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Cervical length and preterm birth

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https://www.readbyqxmd.com/read/28418597/mid-trimester-residual-cervical-length-and-the-risk-of-preterm-birth-in-pregnancies-after-abdominal-radical-trachelectomy-a-retrospective-analysis
#1
Yoshifumi Kasuga, Kei Miyakoshi, Hiroshi Nishio, Yohei Akiba, Toshimitsu Otani, Marie Fukutake, Satoru Ikenoue, Daigo Ochiai, Tadashi Matsumoto, Kyoko Tanaka, Kazuhiro Minegishi, Naoaki Kuji, Rachel Roberts, Daisuke Aoki, Mamoru Tanaka
OBJECTIVE: To investigate the association between the mid-trimester residual cervical length (CL) and the risk of preterm birth in pregnancies after abdominal radical trachelectomy (RT). DESIGN: Retrospective cohort study. SETTING: University Hospital. POPULATION: A total of 33 deliveries after 22 weeks' gestation in 30 women who underwent abdominal RT including prophylactic cervical cerclage and perinatal care between January 2002 and May 2016...
April 18, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28399138/short-cervical-lengths-initially-detected-in-mid-trimester-and-early-in-the-third-trimester-in-asymptomatic-twin-gestations-association-with-histologic-chorioamnionitis-and-preterm-birth
#2
Jeong Woo Park, Kyo Hoon Park, Eun Young Jung, Soo-Hyun Cho, Ji Ae Jang, Ha-Na Yoo
OBJECTIVE: To determine whether short cervical lengths (≤20 mm) that were initially detected in mid-trimester and early in the third trimester are independently associated with increased risks of subsequent histologic chorioamnionitis and spontaneous preterm birth (SPTB, defined as a delivery before 34 weeks) in asymptomatic women with twin pregnancies. MATERIAL AND METHODS: This is a prospective study including 292 consecutive asymptomatic women with twin gestations...
2017: PloS One
https://www.readbyqxmd.com/read/28398701/cervical-pessary-for-preventing-preterm-birth-in-singleton-pregnancies-with-short-cervical-length-a-systematic-review-and-meta-analysis
#3
Gabriele Saccone, Andrea Ciardulli, Serena Xodo, Lorraine Dugoff, Jack Ludmir, Giorgio Pagani, Silvia Visentin, Salvatore Gizzo, Nicola Volpe, Giuseppe Maria Maruotti, Giuseppe Rizzo, Pasquale Martinelli, Vincenzo Berghella
OBJECTIVES: To evaluate the effectiveness of cervical pessary for preventing spontaneous preterm birth (SPTB) in singleton gestations with a second trimester short cervix. METHODS: Electronic databases were searched from their inception until February 2016. We included randomized clinical trials (RCTs) comparing the use of the cervical pessary with expectant management in singletons pregnancies with transvaginal ultrasound cervical length (TVU CL) ≤25 mm. The primary outcome was incidence of SPTB <34 weeks...
April 11, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28397052/pregnancy-outcomes-following-transvaginal-cerclage-for-cervical-insufficiency-results-from-a-single-center-retrospective-study
#4
Sheng Wang, Ying Wang, Ling Feng
To study maternal and perinatal outcomes after cervical cerclage in both singleton and twin pregnancies, we retrospectively reviewed women undergoing cervical cerclage for cervical insufficiency at Tongji Hospital, Wuhan, China from January 1, 2010 to July 31, 2015 to evaluate primary and secondary outcomes for subgroups with cervical length (CL) ≤15, >15 to <25, and ≥25 mm. Of 166 patients who underwent cervical cerclage, after exclusion of patients with missed abortion and continuing pregnancy, 141 patients (121 singleton and 20 twin pregnancies) were included in the analysis...
