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Shortened cervix

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
Barbara Bodner-Adler, Oliver Kimberger, Cora Schneidinger, Heinz Kölbl, Klaus Bodner
AIM: To evaluate pre-treatment serum C-reactive protein (CRP) level as a prognostic parameter in patients with adenocarcinoma of the uterine cervix. MATERIALS AND METHODS: Pre-treatment CRP levels were analyzed to determine potential associations with clinicopathological parameters and to assess prognostic value in 46 patients with sole adenocarcinoma of the uterine cervix. RESULTS: The mean (±SD) pre-treatment serum CRP level was 5.82 (7...
September 2016: Anticancer Research
Malipati Maerdan, Chunyan Shi, Xiaoxiao Zhang, Lixin Fan
OBJECTIVE: The objective of this study is to understand the prevalence of short cervical length between 20 and 24 weeks gestation in China and to evaluate the efficacy of micronized progesterone for prolonging gestation in nulliparous patients with a short cervix. METHODS: From May 2010 to May 2015, a total of 25 328 asymptomatic women with singleton pregnancies at Peking University First Hospital had their cervical length routinely measured between 20 and 24 weeks of gestation...
September 7, 2016: Journal of Maternal-fetal & Neonatal Medicine
Koji Koizumi, Toru Fujioka, Toshiaki Yasuoka, Aya Inoue, Yuka Uchikura, Hiroki Tanaka, Katsuko Takagi, Miki Mori, Masae Koizumi, Hisashi Hashimoto, Takashi Matsumoto, Yuko Matsubara, Keiichi Matsubara, Akihiro Nawa
Multiple techniques have been used for the conservative treatment of high-grade cervical intraepithelial neoplasia (HG-CIN) in women of fertile age. Conization has been associated with stenosis of the cervix and a decrease in cervical mucus secretion, in addition to the increase in the risk of cervical canal shortening and problems during the perinatal period, including premature birth and premature rupture of membranes. Although the laser transpiration technique does not cause shortening of the cervical canal, it is associated with the recurrent risk of deep residual disease...
August 2016: Molecular and Clinical Oncology
Tuncay Yüce, Bahar Konuralp, Erkan Kalafat, Feride Söylemez
The purpose of this case series is to provide preliminary evidence on the efficacy of pessary application in women with short cervix and at risk for preterm labor. Between May 2015 and July 2015, four pregnant women were followed-up with Arabin pessaries. The gestational age at the time of diagnosis was between the 23(th) and 29(th) weeks. Pessary application was associated with a prolongation of pregnancy lasting between 28 and 98 days. The gestational age at the time of delivery was between the 33rd and 39th weeks...
2016: Journal of the Turkish German Gynecological Association
Nir Melamed, Alex Pittini, Liran Hiersch, Yariv Yogev, Steven J Korzeniewski, Roberto Romero, Jon Barrett
BACKGROUND: Cervical length at midtrimester is a powerful predictor of preterm birth in twin gestations. However, given the fact that, in some cases, cervical shortening may become evident only later during the second trimester, it seems reasonable that serial monitoring of cervical length may improve the detection of preterm birth in women with twins. However, data in support of such a practice are limited and conflicting. The contradictory results may be related to the fact that in most of these studies, the analysis of the predictive value of serial measurements of cervical length was limited to data derived from only two sequential measurements of cervical length, while data on the predictive value of multiple (>2) measurements are scarce...
June 27, 2016: American Journal of Obstetrics and Gynecology
Arrigo Fruscalzo, Edoardo Mazza, Helen Feltovich, Ralf Schmitz
In normal pregnancy, the cervix functions as a protective mechanical barrier that must remain tight and closed. Premature remodeling and consecutive shortening occur in many cases of spontaneous preterm birth. Although the complex underlying physiology of normal and abnormal cervical remodeling is not fully understood, it is clear that cervical softening occurs prior to delivery, and inappropriate timing seems to be associated with preterm delivery. Also, degree of cervical softness is a component of the Bishop score currently used clinically to predict successful induction of labor...
