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Cervical length and preterm birth

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https://www.readbyqxmd.com/read/27889000/not-transabdominal
#1
EDITORIAL
Adeeb Khalifeh, Vincenzo Berghella
Preterm birth remains a major cause of perinatal morbidity and mortality. A short cervix is strongly associated with spontaneous preterm birth. Professional organizations support cervical length screening for singleton gestations with a prior spontaneous preterm birth and second-trimester cervical length measurements between 16-24 weeks. All interventions used to decrease the risk of preterm birth in women with a short cervix are based on clinical trials that used transvaginal cervical length measurement, but transabdominal ultrasound has been shown to correlate well with transvaginal measurement in some observational studies...
December 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27888999/transabdominal-ultrasound-is-appropriate
#2
EDITORIAL
David Stamilio, Laura M Carlson
Preterm birth remains a major cause of perinatal morbidity and mortality. A short cervix is strongly associated with spontaneous preterm birth. Professional organizations support cervical length screening for singleton gestations with a prior spontaneous preterm birth and second-trimester cervical length measurements between 16-24 weeks. All interventions used to decrease the risk of preterm birth in women with a short cervix are based on clinical trials that used transvaginal cervical length measurement, but transabdominal ultrasound has been shown to correlate well with transvaginal measurement in some observational studies...
December 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27871275/rationale-and-design-of-support-a-multi-centre-randomised-controlled-trial-to-compare-three-treatments-cervical-cerclage-cervical-pessary-and-vaginal-progesterone-for-the-prevention-of-preterm-birth-in-women-who-develop-a-short-cervix
#3
Natasha L Hezelgrave, Helena A Watson, Alexandra Ridout, Falak Diab, Paul T Seed, Evonne Chin-Smith, Rachel M Tribe, Andrew H Shennan
BACKGROUND: Clinically, once a woman has been identified as being at risk of spontaneous preterm birth (sPTB) due to a short cervical length, a decision regarding prophylactic treatment must be made. Three interventions have the potential to improve outcomes: cervical cerclage (stitch), vaginal progesterone and cervical pessary. Each has been shown to have similar benefit in reduction of sPTB, but there have been no randomised control trials (RCTs) to compare them. METHODS: This open label multi-centre UK RCT trial, will evaluate whether the three interventions are equally efficacious to prevent premature birth in women who develop a short cervix (<25 mm on transvaginal ultrasound)...
November 21, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27843353/prevention-of-preterm-delivery-current-challenges-and-future-prospects
#4
REVIEW
Maud D van Zijl, Bouchra Koullali, Ben Wj Mol, Eva Pajkrt, Martijn A Oudijk
Preterm birth (PTB), defined as delivery at <37 weeks of gestation, is the most important cause of neonatal morbidity and mortality. Therefore, preventing PTB is one of the main goals in obstetric care. In this review, we provide an overview of the current available literature on screening for risk factors for PTB and a summary of preventive strategies in both low-risk and high-risk women with singleton or multiple gestations. Furthermore, current challenges and future prospects on PTB are discussed. For an optimal prevention of PTB, risk stratification should be based on a combination of (maternal) risk factors, obstetric history, and screening tools...
2016: International Journal of Women's Health
https://www.readbyqxmd.com/read/27836521/-does-post-operative-sonographic-position-of-preventive-cervical-cerclage-affect-gestational-age-at-birth
#5
L Melle, C Le Ray, P Delorme, O Anselem, F Goffinet, L Marcellin
OBJECTIVE: To evaluate whether the position of preventive cerclage determined by immediate postoperative transvaginal cervical ultrasound is predictive of preterm birth. METHODS: A single-center retrospective study conducted between 1 August 2007 and 31 December 2015 in a maternity type III who included women carrying out for a single pregnancy and who receive a McDonald preventive cerclage. Measurements of internal os-stitch, stitch-external os and the total length of the cervix were performed during immediate postoperative transvaginal cervical ultrasound...
December 2016: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/27836377/-prevention-of-spontaneous-preterm-birth-excluding-preterm-premature-rupture-of-membranes-guidelines-for-clinical-practice%C3%A2-%C3%A2-text-of-the-guidelines-short-text
#6
L Sentilhes, M-V Sénat, P-Y Ancel, E Azria, G Benoist, J Blanc, G Brabant, F Bretelle, S Brun, M Doret, C Ducroux-Schouwey, A Evrard, G Kayem, E Maisonneuve, L Marcellin, S Marret, N Mottet, S Paysant, D Riethmuller, P Rozenberg, T Schmitz, H Torchin, B Langer
OBJECTIVES: To determine the measures to prevent spontaneous preterm birth (excluding preterm premature rupture of membranes)and its consequences. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: In France, premature birth concerns 60,000 neonates every year (7.4 %), half of them are delivered after spontaneous onset of labor...
