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"cervical length"

Jabacsmick Sharmila Thangaraj, Syed Habeebullah, Sunil Kumar Samal, Sunita S Amal
Objective: Even though cervical length is considered as predictor of timing and mode of delivery, it is not used as a screening tool in low risk asymptomatic population. This study was carried out with the intention to know the timing and mode of delivery in asymptomatic low risk women using second trimester ultrasonographic cervical length measurement and predict the risk of pretermlabor, prolonged pregnancy and need for caesarean section. 1) To determine the association between cervical length at mid-pregnancy and timing of delivery...
March 2018: Journal of Family & Reproductive Health
Richard Brown, Robert Gagnon, Marie-France Delisle
OBJECTIF: La présente directive clinique vise à fournir aux cliniciens un cadre à utiliser pour déterminer quelles femmes présentent un risque accru d'insuffisance cervicale et dans quelles situations le cerclage aurait une valeur potentielle. DONNéES PROBANTES: Nous avons examiné des études publiées récupérées au moyen de recherches dans PubMed, Medline, CINAHL et The Cochrane Library en 2018 à l'aide d'une terminologie (p. ex., uterine cervical incompetence) et de mots-clés (p...
February 2019: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Richard Brown, Robert Gagnon, Marie-France Delisle
OBJECTIVE: The purpose of this guideline is to provide a framework that clinicians can use to determine which women are at greatest risk of having cervical insufficiency and in which set of circumstances a cerclage is of potential value. EVIDENCE: Published literature was retrieved through searches of PubMed or Medline, CINAHL, and The Cochrane Library in 2018 using appropriate controlled vocabulary (e.g., uterine cervical incompetence) and key words (e.g., cervical insufficiency, cerclage, Shirodkar, cerclage, McDonald, cerclage, abdominal, cervical length, mid-trimester pregnancy loss)...
February 2019: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Sofia Amylidi-Mohr, Martin Mueller
Preterm Birth Screening: What Does Really Make Sense? Abstract. Spontaneous preterm birth is a syndrome triggered by multiple mechanisms. In view of the pathophysiological heterogeneity of preterm birth, a single biomarker cannot show the required high negative and positive predictive values. From a clinical point of view, anamnesis, sonographic measurement of cervical length, and placental alpha-microglobulin-1 (PAMG-1) testing from cervico-vaginal secretion are established. Further prospective, large-scale longitudinal studies must validate the combined use of new biomarkers...
January 2019: Praxis
Olga Pustotina
OBJECTIVE: The aim of this prospective study was to assess the efficacy of antibacterial therapy and in combination with vaginal progesterone (VP) or VP/indomethacin for the prevention of adverse pregnancy outcomes in women with the amniotic fluid "sludge" at 15-24 weeks of gestation. METHODS: 245 women underwent transvaginal ultrasound cervical length measurement at 15-24 weeks of pregnancy and 29 out of them with sonographic signs of amniotic fluid "sludge" were included in the study...
January 8, 2019: Journal of Maternal-fetal & Neonatal Medicine
Tino L Tran, Sushma Jwala, Courtney Terenna, Ali McGregor, Anita Das, Jason K Baxter, Vincenzo Berghella
OBJECTIVE: To determine if quantitative fetal fibronectin (qFFN) in addition to transvaginal ultrasound (TVU) cervical length (CL) measurement between 180/7 and 236/7 weeks would be predictive of spontaneous preterm birth (sPTB) at <350/7 weeks among asymptomatic high-risk women as defined by those with prior sPTB > 200/7 weeks. MATERIAL AND METHODS: A prospective observational study of asymptomatic women with singleton gestations between 180/7 and 236/7 weeks and one or more prior SPTB was performed...
January 7, 2019: Journal of Maternal-fetal & Neonatal Medicine
Clifton O Brock, Leslie A Moroz, Cynthia Gyamfi-Bannerman
OBJECTIVE:  To determine the risk of spontaneous preterm delivery (SPTD) associated with transvaginal cervical length (TVCL) in an unselected cohort. METHODS:  This is a retrospective study of serial TVCLs in unselected twin gestations. Receiver operator curves for SPTD were constructed from TVCLs at 18, 20, 22, and 24 weeks. Prediction thresholds were determined using a false discovery rate of 10%. The risk of SPTD was compared with previously published, prospective data from a meta-analysis...
