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Cervical length and preterm birth

Siddhidatri Mishra, Rashmi Bagga, Jasvinder Kalra, Vanita Jain, Sourabh Dutta
Women (n = 300) at 'low risk' for a preterm birth (PTB), a singleton pregnancy and for a 16-24 week period of gestation (POG) were randomised to undergo cervical length (CL) measurement by transvaginal sonography (TVS) or not. The aim was to see if routine CL measurement and treatment of a short CL reduced the PTB rate. 'Low risk' was defined by an absence of a prior abortion or PTB of a singleton infant (>16 to <37 weeks) due to a spontaneous preterm labour (PTL) or a preterm pre-labour rupture of membranes (pPROM)...
March 14, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Athena P Souka, Ioannis Papastefanou, Athanasios Pilalis, Dimitrios Kassanos, George Papadopoulos
OBJECTIVES: To assess the feasibility and the results of introducing a policy of universal screening for preterm delivery. METHODS: Transvaginal sonography for cervical length (CL) measurement was performed at 20-24 weeks of gestation. Vaginal progesterone therapy was offered to women with CL ≤ 15mm. RESULTS: 10,969 singleton pregnancies were assessed. The decline rate was 1.32%. Spontaneous preterm delivery at less than 32 weeks (SPD32), less than 34 weeks (SPD34) and less than 37 weeks (SPD37) occurred in 0...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
Janneke van 't Hooft, Johanna H van der Lee, Brent C Opmeer, Aleid G van Wassenaer-Leemhuis, Anneloes L van Baar, Dick J Bekedam, Leonie J P Steenis, Sophie Liem, Ewoud Schuit, Cuny Cuijpers, Elise Bleeker, Margot E Vinke, Noor Simons, Irene M de Graaf, Ben Willem J Mol, Cornelieke van de Beek
OBJECTIVE: We recently found in a randomized clinical trial (ProTWIN) that cervical pessary prevented preterm birth and improved neonatal outcome in women with a multiple pregnancy and a cervical length (CL) <38mm. In this follow-up study we evaluated long-term developmental outcomes in the offspring of these women at three years corrected age. METHODS: We conducted a follow-up study of the ProTWIN trial, a trial in which between 2009 and 2012 asymptomatic women with a multiple pregnancy had been randomized to pessary or no pessary...
February 22, 2018: Ultrasound in Obstetrics & Gynecology
Su Jin Sung, Seung Mi Lee, Sohee Oh, Joo Hee Choi, Jee Yoon Park, Byoung Jae Kim, Joon Ho Lee, Chan-Wook Park, Joong Shin Park, Jong Kwan Jun
OBJECTIVE: It is well known that a short cervix at mid-pregnancy is a risk factor for spontaneous preterm birth in both singleton and twin gestations. Recent evidence also suggests that a long cervix at mid-pregnancy is a predictor of the risk of cesarean section (C/S) in singleton gestation. The purpose of this study was to determine whether a long cervix at mid-pregnancy was associated with an increased risk of C/S in women with twin pregnancies. METHODS: We enrolled 746 women pregnant with twins whose cervical length was measured by trans-vaginal ultrasonography at a mean of 22 weeks of gestation and who delivered in our institution...
February 20, 2018: Journal of Perinatal Medicine
Nancy Medley, Borna Poljak, Silvia Mammarella, Zarko Alfirevic
BACKGROUND: Clinical practice guidelines (CPG) endorse multiple strategies to prevent or manage preterm birth (PTB). OBJECTIVES: To summarise CPG recommendations for PTB and identify areas of international consensus. SEARCH STRATEGY: In June 2017 we searched for all CPG relavant to PTB without language restrictions. SELECTION CRITERIA: CPG were eligible if the following criteria were met. i.The guideline was published or current from June 2013...
