 17 (37%) were associated with identifiable perinatal morbidity. When prematurity due to delivery for the sole indication of oligohydramnios was excluded, morbidity occurred in five patients (11%). Conversely, of the 30 patients with abnormal Doppler indices, 80% had an adverse outcome.\u0000\u0000\u0000CONCLUSION\u0000Pregnancies with oligohydramnios and normal umbilical artery Doppler velocimetry were significantly (P < .001) less likely to experience an abnormal perinatal outcome as compared to those with abnormal Doppler indices. An elevated S/D ratio identified an increased risk of an adverse perinatal outcome in women with oligohydramnios. Avoiding intervention in pregnancies with oligohydramnios and normal umbilical artery Doppler velocimetry may decrease iatrogenic morbidity due to prematurity by as much as 26%.","PeriodicalId":192418,"journal":{"name":"The Journal of reproductive medicine","volume":"179 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124484144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 19

Conservative management of isolated posthysterectomy fever. 孤立性胸切除术后发热的保守治疗。

The Journal of reproductive medicine Pub Date : 2000-07-01 DOI: 10.1097/00006254-200011000-00013

C. McNally, T. Krivak, T. Alagoz

{"title":"Conservative management of isolated posthysterectomy fever.","authors":"C. McNally, T. Krivak, T. Alagoz","doi":"10.1097/00006254-200011000-00013","DOIUrl":"https://doi.org/10.1097/00006254-200011000-00013","url":null,"abstract":"OBJECTIVE\u0000To demonstrate that an isolated fever in the absence of other signs or symptoms of infection following hysterectomy does not require empiric antibiotics and laboratory tests.\u0000\u0000\u0000METHODS\u0000Retrospective analysis of all the charts of patients who had a hysterectomy from July 1995 to December 1996 at our institution. Patients with a postoperative temperature > 38 degrees C had a physical examination. If the examination was normal, no studies were ordered, and antibiotic therapy was not initiated. If a patient was febrile after 72 hours postoperatively, laboratory studies and radiographic tests were ordered. If the results were negative, the patient did not appear septic, and physical examination was normal, no antibiotics were given. Outcomes were measured by comparing patients with postoperative infections and fever to those without infections.\u0000\u0000\u0000RESULTS\u0000Of 132 patients, 112 were included in the study. Seventy-two hysterectomies were abdominal and 40 vaginal. Postoperative fever during the first 72 hours following hysterectomy occurred in 51/112 (46%) patients. Clinically significant infection was documented in seven patients, all of whom manifested signs and symptoms of infection > 72 hours postoperatively.\u0000\u0000\u0000CONCLUSION\u0000Postoperative fever in the first 72 hours after hysterectomy is common and nonspecific. If a febrile patient does not show any other signs or symptoms of infection, it is safe to forego routine laboratory and imaging studies as well as therapeutic antibiotics.","PeriodicalId":192418,"journal":{"name":"The Journal of reproductive medicine","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121778748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Cesarean delivery for suspected fetal distress among preterm parturients. 怀疑胎儿窘迫的早产儿剖宫产。

The Journal of reproductive medicine Pub Date : 2000-06-22 DOI: 10.1097/00006254-200102000-00008

