American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Sep 2005
Multicenter StudyProgesterone for prevention of recurrent preterm birth: impact of gestational age at previous delivery.
Preterm birth occurs in 1 of 8 pregnancies and may result in significant morbidity and mortality. 17-alpha hydroxyprogesterone caproate (17-OHP caproate) has been found to be efficacious in reducing the risk of subsequent preterm delivery in women who have had a previous spontaneous preterm birth (sPTB). This analysis was undertaken to evaluate if 17-OHP caproate therapy works preferentially depending on the gestational age at previous spontaneous delivery. We hypothesized that treatment with 17-OHP caproate is more effective in prolonging pregnancy depending on the gestational age of the earliest previous preterm birth (20-27.9, 28-33.9 vs 34-36.9 weeks). ⋯ 17-OHP caproate therapy given to prevent recurrent PTB is associated with a prolongation of pregnancy overall, and especially for women with a previous spontaneous PTB at <34 weeks.
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Am. J. Obstet. Gynecol. · Sep 2005
A comprehensive ethical framework for responsibly designing and conducting pharmacologic research that involves pregnant women.
We present and defend ethically justified guidelines for pharmacologic research that involves pregnant women. ⋯ The concept of the fetus as a patient plays an essential role in the ethically justified design and conduct of pharmacologic research in pregnant women.
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Am. J. Obstet. Gynecol. · Sep 2005
Randomized Controlled Trial Comparative Study Clinical TrialHigh-dose vaginal misoprostol versus concentrated oxytocin plus low-dose vaginal misoprostol for midtrimester labor induction: a randomized trial.
This study was undertaken to compare the efficacy and side effects of a high-dose vaginal misoprostol regimen to concentrated intravenous oxytocin plus low-dose vaginal misoprostol for midtrimester labor induction. ⋯ Compared with concentrated oxytocin plus low-dose vaginal misoprostol, high-dose vaginal misoprostol significantly shortens midtrimester labor inductions.
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Am. J. Obstet. Gynecol. · Sep 2005
Obstetric outcomes after surgical abortion at > or = 20 weeks' gestation.
The purpose of this study was to describe obstetric outcomes after surgical abortion at > or = 20 weeks, and to identify risk factors for subsequent spontaneous preterm birth. ⋯ In those who have undergone D&E at > or = 20 weeks, only a history of midtrimester cervical dilation and/or PPROM or a current multifetal pregnancy were associated with spontaneous preterm birth.
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Am. J. Obstet. Gynecol. · Sep 2005
Case ReportsSpontaneous epidural hematoma of the spine in pregnancy.
Spontaneous spinal epidural hematomas are uncommon. Progressive neurologic deficits that are associated with epidural hematomas can develop rapidly and require prompt treatment. We present a case of spontaneous epidural hematoma of the thoracic spine that complicated a term pregnancy.