February 20, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Mehmet Aral Atalay, Turan Ozmen, Bilge Cetinkaya Demir, Isil Kasapoglu, Guven Ozkaya
OBJECTIVE: To define serum decorin (sDEC) levels in healthy pregnants and in patients with preterm labor (PTL), and to introduce possible role of sDEC in predicting the risk for preterm birth (PTB). MATERIALS AND METHODS: Thirty-one women with diagnosis of PTL between 24th to 32nd weeks of pregnancy were compared with 44 healthy pregnants in this prospective case-control study. Maternal blood sDEC and uterine cervical length (CL) measurements were conducted at referral...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
Shubhra Agarwal, Arjit Agarwal, Pawan Joon, Shalini Saraswat, Shruti Chandak
Background: Preterm birth is a major health problem in developing and developed countries leading to rising health care costs and long-term neurodevelopmental disability. The study aims to evaluate the role of new quantitative markers, like the elastography of cervix (shear wave speed estimation), fetal adrenal zone enlargement, and corrected fetal adrenal gland volume; in preterm birth prediction and analyze their relative importance. Thus, these markers may be beneficial in early preterm birth detection and prevent the related morbidities...
February 2018: Ultrasound: Journal of the British Medical Ultrasound Society
Kenneth Lim, Kimberly Butt, Joan M Crane
OBJECTIVES: To review (1) the use of ultrasonographic-derived cervical length measurement in predicting preterm birth and (2) interventions associated with a short cervical length. OUTCOMES: Reduction in rates of prematurity and/or better identification of those at risk, as well as possible prevention of unnecessary interventions. EVIDENCE: Published literature was retrieved through searches of PubMed and The Cochrane Library up to December 2009, using appropriate controlled vocabulary and key words (preterm labour, ultrasound, cervix, incompetent cervix, transvaginal, transperineal, cervical length, fibronectin)...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Kaouther Dimassi, Ines Bouriel, Amel Triki, Ali Mrabet, Mohamed Faouzi Gara
BACKGROUND: Preterm delivery is the major cause of adverse outcomes in twin pregnancy.  A shortened cervix at 20-24 weeks of amenorrhea is a good predictor of preterm birth in asymptomatic patients. However, there are no recommendations for serial cervical length measurements for these high risk pregnancies. OBJECTIVES: To evaluate the benefits from monthly cervical length monitoring in asymptomatic twin pregnancies. METHODS: This was a prospective study...
March 2017: La Tunisie Médicale
Stuart Campbell
No abstract text is available yet for this article.
February 2018: American Journal of Obstetrics and Gynecology
Homeira Vafaei, Neda Rahimirad, Seyedeh Marjan Hosseini, Maryam Kasraeian, Nasrin Asadi, Hadi Raeisi Shahraki, Khadijeh Bazrafshan
Background: Preterm labor and birth are associated with several neonatal complications including respiratory distress syndrome and intraventricular hemorrhage. Differentiating true and false labor pain is a dilemma to obstetricians. Objective: To elucidate the role of cervical length measurement in prediction of birth in pregnant women with threatened preterm labor. Materials and Methods: In this double blind randomized clinical trial, 120 women with gestational age <34 wk who presented painful uterine contractions randomly assigned to undergo measurement of cervical length...
November 2017: International Journal of Reproductive Biomedicine (Yazd, Iran)
Nur Betül Tekiner, Berna Aslan Çetin, Lale Susan Türkgeldi, Gökçe Yılmaz, İbrahim Polat, Ali Gedikbaşı
BACKGROUND: We aimed to determine if there is a difference in the size of the cesarean scar defect using saline infusion sonography (SIS) performed on the postoperative third month in patients who underwent single- or double-layered unlocked closure of their uterine incision during their first cesarean delivery. METHODS: This study was conducted as a prospective cross-sectional study between February 2015 and January 2016 in patients admitted to the labour ward of the Kanuni Sultan Suleyman Training and Research Hospital who subsequently underwent their first delivery by cesarean section...
February 3, 2018: Archives of Gynecology and Obstetrics
Florent Fuchs, Clémentine Lefevre, Marie-Victoire Senat, Hervé Fernandez
Our goal was to evaluate the performance of fetal fibronectin (fFN) test alone or combined with cervical length (CL), to predict spontaneous preterm birth (PTB) in symptomatic twin pregnancies. We carry out a short pilot study including all uncomplicated diamniotic twin pregnancies with symptoms of preterm labor (PTL) and intact membranes at 24-33 weeks + 6 days of gestation. Studied outcome were spontaneous delivery within 7 and 14 days of testing and spontaneous PTB at <34 and <37 weeks of gestation...
