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Cervical length and preterm birth

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https://www.readbyqxmd.com/read/29344987/prior-uterine-evacuation-and-the-risk-of-short-cervical-length-a-retrospective-cohort-study
#1
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
https://www.readbyqxmd.com/read/29303014/decrease-in-the-incidence-of-threatened-preterm-labor-after-implementation-of-transvaginal-ultrasound-cervical-length-universal-screening
#2
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
https://www.readbyqxmd.com/read/29297658/current-perspectives-on-the-use-of-fetal-fibronectin-testing-in-preterm-labor-diagnosis-and-management
#3
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
https://www.readbyqxmd.com/read/29295659/optimal-timing-of-antenatal-corticosteroids-in-women-with-bleeding-placenta-previa-or-low-lying-placenta
#4
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 2, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29260226/effect-of-cervical-pessary-on-spontaneous-preterm-birth-in-women-with-singleton-pregnancies-and-short-cervical-length-a-randomized-clinical-trial
#5
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/29212400/cervical-pessaries-for-the-prevention-of-preterm-birth-a-systematic-review-and-meta-analysis
#6
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
https://www.readbyqxmd.com/read/29207386/follow-up-of-asymptomatic-high-risk-patients-with-normal-cervical-length-to-predict-recurrence-of-preterm-birth
#7
Javier Caradeux, Clara Murillo, Carla Julià, Silvia Escura, Silvia Ferrero, Teresa Cobo, Eduard Gratacós, Montse Palacio
BACKGROUND: A midtrimester cervical length (CL) <25 mm is associated with spontaneous preterm birth (sPTB). However, as CL ≥25 mm is not enough to exclude recurrence in high-risk patients, follow-up CL measurement later in pregnancy has been proposed. OBJECTIVES: To evaluate whether CL measurement at 26±1 weeks in asymptomatic high-risk patients improves the prediction of sPTB recurrence. METHODS: A retrospective cohort of high-risk women because of previous sPTB was analyzed...
December 5, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29205573/serum-relaxin-and-cervical-length-for-the-prediction-of-spontaneous-preterm-birth-in-second-trimester-symptomatic-women
#8
Athanasios Pantelis, Alexandros Sotiriadis, Kimon Chatzistamatiou, Georgios Pratilas, Konstantinos Dinas
OBJECTIVE: to investigate whether serum relaxin is associated with preterm birth in symptomatic women, either as a standalone test or in the context of a combined model. METHODS: This was a case-control study of women with singleton pregnancy, who presented between 24+0 and 26+6 weeks with threatened preterm labor and intact membranes. Cervical length, full blood count, C-reactive protein and maternal demographics were recorded at presentation. Blood samples were taken for relaxin and these parameters were compared between women who delivered <37 weeks (N=46) and women delivering at term (N=66)...
December 5, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29188370/predictors-of-cerclage-failure-in-patients-with-singleton-pregnancy-undergoing-prophylactic-cervical-cerclage
#9
K Taghavi, M L Gasparri, D Bolla, D Surbek
PURPOSE: The role of cervical cerclage to prevent preterm birth (PTB) remains controversial. The aim of this study was to identify prognostic factors for cerclage failure among singleton pregnant women following prophylactic cerclage (PC). METHODS: A retrospective analysis of PC was performed in a single center. The main outcome measure was cerclage failure, defined by spontaneous early PTB prior to 32 weeks' gestation. Age, BMI, history of instrumentation of the uterus, history of second trimester miscarriage, previous conization, positive vaginal swab prior cerclage, gestational age at time of cerclage, CRP 1 week after cerclage and post-cerclage US changes of cervical length were tested as predictive factors...
November 29, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29157866/vaginal-progesterone-for-preventing-preterm-birth-and-adverse-perinatal-outcomes-in-singleton-gestations-with-a-short-cervix-a-meta-analysis-of-individual-patient-data
#10
Roberto Romero, Agustin Conde-Agudelo, Eduardo Da Fonseca, John M O'Brien, Elcin Cetingoz, George W Creasy, Sonia S Hassan, Kypros H Nicolaides
BACKGROUND: The efficacy of vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix has been questioned after publication of the OPPTIMUM study. OBJECTIVE: To determine whether vaginal progesterone prevents preterm birth and improves perinatal outcomes in asymptomatic women with a singleton gestation and a midtrimester sonographic short cervix. DATA SOURCES: MEDLINE, EMBASE, LILACS, and CINAHL (from their inception to September 2017), Cochrane databases, bibliographies, and conference proceedings...