April 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28370687/mid-trimester-sonographic-cervical-consistency-index-to-predict-spontaneous-preterm-birth-in-a-low-risk-population
#5
Núria Baños, Clara Murillo-Bravo, Carla Julià, Federico Migliorelli, Alvaro Perez-Moreno, Jose Ríos, Eduard Gratacos, Lil Valentin, Montse Palacio
OBJECTIVES: To estimate the ability of mid-trimester sonographic Cervical Consistency Index (CCI) to predict spontaneous preterm birth (sPTB) in low-risk pregnancies and to compare its performance with mid-trimester sonographic cervical length (CL). METHODS: This is a prospective cohort study including women with singleton pregnancies examined with ultrasound at 19 + 0 to 24 + 6 gestational weeks. All underwent transvaginal ultrasound examination of the cervix, but CCI and CL were measured off-line only in women without risk factors for sPTB...
March 31, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28339114/cervical-length-in-patients-at-risk-for-placenta-accreta
#6
Martha W F Rac, Donald D McIntire, C Edward Wells, Elysia Moschos, Diane D Twickler
OBJECTIVES: To evaluate cervical length measurements in women with placenta accreta compared to women with a nonadherent low-lying placenta or placenta previa and evaluate this relationship in terms of vaginal bleeding, preterm labor, and preterm birth. METHODS: We conducted a retrospective cohort study between 1997 and 2011 of gravidas with more than 1 prior cesarean delivery who had a transvaginal ultrasound examination between 24 and 34 weeks for a low-lying placenta or placenta previa...
March 24, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28320241/implementation-of-a-universal-cervical-length-screening-program-identifying-factors-associated-with-decline-rates
#7
Jeny Ghartey, Neda Ghaffari, Lisa D Levine, Nadav Schwartz, Celeste P Durnwald
PURPOSE: Cervical length (CL) measurement is now accepted as a screening strategy for identifying women at risk for preterm birth (PTB). However, patient acceptability may limit its implementation. Our objective was to identify characteristics associated with women who decline this screening. MATERIALS AND METHODS: This is a secondary analysis of a prospective cohort study of women offered UCL screening from January 2012-June 2012. Women with a singleton gestation 18 0/7-23 6/7 weeks at the time of anatomy scan were included...
March 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28320233/does-cervical-cerclage-decrease-preterm-birth-in-twin-pregnancies-with-a-short-cervix
#8
Tracy M Adams, Timothy J Rafael, Nadia B Kunzier, Supriya Mishra, Rose Calixte, Anthony M Vintzileos
PURPOSE: To determine if use of cerclage in twin gestations with mid-trimester short cervix is associated with decreased preterm birth rate. STUDY DESIGN: This is a retrospective cohort of twin gestations identified with cervical length of ≤2.5 cm before 24 weeks of gestation through the perinatal ultrasound database of two institutions from 2008 to 2014. Patients with and without cerclage were compared for a primary outcome of preterm birth at <35 weeks...
April 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28320033/is-the-relationship-between-short-interpregnancy-interval-and-preterm-birth-related-to-a-short-cervix
#9
S Govindappagari, N Zork, A Merriam, C Gyamfi-Bannerman
Objective Our objective was to determine if the relationship between interpregnancy interval (IPI) and preterm delivery was related to cervical shortening. Methods This is a secondary analysis of a prospective cohort study designed to assess the relationship between cervical length (CL) and preterm delivery. Multiparous patients, who had transvaginal CLs obtained at 22 to 24 weeks and complete pregnancy outcome data available were included. The women were divided into two groups: Group 1 with an IPI of ≤ 1 year and Group 2 with an IPI of > 1 year...
