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Cervical length and preterm birth

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https://www.readbyqxmd.com/read/28217665/elastographic-measurement-of-the-cervix-during-pregnancy-current-status-and-future-challenges
#1
REVIEW
Hyunjung Kim, Han Sung Hwang
The cervix is a cylindrical structure that is proximally connected to the uterus and distally to the vaginal cavity. The Bishop score has been used to evaluate the cervix during pregnancy. However, alternatives have been evaluated because the Bishop score is uncomfortable for patients, relies on a subjective examination, and lacks internal os data. Elastography has been used to assess the cervix, as it can estimate tissue stiffness. Recent articles on elastography for cervical assessment during pregnancy have focused on its usefulness for prediction of preterm birth and successful labor induction...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28170117/prevention-of-preterm-birth-with-pessary-in-twins-poppt-a-randomized-controlled-trial
#2
Vincenzo Berghella, Lorraine Dugoff, Jack Ludmir
OBJECTIVES: To evaluate if cervical pessary placement prevents PTB in twin gestations with a short midtrimester transvaginal ultrasound (TVU) cervical length (CL). METHODS: Multicenter randomized controlled trial of asymptomatic women with twin gestations with a TVU CL ≤30 mm at 18(0) -27(6) weeks. TVU CL screening was performed at the time of the anatomy scan at 18(0) -23(6) , and at subsequent scheduled ultrasounds prior to 28 weeks. Women with a TVU CL ≤30 mm at 18(0) -27(6) weeks were randomized to receive the Bioteque cup cervical pessary or no pessary...
February 7, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28166925/-is-universal-screening-for-cervical-length-among-singleton-pregnancies-with-no-history-of-preterm-birth-justified
#3
P Rozenberg
The ultrasonographic measurement of cervical length with a cutoff of 15mm is currently the best method to identify a group of asymptomatic women in the general population at risk of spontaneous preterm birth, especially among asymptomatic patients with a singleton pregnancy with no history of preterm birth. Cerclage and 17 alpha-hydroxyprogesterone caproate (17OHP-C) are ineffective to reduce the risk of preterm birth among asymptomatic patients with a short cervix in midtrimester. However, vaginal progesterone (200-mg capsules of micronized progesterone or gel containing 90mg progesterone) has been demonstrated effective in 2 large randomized trials to reduce the risk of preterm birth and possibly the composite morbidity and perinatal mortality associated among asymptomatic women with a short cervix in the general population screened by ultrasound of the cervix in midtrimester...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28145653/maternal-characteristics-short-mid-trimester-cervical-length-and-preterm-delivery
#4
Soo Hyun Cho, Kyo Hoon Park, Eun Young Jung, Jung Kyung Joo, Ji Ae Jang, Ha Na Yoo
We aimed to determine the maternal characteristics (demographics, an obstetric history, and prior cervical excisional procedure) associated with a short mid-trimester cervical length (CL, defined as a CL of ≤ 25 mm) and whether having a short cervix explains the association between these maternal characteristics and spontaneous preterm delivery (SPTD, defined as a delivery before 34 weeks). This is a single-center retrospective cohort study of 3,296 consecutive women with a singleton pregnancy who underwent routine CL measurement between 20 and 24 weeks...
March 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28141949/ability-of-cervical-length-to-predict-spontaneous-preterm-delivery-in-twin-pregnancies-using-the-receiver-operating-characteristic-curve-analysis-and-an-a-priori-cut-off-value
#5
Lucia Pasquini, Giovanni Sisti, Dimitrios Nasioudis, Tomi Kanninen, Flavia Sorbi, Massimiliano Fambrini, Irene Turrini, Viola Seravalli, Mariarosaria Di Tommaso
In this retrospective study based on cervical length (CL) measurements between 20 and 24 + 6 weeks, we examined the ability of CL to predict spontaneous preterm birth (SPTB) in 222 twin pregnancies using the receiver-operating curve (ROC) analysis and an a priori cut-off. CL predicted SPTB before 34 weeks. Using the ROC the selected cut-off was 37.5 mm. Positive predictive value (PPV) and negative predictive value (NPV) regarding SPTB before 34 weeks for 37.5 mm were 15.7% and 5.3% respectively. Using the 5th percentile, PPV and NPV regarding SPTB before 34 weeks for 24 mm were 41...
