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Cervical length and preterm birth

Lunthaporn Puttanavijarn, Vorapong Phupong
The aim of this study was to assess the relationship between transabdominal and transvaginal ultrasonography for the cervical length assessment and to evaluate the predictive value of the transabdominal ultrasonography cervical length assessment for predicting preterm birth. A prospective cohort study was conducted. Transabdominal and transvaginal ultrasonography cervical length assessments were performed in 160 pregnant women between 16 and 23 (+) (6) weeks of gestation. Transabdominal ultrasonography cervical length assessment was positively correlated with the transvaginal ultrasonography cervical length assessment...
October 18, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Merel M C Bruijn, Jolande Y Vis, Femke F Wilms, Martijn A Oudijk, Anneke Kwee, Martina M Porath, Guid Oei, Hubertina C J Scheepers, Marc E A Spaanderman, Kitty W M Bloemenkamp, Monique C Haak, Antoinette C Bolte, Frank P H A Vandenbussche, Mallory D Woiski, Caroline J Bax, Jérôme M J Cornette, Johannes J Duvekot, Bas W A Nij Bijvank, Jim van Eyck, Maureen T M Franssen, Krystyna M Sollie, Joris A M van der Post, Patrick M M Bossuyt, Brent C Opmeer, M Kok, Ben W J Mol, Gert-Jan van Baaren
OBJECTIVE: To compare the accuracy of the Actim Partus test and fetal fibronectin (fFN) test in the prediction of spontaneous preterm delivery within seven days in symptomatic women undergoing cervical length measurement. STUDY DESIGN: We performed a post-hoc analysis on frozen samples of a nationwide cohort study in all 10 perinatal centres in the Netherlands. We selected samples from women with signs of preterm labour between 24 and 34 weeks of gestational age and a cervical length below 30mm...
September 20, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Leslie A Moroz, Clifton O Brock, Shravya Govindappagari, Denise L Johnson, Elizabeth H Leopold, Cynthia Gyamfi-Bannerman
BACKGROUND: There is a lack of consensus on the optimal transvaginal cervical length (TVCL) for determining risk for spontaneous preterm (SPTB) in twin pregnancies. Change in TVCL over time may reflect early activation of the parturition process, as has been demonstrated in singleton pregnancies. The association between change in TVCL and the risk for SPTB has not yet been described in the population of women with diamniotic twin pregnancies. OBJECTIVES: Our primary objective is to determine whether rate of change in TVCL in the midtrimester is associated with SPTB in twin gestations...
October 8, 2016: American Journal of Obstetrics and Gynecology
Giovanni Grandi, Lucrezia Pignatti, Francesca Ferrari, Giulia Dante, Isabella Neri, Fabio Facchinetti
INTRODUCTION: Inflammation might be an important underlying cause of preterm birth. Our aim is to explore whether vaginal administration α-lipoic acid reduces cervical inflammation and shortening after primary tocolysis. Matherials and Methods: Singleton pregnancies between 24-30 weeks remaining undelivered after hospitalization for preterm labor were randomly allocated to placebo (20 women, 15 analyzed) or vaginal ALA 400 mg daily (20 women, 17 analyzed) for 30 days. A cervical swab to quantify pro-inflammatory (IL1, IL2, IL6, IL8, TNFα) and anti-inflammatory (IL4, IL10) cytokines as well as transvaginal ultrasound cervical length measurement (CL) were performed before and after treatment...
October 9, 2016: Journal of Maternal-fetal & Neonatal Medicine
Jaroslaw Kalinka, Elwira Agata Jasinska, Piotr Laudanski, Adam Bitner
We present a rare case of a complication after pessary insertion during pregnancy due to short cervix. A woman in the 35th week of gestation was admitted to the Department of Perinatology due to preterm labor. The patient's history revealed cervical pessary insertion during the 29th week of pregnancy due to a cervix of 18 mm in length. Because of threatened preterm labor, the pessary was removed. After pessary removal, a rupture of the cervix was diagnosed. Because of active labor and cervical rupture, a cesarean section was performed and a healthy newborn was delivered...
October 8, 2016: Journal of Obstetrics and Gynaecology Research
Niloofar Karbasian, Mahdi Sheikh, Reihaneh Pirjani, Shahla Hazrati, Fatemeh Tara, Sedigheh Hantoushzadeh
AIM: We compared the effectiveness of a combined treatment involving cervical pessary plus vaginal progesterone to vaginal progesterone alone in decreasing the rate of preterm birth in women with short cervix in the second gestational trimester. METHODS: This prospective, open-label, randomized clinical trial was conducted on 144 pregnant women with singleton pregnancy who had a cervical length ≤ 25 mm, at 18-22 gestational weeks (GW). Seventy-three patients were assigned to receive 400 mg of daily vaginal progesterone (group A), and 73 to receive cervical pessary plus 400 mg of daily vaginal progesterone (group B), until the 37th GW...