March 20, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28303276/a-parameterized-ultrasound-based-finite-element-analysis-of-the-mechanical-environment-of-pregnancy
#10
Andrea R Westervelt, Michael Fernandez, Michael House, Joy Vink, Chia-Ling Nhan-Chang, Ronald Wapner, Kristin M Myers
Preterm birth is the leading cause of childhood mortality and can lead to health risks in survivors. The mechanical functions of the uterus, fetal membranes, and cervix have dynamic roles to protect the fetus during gestation. To understand their mechanical function and relation to preterm birth, we built a three-dimensional parameterized finite element model of pregnancy. This model is generated by an automated procedure that is informed by maternal ultrasound measurements. A baseline model at 25 weeks of gestation was characterized, and to visualize the impact of cervical structural parameters on tissue stretch, we evaluated the model sensitivity to (1) anterior uterocervical angle, (2) cervical length, (3) posterior cervical offset, and (4) cervical stiffness...
May 1, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28295801/cervical-length-measurement-at-mid-gestation-to-predict-spontaneous-preterm-birth-in-asymptomatic-triplet-pregnancies
#11
A Fichera, G Pagani, V Stagnati, S Cascella, S Faiola, C Gaini, M Lanna, L Pasquini, R Raffaelli, T Stampalija, A Tommasini, F Prefumo
OBJECTIVE: To assess the predictive value of cervical length (CL) measured at mid gestation for spontaneous preterm birth (PTB) in triplet pregnancies. METHODS: Retrospective study on asymptomatic triplet pregnancies followed at five Italian tertiary referral centres, between 2002 and 2015. CL was measured transvaginally between 18-24 weeks of gestation. Pregnancies with a medically indicated PTB were excluded. Demographic and pregnancy characteristics of pregnancies complicated with PTB were analysed and the distributions of CL measurements in these patients were calculated...
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295722/cerclage-for-short-cervix-on-ultrasound-in-singleton-gestations-without-prior-spontaneous-preterm-birth-a-systematic-review-and-meta-analysis-of-trials-using-individual-patient-level-data
#12
REVIEW
Vincenzo Berghella, Andrea Ciardulli, Orion A Rust, Meekai To, Katsufumi Otsuki, Sietske Althuisius, Kypros Nicolaides, Amanda Roman, Gabriele Saccone
OBJECTIVE: The aim of this systematic review and meta-analysis was to quantify the efficacy of cervical cerclage in preventing preterm birth (PTB) in asymptomatic singleton pregnancies with a mid-trimester short transvaginal ultrasound cervical length (TVU CL) and without prior spontaneous PTB. METHODS: Electronic databases were searched from inception of each database until February 2017. No language restrictions were applied. We included all randomized controlled trials (RCTs) of asymptomatic singleton pregnancies without prior spontaneous PTB screened with TVU CL, found to have a midtrimester short CL <25 mm, and then randomized to management with either cerclage (i...
March 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295170/implementing-universal-cervical-length-screening-in-asymptomatic-women-with-singleton-pregnancies-challenges-and-opportunities
#13
Michelle K Pedretti, Brenda M Kazemier, Jan E Dickinson, Ben W J Mol
Cervical length (CL) screening has been successfully utilised to identify asymptomatic women, with a singleton pregnancy, at risk of preterm birth (PTB), thereby providing an opportunity to offer interventions that may reduce that risk. Cervical length screening with ultrasound is most effectively performed with a transvaginal approach. Universal cervical length screening, encompassing all singleton pregnancies rather than restricting screening to those considered at increased risk of PTB, is currently not widely used, despite a growing body of evidence in support of its utility for PTB prevention...
March 10, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28291893/predictive-accuracy-of-serial-transvaginal-cervical-lengths-and-quantitative-vaginal-fetal-fibronectin-levels-for-spontaneous-preterm-birth-among-nulliparous-women
#14
M Sean Esplin, Michal A Elovitz, Jay D Iams, Corette B Parker, Ronald J Wapner, William A Grobman, Hyagriv N Simhan, Deborah A Wing, David M Haas, Robert M Silver, Matthew K Hoffman, Alan M Peaceman, Steve N Caritis, Samuel Parry, Pathik Wadhwa, Tatiana Foroud, Brian M Mercer, Shannon M Hunter, George R Saade, Uma M Reddy
Importance: Spontaneous preterm birth is a leading cause of infant mortality. Prediction, largely based on prior pregnancy outcomes, is not possible in women pregnant for the first time. Objective: To assess the accuracy of universal screening to predict spontaneous preterm birth in nulliparous women using serial measurements of vaginal fetal fibronectin levels and cervical length. Design, Settings, and Participants: A prospective observational cohort study of nulliparous women with singleton pregnancies, from 8 clinical sites across the United States between October 2010 and May 2014...