December 28, 2018: American Journal of Perinatology
Anna Fichera, Federico Prefumo, Giorgia Mazzoni, Valentina Molinaris, Cristina Zanardini, Nicola Fratelli, Tiziana Frusca, Enrico Sartori
INTRODUCTION: Spontaneous preterm birth in women with a twin pregnancy is one of the main causes of perinatal mortality and morbidity. Our aim was to review the perinatal outcome of asymptomatic twin pregnancies with a sonographic short cervical length during the second trimester treated with an ultrasound-indicated cerclage or cervical pessary MATERIAL AND METHODS: Retrospective study on asymptomatic twin pregnancies with a short cervix (≤ 25 mm) at ultrasound transvaginal examination, during the second trimester, treated with a cervical cerclage or pessary (2001-2017)...
December 23, 2018: Acta Obstetricia et Gynecologica Scandinavica
Pankhuri Sharma, Simi Khan, Mohan Ghule, V B Shivkumar, Ritu Dargan, Paul T Seed, Archana Sarkar, Sunil Mehra, Poonam Varma Shivkumar, Rachel M Tribe
BACKGROUND: In India, 3.6 million pregnancies are affected by preterm birth annually, with many infants dying or surviving with disability. Currently, there is no simple test available for screening all women at risk of spontaneous PTB in low income setting, although high resource settings routinely use cervical length measurement and cervico-vaginal fluid fetal fibronectin for identification and care of women at risk due to clinical history. In rural India, where the public health system has limited infrastructure, trained staff and equipment, there is a greater need to develop a low-cost screening approach for providing early referral, treatment and remedial support for pregnant women at risk of preterm birth...
December 22, 2018: Reproductive Health
Katherine A Connolly, Luciana Vieira, Elizabeth M Yoselevsky, Stephanie Pan, Joanne L Stone
OBJECTIVE:  To quantify the degree of change in cervical length (CL) over a 3-minute transvaginal ultrasound. STUDY DESIGN:  We conducted a prospective observational study of nulliparous patients who underwent routine transvaginal CL screening at the time of their second-trimester ultrasound. We recorded CL at four time points (0, 1, 2, 3 minutes) and compared these values to determine the minute-to-minute change within a single patient. RESULTS:  A total of 771 patients were included...
December 21, 2018: American Journal of Perinatology
Noelia Zork, Moti Gulersen, Anne Mardy, Caroline Pessel, Sara Brubaker, Joy Vink, Cynthia Gyamfi-Bannerman, Cande V Ananth
OBJECTIVE: To examine the utility of fetal fibronectin (fFN) for predicting spontaneous preterm birth (PTB) in asymptomatic women with a cervical length (CL) < 10 mm compared to those with a CL 11-25 mm. METHODS: Data was collected on all women with nonanomalous singleton and twin gestations who underwent transvaginal CL at a single institution between 2009 and 2012. Women with an incidental short cervix (CL ≤ 25 mm) between 22-32 weeks who had an fFN result within 7 days thereafter were included...
December 20, 2018: Journal of Maternal-fetal & Neonatal Medicine
Wen Liu, Xin Chen, Cong Sun, Xinhong Wei, Guangbin Wang, Ruiqin Shan
This study is to investigate the role of cervical morphology evaluated by magnetic resonance imaging (MRI) in predicting invasive placenta previa (IPP).Totally 105 cases of pregnant women underwent prenatal placental MRI at 32 to 36 weeks of gestation for suspected IPP were included in this study. Cervical morphology (cervical length and placental protrusion) was evaluated independently by 2 radiologists. The association between the cervical morphology and surgery findings was analyzed.Totally, 57 pregnant women were confirmed as IPP...
December 2018: Medicine (Baltimore)
Jane E Norman, John Norrie, Graeme Maclennan, David Cooper, Sonia Whyte, Sarah Cunningham Burley, Joel B E Smith, Andrew Shennan, Stephen C Robson, Steven Thornton, Mark D Kilby, Neil Marlow, Sarah J Stock, Philip R Bennett, Jane Denton
INTRODUCTION: The STOPPIT-2 study aims to determine the clinical utility of the Arabin cervical pessary in preventing preterm birth in women with a twin pregnancy and a short cervix, about which there is current uncertainty. STOPPIT-2 will resolve uncertainty around effectiveness for women with a twin pregnancy and a cervical length of 35 mm or less, define adverse effects, ascertain acceptability and estimate National Health Service costs and savings. METHODS: STOPPIT-2 is a pragmatic multicentre open-label randomised controlled trial...