October 2016: Journal of Medical Ultrasonics
Nir Melamed, Alex Pittini, Liran Hiersch, Yariv Yogev, Steven S Korzeniewski, Roberto Romero, Jon Barrett
BACKGROUND: Women with a twin gestation are at increased risk for preterm birth (PTB), and sonographic cervical length (CL) is a powerful predictor for spontaneous PTB. Obstetricians frequently monitor CL in multiple gestations; yet, the optimal method to integrate and interpret the results of serial sonographic CL has not been determined. OBJECTIVE: We sought to determine whether there are different patterns of cervical shortening in twin gestations, and whether such patterns are related to the risk of PTB...
October 2016: American Journal of Obstetrics and Gynecology
Roxana Geoffrion, Kimberley Louie, Momoe T Hyakutake, Nicole A Koenig, Terry Lee, James D Filipenko
OBJECTIVE: The cervix often appears to be elongated in women with pelvic organ prolapse (POP). This can pose surgical challenges. MRI evidence has suggested that prolapsed cervices are significantly longer than those in normal controls. Our objective was to compare cervical length in surgical hysterectomy specimens from women with symptomatic POP with the length in specimens from women with other benign gynaecological conditions. METHODS: In this pilot, prospective, case-control study, hysterectomy specimens were collected at St...
March 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
C Huchon, X Deffieux, G Beucher, P Capmas, X Carcopino, N Costedoat-Chalumeau, A Delabaere, V Gallot, E Iraola, V Lavoue, G Legendre, V Lejeune-Saada, J Leveque, S Nedellec, J Nizard, T Quibel, D Subtil, F Vialard, D Lemery
In intrauterine pregnancies of uncertain viability with a gestational sac without a yolk sac (with a mean of three orthogonal transvaginal ultrasound measurements <25mm), the suspected pregnancy loss should only be confirmed after a follow-up scan at least 14 days later shows no embryo with cardiac activity (Grade C). In intrauterine pregnancies of uncertain viability with an embryo <7mm on transvaginal ultrasound, the suspected pregnancy loss should only be confirmed after a follow-up scan at least 7 days later (Grade C)...
June 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Patricia Lynn Hudson, Mary C Brandes
BACKGROUND: Anterior colporrhaphy is associated with a reduction in vaginal length after repair. These 2 case reports describe a potential solution for cervical elongation and prolapse in the setting of shortened vaginal length after anterior colporrhaphy. CASES: Two sexually active women underwent anterior colporrhaphies by outside providers. They quickly re-presented with cervical prolapse and compromised anterior vaginal lengths. In each case, sacrocolpopexy with supracervical hysterectomy was performed, establishing a new vaginal apex...
May 2016: Female Pelvic Medicine & Reconstructive Surgery
Lorene A Temming, Jennifer K Durst, Methodius G Tuuli, Molly J Stout, Jeffrey M Dicke, George A Macones, Alison G Cahill
BACKGROUND: Transvaginal measurement of cervical length (CL) has been advocated as a screening tool to prevent preterm birth, but controversy remains regarding the overall utility of universal screening. OBJECTIVE: We aimed to evaluate the acceptability of a universal CL screening program. Additionally we evaluated risk factors associated with declining screening and subsequent delivery outcomes of women who accepted or declined screening. STUDY DESIGN: This was a retrospective cohort study of transvaginal CL screening at a single institution from July 1, 2011, through December 31, 2014...
April 2016: American Journal of Obstetrics and Gynecology
Tone Shetelig Løvvik, Solhild Stridsklev, Sven M Carlsen, Øyvind Salvesen, Eszter Vanky
CONTEXT: Women with polycystic ovary syndrome (PCOS) have increased risk of preterm delivery. Shortening of the cervix is a sign of preterm delivery. OBJECTIVE: This study aimed to investigate potential effect of metformin on cervical length and whether androgen levels correlate with cervical length in PCOS pregnancies. DESIGN AND SETTING: This was a sub-study of a randomized, placebo-controlled, multicenter study (The PregMet study) performed at 11 secondary or tertiary centers from 2005 to 2009...