March 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28282774/cervical-length-in-adolescents-versus-adults
#15
Jessica N Buck, Kelly M Orzechowski, Jason K Baxter, Vincenzo Berghella
PURPOSE: Two of the known risk factors for spontaneous preterm birth (sPTB) are short cervical length (CL) ≤ 25 mm and adolescence (≤19 years). Our objective was to evaluate whether adolescent women have a higher incidence of short CL compared to their 20-24 year old counterparts. MATERIALS AND METHODS: Retrospective cohort of nulliparous singleton gestations undergoing universal second trimester transvaginal ultrasound (TVU) CL screening between January 2012 and June 2013...
February 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28277920/the-role-of-serial-measurements-of-cervical-length-in-asymptomatic-women-with-triplet-pregnancy
#16
Hadar Rosen, Liran Hiersch, Howie Freeman, Jon Barrett, Nir Melamed
OBJECTIVE: To assess the predictive accuracy of serial measurements of cervical length (CL) for preterm birth in asymptomatic women with triplet pregnancy. METHODS: A retrospective study of women with triplets who underwent serial sonographic measurements of CL until 28-32 weeks of gestation. The predictive accuracy of CL for preterm birth was determined at 4 periods along gestation: 18-20 weeks (period 1), 21-24 weeks (period 2), 25-27 weeks (period 3) and 28-32 weeks (period 4)...
February 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28277132/maternal-serum-cytokine-levels-in-pregnancies-complicated-with-threatened-preterm-labour
#17
Alejandra Herrera-Muñoz, Ana M Fernández-Alonso, Natalia Fischer-Suárez, Peter Chedraui, Faustino R Pérez-López
OBJECTIVE: To investigate serum inflammatory markers in singleton gestations complicated with threatened preterm labour (TPL). METHODS: Pregnant women complicated with TPL (n = 61) were recruited to measure maternal serum levels of a panel of cytokines and C-reactive protein and then compared to controls without TPL, matched for gestational age (n = 64) and term pregnancies in the prodromal phase of labour (PPL) (n = 31). In addition, baseline cytokine levels were compared among cases and controls according to the outcome...
February 21, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28266156/re-cervical-length-screening-for-prevention-of-preterm-birth-in-singleton-pregnancy-with-threatened-preterm-labor-systematic-review-and-meta-analysis-of-randomized-controlled-trials-using-individual-patient-level-data-v-berghella-m-palacio-a-ness-z-alfirevic
#18
COMMENT
https://www.readbyqxmd.com/read/28258974/assessment-of-cervical-elastography-strain-pattern-and-its-association-with-preterm-birth
#19
Vera Oturina, Kerstin Hammer, Mareike Möllers, Janina Braun, Maria Karina Falkenberg, Kathrin Oelmeier de Murcia, Ute Möllmann, Maria Eveslage, Arrigo Fruscalzo, Walter Klockenbusch, Ralf Schmitz
OBJECTIVE: The aim of the study was to assess the cervical strain pattern by an ultrasound elastography cervix examination and to determine its association with preterm delivery. METHODS: In this study, 30 cases resulting in preterm birth and 30 gestational age-matched controls were included. A vaginal ultrasound examination with cervical length and elastography measurement was performed. We calculated four strain ratios (SR1-SR4) of the regions of interest (ROIs) arranged in pairs in four different positions on the anterior cervical lip...
March 4, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28217665/elastographic-measurement-of-the-cervix-during-pregnancy-current-status-and-future-challenges
#20
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
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