November 8, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27823998/role-of-cervical-cerclage-and-vaginal-progesterone-in-the-treatment-of-cervical-incompetence-with-without-preterm-birth-history
#7
Shao-Wei Wang, Lin-Lin Ma, Shuai Huang, Lin Liang, Jun-Rong Zhang
BACKGROUND: Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality worldwide, and its prevention is an important health-care priority. The cervical incompetence is a well-known risk factor for PTB and its incidence is about 0.1-2.0%, while there is no ideal optimum treatment recommended currently. The cervical incompetence causes about 15% of habitual abortion in 16-28 weeks. This study aimed to evaluate the effectiveness and safety of cervical cerclage and vaginal progesterone in the treatment of cervical incompetence with/without PTB history...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27813278/universal-cervical-length-screening-for-singleton-pregnancies-with-no-history-of-preterm-delivery-or-the-inverse-of-the-pareto-principle
#8
REVIEW
P Rozenberg
: Ultrasound measurement of cervical length in the general population enables the identification of women at risk for spontaneous preterm delivery. Vaginal progesterone is effective in reducing the risk of preterm delivery in this population. This screening associated with treatment by vaginal progesterone is cost-effective. Universal screening of cervical length can therefore be considered justified. Nonetheless, this screening will not appreciably reduce the preterm birth prevalence: in France or UK, where the preterm delivery rate is around 7...
November 4, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27812088/preterm-birth-prevention-post-conization-a-model-of-cervical-length-screening-with-targeted-cerclage
#9
Lindsay M Kindinger, Maria Kyrgiou, David A MacIntyre, Stefano Cacciatore, Angela Yulia, Joanna Cook, Vasso Terzidou, T G Teoh, Phillip R Bennett
Women with a history of excisional treatment (conization) for cervical intra-epithelial neoplasia (CIN) are at increased risk of preterm birth, perinatal morbidity and mortality in subsequent pregnancy. We aimed to develop a screening model to effectively differentiate pregnancies post-conization into low- and high-risk for preterm birth, and to evaluate the impact of suture material on the efficacy of ultrasound indicated cervical cerclage. We analysed longitudinal cervical length (CL) data from 725 pregnant women post-conization attending preterm surveillance clinics at three London university Hospitals over a ten year period (2004-2014)...
2016: PloS One
https://www.readbyqxmd.com/read/27777928/cervicovaginal-fluid-acetate-a-metabolite-marker-of-preterm-birth-in-symptomatic-pregnant-women
#10
Emmanuel Amabebe, Steven Reynolds, Victoria Stern, Graham Stafford, Martyn Paley, Dilly O C Anumba
Changes in vaginal microbiota that is associated with preterm birth (PTB) leave specific metabolite fingerprints that can be detected in the cervicovaginal fluid (CVF) using metabolomics techniques. In this study, we characterize and validate the CVF metabolite profile of pregnant women presenting with symptoms of threatened preterm labor (PTL) by both (1)H-nuclear magnetic resonance spectroscopy (NMR) and enzyme-based spectrophotometry. We also determine their predictive capacity for PTB, singly, and in combination, with current clinical screening tools - cervicovaginal fetal fibronectin (FFN) and ultrasound cervical length (CL)...
2016: Frontiers in Medicine
https://www.readbyqxmd.com/read/27775195/17-alpha-hydroxyprogesterone-caproate-versus-vaginal-progesterone-suppository-for-the-prevention-of-preterm-birth-in-women-with-a-sonographically-short-cervix-a-randomized-controlled-trial
#11
Reihaneh Pirjani, Reza Heidari, Abbas Rahimi-Foroushani, Seyedehsara Bayesh, Arezoo Esmailzadeh
AIM: The aim of this study was to compare 17-alpha-hydroxyprogesterone caproate (17OHP-C) with vaginal progesterone suppository for the prevention of preterm birth in women with a sonographically short cervix and to evaluate the changes of the cervical length (CL) over time. METHODS: In this prospective randomized controlled trial, eligible patients were asymptomatic pregnant women with a sonographically short cervix. The participants in group 1 (n = 147) received vaginal progesterone suppositories at a dose of 400 mg daily and the women in group 2 (n = 150) received an i...
October 24, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27750471/comparison-of-transabdominal-and-transvaginal-ultrasonography-for-the-assessment-of-cervical-length-at-16-23-weeks-of-gestation
#12
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
https://www.readbyqxmd.com/read/27750180/comparison-of-the-actim-partus-test-and-the-fetal-fibronectin-test-in-the-prediction-of-spontaneous-preterm-birth-in-symptomatic-women-undergoing-cervical-length-measurement
#13
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...
November 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27729253/association-between-change-in-cervical-length-and-spontaneous-preterm-birth-in-twin-pregnancies
#14
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
https://www.readbyqxmd.com/read/27718765/vaginal-alpha-lipoic-acid-shows-an-anti-inflammatory-effect-on-the-cervix-preventing-its-shortening-after-primary-tocolysis-a-pilot-randomized-placebo-controlled-study
#15
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
https://www.readbyqxmd.com/read/27718293/rupture-of-the-cervix-during-pregnancy-after-cervical-pessary-insertion-for-preventing-preterm-birth
#16
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
https://www.readbyqxmd.com/read/27718280/combined-treatment-with-cervical-pessary-and-vaginal-progesterone-for-the-prevention-of-preterm-birth-a-randomized-clinical-trial
#17
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
https://www.readbyqxmd.com/read/27704492/association-among-maternal-obesity-cervical-length-and-preterm-birth
#18
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
https://www.readbyqxmd.com/read/27689180/cervical-sonoelastography-and-cervical-length-measurement-but-not-cervicovaginal-interleukin-6-are-predictors-for-preterm-birth
#19
A Weichert, D von Schöning, T Fischer, A Thomas
No abstract text is available yet for this article.
September 2016: Ultrasound International Open
https://www.readbyqxmd.com/read/27661402/placental-implantation-abnormalities-a-modern-approach
#20
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%...
December 2016: Current Opinion in Obstetrics & Gynecology
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