January 31, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28128525/cervical-length-screening-will-we-truly-reap-economic-benefits-with-a-universal-screening-approach
#6
Aaron B Caughey
Preterm birth is a leading cause of perinatal morbidity and mortality. Despite extensive research utilizing a wide-range of approaches and public efforts, the rate of preterm birth has not changed substantially over the past two decades, other than a rise in late preterm births from the late 1990s that was most likely due to iatrogenic causes.(National Vital Statistics Reports 2010;58:1-32) Thus, preterm birth prevention remains one of the single most impactful ways to improve perinatal outcomes, but a successful approach has remained elusive...
January 27, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28103952/the-interaction-between-vaginal-microbiota-cervical-length-and-vaginal-progesterone-treatment-for-preterm-birth-risk
#7
Lindsay M Kindinger, Phillip R Bennett, Yun S Lee, Julian R Marchesi, Ann Smith, Stefano Cacciatore, Elaine Holmes, Jeremy K Nicholson, T G Teoh, David A MacIntyre
BACKGROUND: Preterm birth is the primary cause of infant death worldwide. A short cervix in the second trimester of pregnancy is a risk factor for preterm birth. In specific patient cohorts, vaginal progesterone reduces this risk. Using 16S rRNA gene sequencing, we undertook a prospective study in women at risk of preterm birth (n = 161) to assess (1) the relationship between vaginal microbiota and cervical length in the second trimester and preterm birth risk and (2) the impact of vaginal progesterone on vaginal bacterial communities in women with a short cervix...
January 19, 2017: Microbiome
https://www.readbyqxmd.com/read/28079869/racial-and-social-predictors-of-longitudinal-cervical-measures-the-cervical-ultrasound-study
#8
E W Harville, K S Miller, L R Knoepp
OBJECTIVE: To evaluate whether the racial and socioeconomic disparities are present in adverse cervical parameters, and, if so, when such disparities develop. STUDY DESIGN: A prospective cohort study was conducted. 175 women with a prior preterm birth had up to four endovaginal ultrasounds between gestational weeks 16 and 24 (Cervical Ultrasound Trial of the MFMU). Each sociodemographic factor (race/ethnicity, marital status, insurance funding and education) was examined as a predictor of short cervix or U/funnel shape, using multiple logistic and linear regression...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28068849/maternal-serum-calponin-1-level-as-a-biomarker-for-the-short-term-prediction-of-preterm-birth-in-women-with-threatened-preterm-labor
#9
Orkun Cetin, Erbil Karaman, Baris Boza, Numan Cim, Hanım Guler Sahin
PURPOSE: To assess the utility of maternal serum calponin 1 level in the prediction of delivery within 7 days among pregnancies complicated with threatened preterm labor. MATERIALS AND METHODS: Eligible women who presented at 24-34 weeks of gestation with threatened preterm labor underwent sampling for serum calponin 1 level and cervical length measurement. They were followed-up until delivery prospectively and the perinatal outcomes of the patients were recorded...
January 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28068594/prevention-of-spontaneous-preterm-birth-guidelines-for-clinical-practice-from-the-french-college-of-gynaecologists-and-obstetricians-cngof
#10
REVIEW
Loïc Sentilhes, Marie-Victoire Sénat, Pierre-Yves Ancel, Elie Azria, Guillaume Benoist, Julie Blanc, Gilles Brabant, Florence Bretelle, Stéphanie Brun, Muriel Doret, Chantal Ducroux-Schouwey, Anne Evrard, Gilles Kayem, Emeline Maisonneuve, Louis Marcellin, Stéphane Marret, Nicolas Mottet, Sabine Paysant, Didier Riethmuller, Patrick Rozenberg, Thomas Schmitz, Héloïse Torchin, Bruno Langer
In France, 60,000 neonates are born preterm every year (7.4%), half of them after the spontaneous onset of labor. Among preventable risk factors of spontaneous prematurity, only cessation of smoking is associated with decreased prematurity (level of evidence [LE]1). It is therefore recommended (Grade A). Routine screening and treatment of vaginal bacteriosis is not recommended in the general population (Grade A). The only population for which vaginal progesterone is recommended is that comprising asymptomatic women with singleton pregnancies, no history of preterm delivery, and a short cervix at 16-24 weeks of gestation (Grade B)...