October 8, 2016: Journal of Obstetrics and Gynaecology Research
Anna Palatnik, Emily S Miller, Moeun Son, Michelle A Kominiarek
Objective The objective of this study was to determine if mid-trimester cervical length is associated with the inverse relationship between maternal body mass index (BMI) at delivery and spontaneous preterm birth (SPTB). Materials and Methods This was a retrospective cohort of women with a singleton pregnancy without prior SPTB who underwent routine transvaginal cervical length assessment between 18 and 24 weeks. Women were categorized into four BMI groups: (1) 18.5 to 24.9, (2) 25 to 29.9, (3) 30 to 34...
September 23, 2016: American Journal of Perinatology
A Weichert, D von Schöning, T Fischer, A Thomas
No abstract text is available yet for this article.
September 2016: Ultrasound Int Open
Sevan A Vahanian, Anthony M Vintzileos
PURPOSE OF REVIEW: Placental implantation abnormalities (PIAs) comprise a large group of disorders associated with significant maternal, fetal, and neonatal morbidity. RECENT FINDINGS: Risk factors include prior uterine surgery/myometrial scarring and the presence of placenta previa with or without prior cesarean delivery. Newly identified risk factors include previous prelabor cesarean delivery and previous postpartum hemorrhage. PIAs contribute substantially to preterm birth with prematurity rates ranging from 38 to 82%...
September 21, 2016: Current Opinion in Obstetrics & Gynecology
David A Crosby, Jan Miletin, Jana Semberova, Sean Daly
INTRODUCTION: A recent meta-analysis has suggested that routine measurement of the cervical length should be performed in conjunction with the anomaly scan to identify a group of women at increased risk of preterm delivery. We decided to investigate whether this recommendation is justifiable in a population where the risk of preterm birth is low. MATERIAL AND METHODS: We reviewed 12 years of obstetric data from the Coombe Women and Infants University Hospital. Relative risks of adverse outcomes from the randomized controlled trial were applied and we extrapolated the possible numbers of women requiring intervention...
September 13, 2016: Acta Obstetricia et Gynecologica Scandinavica
Malipati Maerdan, Chunyan Shi, Xiaoxiao Zhang, Lixin Fan
OBJECTIVE: The objective of this study is to understand the prevalence of short cervical length between 20 and 24 weeks gestation in China and to evaluate the efficacy of micronized progesterone for prolonging gestation in nulliparous patients with a short cervix. METHODS: From May 2010 to May 2015, a total of 25 328 asymptomatic women with singleton pregnancies at Peking University First Hospital had their cervical length routinely measured between 20 and 24 weeks of gestation...
September 7, 2016: Journal of Maternal-fetal & Neonatal Medicine
Adeeb Khalifeh, Johanna Quist-Nelson, Vincenzo Berghella
OBJECTIVE: To evaluate the incidence of implementation of universal cervical length (CL) screening for preterm birth (PTB) prevention among institutions with Maternal-Fetal Medicine (MFM) fellowship training in the United states. METHODS: In January 2015, we conducted a national survey of institutions with MFM Fellowship Programs regarding implementation of universal CL screening, defined as CL screening of women with singleton gestations without a prior spontaneous PTB...
September 7, 2016: Journal of Maternal-fetal & Neonatal Medicine
Rafał Rzepka, Barbara Dołęgowska, Aleksandra Rajewska, Daria Sałata, Marta Budkowska, Sebastian Kwiatkowski, Andrzej Torbé
Preterm birth remains the most prevalent cause of neonatal morbidity. This study aimed to evaluate the diagnostic value of SDF-1α, resistin, secretory RAGE (sRAGE), and endogenous secretory RAGE (esRAGE) in preterm labor. A total of 211 pregnant women participated in the study. Group A contained 72 women between 22 and 36 weeks of gestation, with premature labor, who finally had preterm birth. Group B contained 66 women in labor between 37 and 41 weeks of gestation. Women in group A had lower SDF-1α and sRAGE levels than those in group B...
2016: BioMed Research International
Jessica N Buck, Kelly M Orzechowski, Vincenzo Berghella
PURPOSE: Racial minorities experience higher rates of spontaneous preterm birth (sPTB). Our objective was to evaluate whether there are racial discrepancies in the incidence of second trimester short cervical length (≤25mm). MATERIALS AND METHODS: Retrospective cohort of women with singleton gestations without prior sPTB undergoing universal second trimester transvaginal ultrasound cervical length (CL) screening between January 2012 and December 2013. Black women were compared to non-Hispanic white women...