February 1, 2018: Scientific Reports
Michelle N Han, Betsy E O'Donnell, Melanie M Maykin, Juan M Gonzalez, Khalil Tabsh, Stephanie L Gaw
PURPOSE: To evaluate whether cerclage in twins reduces the rate of spontaneous preterm birth <32 weeks when compared to expectant management. METHODS: This is a retrospective cohort study of twin pregnancies with the following indications for cerclage from two institutions: history of prior preterm birth, ultrasound-identified short cervix ≤2.5 cm, and cervical dilation ≥1.0 cm. The "cerclage" cohort received a cerclage from a single provider at a single institution from 2003-2016...
January 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
Rupsa C Boelig, Michela Villani, Eva Jiang, Kelly M Orzechowski, Vincenzo Berghella
OBJECTIVES: To determine whether a prior uterine evacuation procedure is associated with an increased risk of short cervical length (≤20 mm) in women without prior spontaneous preterm birth. METHODS: This work was a retrospective cohort study from January 2012 to December 2014 of singletons without prior spontaneous preterm birth with cervical length screening between 18 weeks and 23 weeks 6 days. Women with a prior miscarriage/abortion were excluded if management (medical, surgical, or expectant) was not specified...
January 18, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Reshama Navathe, Gabriele Saccone, Michela Villani, Jacquelyn Knapp, Yury Cruz, Rupsa Boelig, Amanda Roman, Vincenzo Berghella
BACKGROUND: It is unknown if universal second-trimester transvaginal ultrasound (TVU) cervical length (CL) screening in asymptomatic women with singleton gestations and no prior spontaneous preterm birth (SPTB) affects the incidence of symptoms of preterm labor (PTL) later in pregnancy. OBJECTIVE: To evaluate the incidence of threatened PTL before and after the implementation of universal second trimester TVU CL screening. STUDY DESIGN: This was a retrospective cohort study of all consecutive singleton gestations without prior SPTB presenting to obstetric triage for threatened PTL between 23 0/7 and 33 6/7 week in 2011 (1 January-31 December), and in 2014 (1 January-31 December) at Thomas Jefferson University Hospital (TJU) (Philadelphia, PA)...
January 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
Michael S Ruma, Katie C Bittner, Clara B Soh
One in 10 infants in the United States is delivered preterm (ie, before the 37th week of pregnancy), contributing to the significant burden on the national healthcare system. Nevertheless, a lack of agreement continues among obstetric professional societies on guidelines for standardization of the approach to the diagnosis and management of patients with symptoms of preterm labor (PTL). This disparity in consensus has likely resulted in poor identification of women at an increased risk for preterm birth (PTB)...
December 2017: American Journal of Managed Care
Eman Alsayegh, Jon Barrett, Nir Melamed
BACKGROUND: Administrating a single course of antenatal corticosteroids to women at risk of preterm birth between 24 and 34 weeks of gestation has been shown to decrease neonatal morbidity and mortality. There is evidence that the optimal timing for the administration of antenatal corticosteroids is within 1-7 days before birth as the effect of antenatal corticosteroids has been shown to decline 7 days after administration. Therefore, given that antenatal corticosteroids are the single most effective intervention in cases of preterm birth, efforts should be made to optimize the timing of administration of antenatal corticosteroids...
January 11, 2018: Journal of Maternal-fetal & Neonatal Medicine
Gabriele Saccone, Giuseppe Maria Maruotti, Antonia Giudicepietro, Pasquale Martinelli
Importance: Spontaneous preterm birth is a major cause of perinatal morbidity and mortality. It is unclear if a cervical pessary can reduce the risk of spontaneous preterm delivery. Objective: To test whether in asymptomatic women with singleton pregnancies and no prior spontaneous preterm birth but with short cervical length on transvaginal ultrasound, use of a cervical pessary would reduce the rate of spontaneous preterm birth at less than 34 weeks of gestation...
December 19, 2017: JAMA: the Journal of the American Medical Association
Limei Zheng, Jun Dong, Yongdong Dai, Yanling Zhang, Libing Shi, Minling Wei, Xiaoying Jin, Chao Li, Songying Zhang
OBJECTIVE: The objective of this study is to evaluate the effectiveness and safety of cervical pessaries for the prevention of preterm birth. METHODS: We searched PubMed, Embase, Web of Science, and other sources from inception to July 2016. This analysis referred to pregnant women with singleton/multiple viable fetus/fetuses, with or without cervical pessary placement. RESULTS: Six randomized control trials and five cohort studies involving 3911 participants were included...
December 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
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