November 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29155504/cervical-funneling-or-intra-amniotic-debris-and-preterm-birth-among-nulliparous-women-with-a-midtrimester-cervical-length-less-than-30-mm
#11
George R Saade, Elizabeth A Thom, William A Grobman, Jay D Iams, Brian M Mercer, Uma M Reddy, Alan T N Tita, Dwight J Rouse, Yoram Sorokin, Ronald J Wapner, Kenneth J Leveno, Sean C Blackwell, M Sean Esplin, Jorge E Tolosa, John M Thorp, Steve N Caritis, J Peter VanDorsten
OBJECTIVE: To evaluate whether the presence of cervical funneling or intra-amniotic debris identified in the second trimester is associated with higher rates of preterm birth (PTB) in asymptomatic nulliparous women with a midtrimester cervical length (CL) less than 30 mm (i.e., less than the 10(th) percentile). METHODS: A secondary cohort analysis of a multicenter trial of women between 16 and 22 weeks with a singleton gestation and a CL less than 30 mm by transvaginal ultrasound randomized to either 17-alpha hydroxyprogesterone caproate or placebo...
November 20, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29108444/outcomes-after-periviable-ultrasound-indicated-cerclage
#12
Daphnie Drassinower, Elizabeth Coviello, Helain J Landy, Cynthia Gyamfi-Bannerman, Annette Perez-Delboy, Alexander M Friedman
BACKGROUND: Cerclage placed for a sonographically short cervix has been shown to reduce the risk of preterm delivery in women with a history of prior preterm birth. While short cervix is traditionally placed before viability, the threshold gestational age at which viability is achieved continues to decrease, and, as a result, a larger subset of women may be ineligible to receive this potentially beneficial procedure. OBJECTIVE: To evaluate the association between obstetric outcomes and perioperative complications after placement of an ultrasound-indicated cerclage at periviability compared to placement in the previable period...
November 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29103351/cervical-pessary-for-preventing-preterm-birth-a-meta-analysis
#13
Zhen Jin, Liqin Chen, Dongyan Qiao, Astha Tiwari, Chhavi Devi Jaunky, Baiyun Sun, Lina Wang, Hong Yu
OBJECTIVE: To evaluate the efficacy of cervical pessary in the prevention of preterm birth and its influence on pregnancy and maternal outcomes, so as to provide a clinical basis for cervical pessary to prevent premature delivery. METHODS: The databases of PubMed, Web of Science, CNKI, WanFang Data, etc, were used to search for the eligible articles. The relevant data were abstracted by two independent reviewers and performed with Stata 12.0. RESULTS: Pregnancy Result: the PTB rates of pessary and control group before 28, 32, 34, and 37 weeks were analyzed and the combined RR (95%CI) values were 0...
November 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29095502/obstetric-outcomes-after-conservative-treatment-for-cervical-intraepithelial-lesions-and-early-invasive-disease
#14
REVIEW
Maria Kyrgiou, Antonios Athanasiou, Ilkka E J Kalliala, Maria Paraskevaidi, Anita Mitra, Pierre Pl Martin-Hirsch, Marc Arbyn, Phillip Bennett, Evangelos Paraskevaidis
BACKGROUND: The mean age of women undergoing local treatment for pre-invasive cervical disease (cervical intra-epithelial neoplasia; CIN) or early cervical cancer (stage IA1) is around their 30s and similar to the age of women having their first child. Local cervical treatment has been correlated to adverse reproductive morbidity in a subsequent pregnancy, however, published studies and meta-analyses have reached contradictory conclusions. OBJECTIVES: To assess the effect of local cervical treatment for CIN and early cervical cancer on obstetric outcomes (after 24 weeks of gestation) and to correlate these to the cone depth and comparison group used...