August 23, 2016: Journal of Maternal-fetal & Neonatal Medicine
Kishwar Azad, Jiji Mathews
Preterm births (PTBs), defined as births before 37 weeks of gestation account for the majority of deaths in the newborn period. Prediction and prevention of PTB is challenging. A history of preterm labour or second trimester losses and accurate measurement of cervical length help to identify women who would benefit from progesterone and cerclage. Fibronectin estimation in the cervicovaginal secretions of a symptomatic woman with an undilated cervix can predict PTB within 10 days of testing. Antibiotics should be given to women with preterm prelabour rupture of membranes but tocolysis has a limited role in the management of preterm labour...
June 24, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
Merel Mc Bruijn, Esme I Kamphuis, Irene M Hoesli, Begoña Martinez De Tejada, Anne R Loccufier, Maritta Kühnert, Hanns Helmer, Marie Franz, Martina M Porath, Martijn A Oudijk, Yves Jacquemyn, Sven M Schulzke, Grit Vetter, Griet Hoste, Jolande Y Vis, Marjolein Kok, Ben Wj Mol, Gert-Jan van Baaren
BACKGROUND: The combination of the qualitative fetal fibronectin test and cervical length measurement has a high negative predictive value for preterm birth within seven days, but positive prediction is poor. A new bedside quantitative fetal fibronectin test showed potential additional value over the conventional qualitative test, but there is limited evidence on the combination with cervical length measurement. OBJECTIVE: To compare quantitative fetal fibronectin and qualitative fetal fibronectin testing in the prediction of spontaneous preterm birth within seven days in symptomatic women undergoing cervical length measurement...
August 16, 2016: American Journal of Obstetrics and Gynecology
Alvaro Sepúlveda-Martínez, Francisco Díaz, Hernán Muñoz, Enrique Valdés, Mauro Parra-Cordero
OBJECTIVE: The aim of this article is to assess the use of the anterior cervical angle (ACA) as a predictor of spontaneous preterm delivery (sPTD) at 20+0-24+6 weeks of gestation in an unselected population. METHODS: We conducted a nested case-control study that included 93 women who later delivered spontaneously <34 weeks of gestation and 225 controls. The ACA was assessed retrospectively on all selected images using ImageJ® software. The concordance correlation coefficient was determined for the assessment of interobserver variability...
August 12, 2016: Fetal Diagnosis and Therapy
Núria Baños, Alvaro Perez-Moreno, Federico Migliorelli, Laura Triginer, Teresa Cobo, Elisenda Bonet-Carne, Eduard Gratacos, Montse Palacio
OBJECTIVES: Quantitative texture analysis has been proposed to extract robust features from the ultrasound image to detect subtle changes in the textures of the images. The aim of this study was to evaluate the feasibility of quantitative cervical texture analysis to assess cervical tissue changes throughout pregnancy. METHODS: This was a cross-sectional study including singleton pregnancies between 20.0 and 41.6 weeks of gestation from women who delivered at term...
August 11, 2016: Fetal Diagnosis and Therapy
Lindsay M Kindinger, David A MacIntyre, Yun S Lee, Julian R Marchesi, Ann Smith, Julie A K McDonald, Vasso Terzidou, Joanna R Cook, Christoph Lees, Fidan Israfil-Bayli, Yazmin Faiza, Philip Toozs-Hobson, Mark Slack, Stefano Cacciatore, Elaine Holmes, Jeremy K Nicholson, T G Teoh, Phillip R Bennett
Preterm birth, the leading cause of death in children under 5 years, may be caused by inflammation triggered by ascending vaginal infection. About 2 million cervical cerclages are performed annually to prevent preterm birth. The procedure is thought to provide structural support and maintain the endocervical mucus plug as a barrier to ascending infection. Two types of suture material are used for cerclage: monofilament or multifilament braided. Braided sutures are most frequently used, although no evidence exists to favor them over monofilament sutures...
August 3, 2016: Science Translational Medicine
Kartik K Venkatesh, David E Cantonwine, Kelly Ferguson, Melanie Arjona, John D Meeker, Thomas F McElrath
PROBLEM: We assess whether inflammatory and oxidative stress markers early in pregnancy are associated with decreasing cervical length in the second trimester. METHOD OF STUDY: This is a secondary analysis of a nested case-control study of preterm birth conducted at a tertiary care center from 2006 to 2008. Plasma inflammatory markers included the following: interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-1 beta (IL-1β), tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP); and urine oxidative stress markers included the following: 8-hydroxydeoxyguanosine (8-OHdG) and 8-isoprostane, measured at two study visits (median 10 and 18 weeks of gestation)...
November 2016: American Journal of Reproductive Immunology: AJRI
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