December 6, 2018: BMJ Open
Chunbo Li, Jie Shen, Keqin Hua
OBJECTIVE: To estimate whether cerclage could extend the prolongation of pregnancy, reduce the risk of preterm birth (PTB) and improve perinatal outcomes in women with twin pregnancies. STUDY DESIGN: The following databases including Medline, EMBASE, Scopus,, Web of Science, and Cochrane Library were searched for all published studies that compared cerclage placement with expectant management in twin pregnancies from inception to July 2018. Each report for inclusion or exclusion standard was reviewed and data extraction was performed by two authors independently...
December 7, 2018: American Journal of Obstetrics and Gynecology
Yelin Lou, Yimin Zhou, Hong Lu, Weiguo Lyu
OBJECTIVE: To establish a prognostic model for preterm birth in women after cervical conization, and to evaluate its effectiveness. METHODS: Seventy three women after cervical conization in Women's Hospital of Zhejiang University were included for this retrospective study. The influencing factors of preterm delivery were analyzed by Logistic regression analysis and a prognostic model was created. Receiver operating characteristic (ROC) curve was used for evaluation of the predictive ability of the model...
February 25, 2018: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Rie Oi, Naoyuki Miyasaka, Takahiro Yamashita, Tomoko Adachi
PURPOSE: A prospective assessment of the risk of spontaneous preterm delivery (sPTD) by evaluating temporal changes in cervical measurements. METHODS: We analyzed clinical variables, focusing on cervical length (CL) and lower uterine segment (LUS) length (LUSL) as measured by transvaginal ultrasonography in 727 pregnant Japanese women. RESULTS: In women undergoing term deliveries, CL increased from gestational week (GW) 8-25. In contrast, the combination of CL and LUSL (ComL for "combined length") gradually decreased and sole LUSL became almost 0 mm by GW 25...
December 1, 2018: Journal of Medical Ultrasonics
Catherine A Bigelow, Mariam Naqvi, Amalia G Namath, Munira Ali, Nathan S Fox
BACKGROUND: Preterm birth is a major cause of neonatal morbidity and mortality in the USA. In many patients at risk for preterm birth, cervical length (CL) screening is used to guide decisions regarding cerclage placement. Quality evidence shows that cerclage prolongs pregnancy in high-risk women with a short CL in women with a history of preterm birth and in women with painless cervical dilation in the second trimester, though the degree of cervical shortening, dilation, or gestational age at cerclage placement are not consistently associated with the subsequent rate of preterm birth...
November 28, 2018: Journal of Maternal-fetal & Neonatal Medicine
Nancy Medley, Joshua P Vogel, Angharad Care, Zarko Alfirevic
BACKGROUND: Preterm birth (PTB) is a major factor contributing to global rates of neonatal death and to longer-term health problems for surviving infants. Both the World Health Organization and the United Nations consider prevention of PTB as central to improving health care for pregnant women and newborn babies. Current preventative clinical strategies show varied efficacy in different populations of pregnant women, frustrating women and health providers alike, while researchers call for better understanding of the underlying mechanisms that lead to PTB...
November 14, 2018: Cochrane Database of Systematic Reviews
Caroline Rouse, David E Cantonwine, Thomas D Shipp
OBJECTIVES: The influence of placental morphologic characteristics on pregnancy outcomes is poorly understood. Our objective was to evaluate the relationship of the distance of the placental cord insertion from the placental edge (PCI-D) with associated placental characteristics as well as birth outcomes. METHODS: We performed a retrospective cohort study of nulliparous women with singleton gestations undergoing obstetric ultrasound examinations between 14 and 23 weeks' gestation with a cervical length of greater than 3...
November 27, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Paul Tyan, Jamal Mourad, Brian Wright, Marc Winter, Devon Garza, Rachael Smith, Janel Brink, Chapman Wei, Gaby Moawad
OBJECTIVE: High-risk pregnancy stratification and the use of Progesterone and prophylactic cerclage based on prior obstetrical outcomes and cervical length screening have been successful in curbing the impact of preterm birth. However, a large number of women will still suffer from preterm delivery even with optimal management. Experts agree that a transabdominal cerclage is the next best option for women who fail a transvaginal cerclage in a prior pregnancy. Our primary objective with this study is to assess the obstetric benefits and feasibility of robotic-assisted transabdominal cerclage in high-risk women projected to have poor obstetric outcomes...
January 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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