November 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29077171/preterm-birth-incidence-risk-factors-and-second-trimester-cervical-length-in-a-single-center-population-a-two-year-retrospective-study
#15
R Granese, S Mantegna, S Mondello, D Amadore, G Imbesi, G Calagna, R Marci, E R Magro Malosso, O Triolo
OBJECTIVE: To report the incidence and the major risk factors (RFs) associated with preterm birth (PTB), combining both maternal RFs and cervical length (CL), and to understand if cervical length measurement is really useful in all the patients. PATIENTS AND METHODS: The study population consisted of 2048 women admitted to the Department of Obstetrics and Gynecology, University Hospital of Messina, over a 2-year period. Preterm cases represented approximately 8...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29055173/safety-and-efficacy-of-the-cervical-pessary-combined-with-vaginal-progesterone-for-the-prevention-of-spontaneous-preterm-birth
#16
Georgios Daskalakis, Dimitrios Zacharakis, Marianna Theodora, Panagiotis Antsaklis, Nikolaos Papantoniou, Dimitris Loutradis, Aris Antsaklis
INTRODUCTION: The aim of this study was to evaluate the safety and efficacy of the combined treatment of cervical pessary and endovaginal progesterone for the prevention of spontaneous preterm birth (SPB) in women with a short cervical length (CL) between 20 and 24 weeks of gestation. MATERIALS AND METHODS: This is a prospective study of women with a singleton pregnancy and a sonographically detected mid-trimester CL ≤25 mm. The primary outcome measure was spontaneous delivery before 34 weeks (238 days) of gestation...
October 21, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29033106/current-options-for-mechanical-prevention-of-preterm-birth
#17
REVIEW
Rupsa C Boelig, Vincenzo Berghella
Cervical insufficiency can be defined by a combination of obstetric history, cervical dilation on exam, and/or short cervical length in women with prior preterm birth. Options for mechanical intervention include cerclage and pessary. There is evidence to support the benefit of a cervical cerclage in women with singleton gestations who have a diagnosis of cervical insufficiency either based on second trimester painless cervical dilatation leading to recurrent early preterm births, or a history of early spontaneous preterm birth and a second trimester transvaginal ultrasound short cervical length or cervical dilation on exam...
December 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28989916/use-of-progesterone-supplement-therapy-for-prevention-of-preterm-birth-review-of-literatures
#18
REVIEW
Suk-Joo Choi
Preterm birth (PTB) is one of the most common complications during pregnancy and it primarily accounts for neonatal mortality and numerous morbidities including long-term sequelae including cerebral palsy and developmental disability. The most effective treatment of PTB is prediction and prevention of its risks. Risk factors of PTB include history of PTB, short cervical length (CL), multiple pregnancies, ethnicity, smoking, uterine anomaly and history of curettage or cervical conization. Among these risk factors, history of PTB, and short CL are the most important predictive factors...
September 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28942691/twin-transvaginal-cervical-length-at-16-20-weeks-and-prediction-of-preterm-birth
#19
Ashley E Hester, Nana-Ama E Ankumah, Suneet P Chauhan, Sean C Blackwell, Baha M Sibai
OBJECTIVE: Our objective was to determine if transvaginal cervical length at 16-20 weeks is predictive of preterm birth <34 weeks in a large cohort of twin pregnancies. STUDY DESIGN: This is a secondary analysis from a randomized trial of 17 alpha-hydroxyprogesterone caproate in twins to prevent preterm birth. Transvaginal cervical length was performed at 16-20-week gestation. The inclusion criteria were non-anomalous twins with transvaginal cervical length at 16-20 weeks...
October 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28940481/prevention-of-preterm-birth-with-pessary-in-singletons-popps-a-randomized-controlled-trial
#20
Lorraine Dugoff, Vincenzo Berghella, Harish Sehdev, A Dhanya Mackeen, Laura Goetzl, Jack Ludmir
OBJECTIVE: To determine if pessary use prevents preterm birth in singleton gestations with a short transvaginal ultrasound cervical length and without a prior spontaneous preterm birth. METHODS: In this open-label multicenter randomized trial we enrolled asymptomatic women with singleton gestations with a transvaginal ultrasound cervical length ≤ 25 mm at 18(0) -23(6) weeks and no prior spontaneous preterm birth. Subjects were randomized to receive the Bioteque cup pessary or no pessary...
September 20, 2017: Ultrasound in Obstetrics & Gynecology
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