S. Chauhan, J. Mobley, N. Hendrix, E. Magann, L. Devoe, J. Martin

{"title":"Cesarean delivery for suspected fetal distress among preterm parturients.","authors":"S. Chauhan, J. Mobley, N. Hendrix, E. Magann, L. Devoe, J. Martin","doi":"10.1097/00006254-200102000-00008","DOIUrl":"https://doi.org/10.1097/00006254-200102000-00008","url":null,"abstract":"OBJECTIVE\u0000Among preterm parturients (< 37 weeks) who underwent cesarean delivery for suspected fetal distress, to determine the factors associated with decision-incision time (DIT) of < or = 30 minutes and to assess if umbilical arterial pH < 7.10 is more common with DIT < or = 30 or > 30 minutes.\u0000\u0000\u0000STUDY DESIGN\u0000The peripartum course of all patients who had cesareans for suspected fetal distress over three years was reviewed. The inclusion criteria were reliable gestational age < 37 weeks and a single indication for cesarean delivery, suspected fetal distress. Twenty antepartum and intrapartum factors were used in a univariate analysis.\u0000\u0000\u0000RESULTS\u0000The mean DIT among the 84 parturients was 30.5 +/- 21.2 minutes, and 63% of patients had surgery started within 30 minutes. The incidence of pH < 7.10 was 20%. Multivariate analysis indicated that the two factors significantly associated with prolonged time to surgery were tachycardia with decreased variability (odds ratio [OR] 5.9, 95% confidence interval [CI] 1.6-21.6) and use of spinal anesthesia (OR 6.2, 95% CI 1.1-35.0). Though none of the 20 variables had significant univariate associations with neonatal acidosis at alpha = .05, those with P < .20 were considered in multiple logistic regression analysis. None of the 20 factors were associated with pH < 7.10, including DIT of > or = 30 minutes (OR 0.26, 95% CI 0.06-1.03).\u0000\u0000\u0000CONCLUSION\u0000DIT is likely to be > 30 minutes if cesarean delivery is due to decreased fetal heart variability or if spinal anesthesia is utilized; neonatal acidosis, however, is not significantly associated with a prolonged interval.","PeriodicalId":192418,"journal":{"name":"The Journal of reproductive medicine","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134288374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 19

Comprehensive gynecologic endoscopic hospital privileging program. Implementation and assessment. 综合妇科内镜医院优惠计划。实施和评估。

The Journal of reproductive medicine Pub Date : 2000-05-01 DOI: 10.1097/00006254-200009000-00012

M. Milad, D. Miller, S. Shaw

{"title":"Comprehensive gynecologic endoscopic hospital privileging program. Implementation and assessment.","authors":"M. Milad, D. Miller, S. Shaw","doi":"10.1097/00006254-200009000-00012","DOIUrl":"https://doi.org/10.1097/00006254-200009000-00012","url":null,"abstract":"OBJECTIVE\u0000To describe a comprehensive gynecologic endoscopic privileging program at an urban teaching hospital and evaluate its effect on complication rates.\u0000\u0000\u0000STUDY DESIGN\u0000In 1996, a gynecologic endoscopy privileging program was instituted. Initially, experienced surgeons were invited to apply for advanced privileges based on submission of a case list. Afterwards, new applications were approved by proctorship. Since 1995, charts have been reviewed using the following indicators; operating time, estimated blood loss, length of stay, readmission, diagnosis of cancer, reexploration and admission for hysteroscopic fluid overload. Cases were also independently identified when a major vascular or visceral injury occurred.\u0000\u0000\u0000RESULTS\u0000Among the 3,880 gynecologic endoscopic procedures performed during the review period, 2,702 medical records were randomly screened. Following institution of the program, there was no change noted in rates of hysteroscopic fluid overload, readmission, reexploration or unrecognized diagnosis of cancer. However, a decrease was noted in excess blood loss (odds ratio [OR] 0.6, 90% confidence interval [CI] 0.4, 0.9) and operating time greater than four hours (OR 0.6, CI 0.4, 0.9). Length of hospital stay was also reduced in the year following implementation of the privileging process (OR 0.2, CI 0.1, 0.3). Fifty-four cases of visceral or major vascular injury occurred during the three-year period. The risk of visceral injury revealed a trend from 1.9% to 1.0% after institution of the privileging process (OR 0.5, CI 0.3, 1.0).\u0000\u0000\u0000CONCLUSION\u0000Establishment of a comprehensive gynecologic endoscopic hospital privileging program was associated with a reduction in rates of excess blood loss and operating times and a decreasing trend in visceral injuries.","PeriodicalId":192418,"journal":{"name":"The Journal of reproductive medicine","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124532512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 12