December 30, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28067007/vaginal-progesterone-decreases-preterm-birth-and-neonatal-morbidity-and-mortality-in-women-with-a-twin-gestation-and-a-short-cervix-an-updated-meta-analysis-of-individual-patient-data
#11
REVIEW
Roberto Romero, Agustin Conde-Agudelo, Waleed El-Refaie, Line Rode, Maria L Brizot, Elcin Cetingoz, Vicente Serra, Eduardo Da Fonseca, Mohamed S Abdelhafez, Ann Tabor, Alfredo Perales, Sonia S Hassan, Kypros H Nicolaides
OBJECTIVE: To assess the efficacy of vaginal progesterone for the prevention of preterm birth and neonatal morbidity and mortality in asymptomatic women with a twin gestation and a sonographic short cervix (cervical length ≤25 mm) in the midtrimester. METHODS: Updated systematic review and meta-analysis of individual patient data from randomized controlled trials comparing vaginal progesterone with placebo/no treatment in women with a twin gestation and a midtrimester sonographic cervical length ≤25 mm...
January 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28055026/anterior-uterocervical-angle-measurement-improves-prediction-of-cerclage-failure
#12
J C Knight, E Tenbrink, J Sheng, A S Patil
OBJECTIVE: To compare the anterior uterocervical angle and cervical length as predictors of spontaneous preterm delivery in patients with transvaginal cerclage. STUDY DESIGN: We retrospectively evaluated a cohort of 142 pregnant women with transvaginal cerclage placed over a 5-year period (2010 to 2015) were evaluated. Cervical morphology characteristics were measured from endovaginal imaging, including cervical length, cerclage height, funnel volume and anterior uterocervical angle prior to cerclage placement (UCA 1), shortly after cerclage placement (UCA 2) and the last image prior to delivery (UCA 3)...
January 5, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28029462/-prediction-of-preterm-delivery-in-symptomatic-women-preterm-labor
#13
G Benoist
OBJECTIVES: To evaluate the predictors of spontaneous preterm birth in case of preterm labor. MATERIALS AND METHODS: Literature search in Medline and Cochrane databases and recommendations of international societies. Selection of studies in symptomatic women (with preterm labor). RESULTS: Preterm labor is defined as a clinical situation occurring between 22 and 36 weeks + 6 days, in which cervical changes are observed associated with uterine contractions, evolving spontaneously or not to preterm delivery (Professional consensus)...
October 28, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28029461/-prevention-of-preterm-birth-by-uterine-cervical-cerclage
#14
L Marcellin
OBJECTIVE: To review the scientific literature on cervical insufficiency and indications of cervical cerclage cervix. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and international obstetrical societies between 1972 and June 2016 have been consulted. RESULTS: Cervical insufficiency is a pathophysiological concept and to date no consensual definition is available: the diagnosis is clinical and discussed retrospectively in case of patients with a history of late miscarriages and/or spontaneous preterm delivery, with asymptomatic dilatation of the cervix (professional consensus)...
October 29, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28029460/-predictive-tools-of-preterm-birth-in-asymptomatic-high-risk-pregnancy
#15
J Blanc, F Bretelle
OBJECTIVE: Describe tools designed to predict preterm birth in asymptomatic high-risk pregnancy and determine their predictive value. METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Obstetric history particularly spontaneous preterm birth identifies a population at risk for preterm birth for the current pregnancy (LE3). This risk is related to the number of prior preterm birth and is even higher than the term of the prior event is more premature and that the event concerns the last pregnancy (LE3)...
October 29, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27997053/cervical-length-screening-for-prevention-of-preterm-birth-in-singleton-pregnancies-with-threatened-preterm-labor-a-cochrane-systematic-review-and-meta-analysis-of-randomized-controlled-trials-using-individual-patient-level-data
#16
REVIEW
Vincenzo Berghella, Montse Palacio, Amen Ness, Zarko Alfirevic, Kypros Nicolaides, Gabriele Saccone
OBJECTIVE: Cervical length screening by transvaginal ultrasound has been shown to be a good predictive test for spontaneous preterm birth (PTB) in symptomatic singleton pregnancies with threatened preterm labor (PTL). The aim of this Cochrane review and meta-analysis of individual participant data was to evaluate the effect of using knowledge of transvaginal ultrasound cervical length (TVU CL) in preventing PTB in singleton pregnancies presenting with threatened PTL. METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register and the Cochrane Complementary Medicine Field's Trials Register (May 2016) and reference lists of retrieved studies...
December 20, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27974821/tracking-the-impact-of-excisional-cervical-treatment-on-the-cervix-using-biospectroscopy
#17
Diane E Halliwell, Maria Kyrgiou, Anita Mitra, Ilkka Kalliala, Evangelos Paraskevaidis, Georgios Theophilou, Pierre L Martin-Hirsch, Francis L Martin
Local excisional treatment for cervical intra-epithelial neoplasia (CIN) is linked to significant adverse sequelae including preterm birth, with cone depth and radicality of treatment correlating to the frequency and severity of adverse events. Attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy can detect underlying cervical disease more accurately than conventional cytology. The chemical profile of cells pre- and post-treatment may differ as a result of altered biochemical processes due to excision, or treatment of the disease...
December 15, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27936911/bacterial-and-cytokine-mixtures-predict-the-length-of-gestation-and-are-associated-with-mirna-expression-in-the-cervix
#18
Alison P Sanders, Chris Gennings, Katherine Svensson, Valeria Motta, Adriana Mercado-Garcia, Maritsa Solano, Andrea A Baccarelli, Martha M Tellez-Rojo, Robert O Wright, Heather H Burris
AIM: Bacterial vaginosis may lead to preterm birth through epigenetic programming of the inflammatory response, specifically via miRNA expression. METHODS: We quantified bacterial 16S rRNA, cytokine mRNA and 800 miRNA from cervical swabs obtained from 80 women at 16-19 weeks' gestation. We generated bacterial and cytokine indices using weighted quantile sum regression and examined associations with miRNA and gestational age at delivery. RESULTS & DISCUSSION: Each decile of the bacterial and cytokine indices was associated with shorter gestations (p < 0...
January 2017: Epigenomics
https://www.readbyqxmd.com/read/27928435/a-debate-about-ultrasound-and-anatomic-aspects-of-the-cervix-in-spontaneous-preterm-birth
#19
REVIEW
Bohîlțea Re, Munteanu O, Turcan N, Baros A, Bodean O, Voicu D, Cîrstoiu Mm
Preterm birth is the legal first global cause of neonatal death. The cervix has two roles: it has to stay closed to allow the fetus to undergo a normal development during gestation, and at term, the cervix has to dilate under the pressure of uterine contractions to allow the delivery. The purpose of this article is to establish if the ultrasound measured length of the cervix and its appearance are predictive for the spontaneous preterm birth. Cervical insufficiency can be described by painless cervical dilatation leading to pregnancy losses/ births, with no other risk factors present...
October 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27925148/a-comparison-of-vaginal-ultrasound-and-digital-examination-in-predicting-preterm-delivery-in-women-with-threatened-preterm-labor-a-cohort-study
#20
Anne Pinton, François Severac, Nicolas Meyer, Cherif Y Akladios, Adrien Gaudineau, Romain Favre, Bruno Langer, Nicolas Sananes
INTRODUCTION: The aim of this study is to evaluate the utility of digital examination in addition to ultrasonic measurement of cervical length for predicting spontaneous preterm delivery in women with threatened preterm labor. MATERIAL AND METHODS: This was a prospective cohort study in Strasbourg University Hospital, France, between January 2013 and January 2015. All women with a singleton pregnancy hospitalized with threatened preterm labor between 23 and 34 weeks of gestation were included...
December 7, 2016: Acta Obstetricia et Gynecologica Scandinavica
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