June 2016: Journal of Clinical Endocrinology and Metabolism
Siddharth Jain, Meredith Kilgore, Rodney K Edwards, John Owen
BACKGROUND: Preterm birth (PTB) is a significant cause of neonatal morbidity and mortality. Studies have shown that vaginal progesterone therapy for women diagnosed with shortened cervical length can reduce the risk of PTB. However, published cost-effectiveness analyses of vaginal progesterone for short cervix have not considered an appropriate range of clinically important parameters. OBJECTIVE: To evaluate the cost-effectiveness of universal cervical length screening in women without a history of spontaneous PTB, assuming that all women with shortened cervical length receive progesterone to reduce the likelihood of PTB...
July 2016: American Journal of Obstetrics and Gynecology
Ning Gu, Tong Ru, Zhiqun Wang, Yimin Dai, Mingming Zheng, Biyun Xu, Yali Hu
OBJECTIVE: This study aimed to determine the optimal Foley catheter balloon volume (30-mL vs. 80-mL) and the maximum time for cervical ripening (12 hours vs. 24 hours) to improve vaginal delivery rate within 24 hours of induction. METHODS: We conducted an open-label, randomized controlled trial in a teaching hospital in China. Women with a term singleton pregnancy, cephalic presentation, intact membrane and an unfavorable cervix (Bishop score <6) were randomly allocated, in 1:1:1:1 ratio, to receive either one of the four treatments: (1) 30-mL balloon for a maximum of 12 hours, (2) 30-mL balloon for a maximum of 24 hours, (3) 80-mL balloon for a maximum of 12 hours, and (4) 80-mL balloon for a maximum of 24 hours...
2015: PloS One
Joseph E Brown, Benjamin P Partlow, Alison M Berman, Michael D House, David L Kaplan
BACKGROUND: Cerclage therapy is an important treatment option for preterm birth prevention. Several patient populations benefit from cerclage therapy including patients with a classic history of cervical insufficiency; patients who present with advanced cervical dilation prior to viability; and patients with a history of preterm birth and cervical shortening. Although cerclage is an effective treatment option in some patients, it can be associated with limited efficacy and procedure complications...
January 2016: American Journal of Obstetrics and Gynecology
Eric Leblanc, Lucie Bresson, Benjamin Merlot, Marco Puga, Frederic Kridelka, Audrey Tsunoda, Fabrice Narducci
Colpohysterectomy is sometimes associated with a large upper colpectomy resulting in a shortened vagina, potentially impacting sexual function. We report on a preliminary experience of a laparoscopic colpoplasty to restore a normal vaginal length. Patients with shortened vaginas after a laparoscopic colpohysterectomy were considered for a laparoscopic modified Davydov's procedure to create a new vaginal vault using the peritoneum of the rectum and bladder. From 2010 to 2014, 8 patients were offered this procedure, after informed preoperative consent...
January 2016: Journal of Minimally Invasive Gynecology
Shirlene Sim, Fabricio Da Silva Costa, Edward Araujo Júnior, Penelope M Sheehan
OBJECTIVE: To determine the predictive value of various cervical length measurements postcerclage for the outcome of preterm birth following both elective and rescue cerclage. MATERIALS AND METHODS: Over a five-year period, we identified 59 women who had a transvaginal cerclage inserted followed by serial cervical length measurement. Of these, 18 were elective cerclages placed at 14 weeks of gestation on the basis of a history of cervical insufficiency and 41 were rescue cerclages performed at gestations ranging from 17 to 23 weeks following a diagnosis of shortened cervix on ultrasound...
August 2015: Australian & New Zealand Journal of Obstetrics & Gynaecology
C Y Akladios, N Sananes, A Gaudineau, E Boudier, B Langer
Cervical cerclage aims to strengthen not only the mechanical properties of the cervix, but also its immunological and anti-infectious functions. The demonstration of a strong interrelation between cervical insufficiency as well as decreased cervical length at endo-vaginal ultrasonography and infection has changed the indications cerclage. Actually we can distinguish three indications for cerclage: prophylactic, for obstetrical history; therapeutic, for shortened cervical length at ultrasonography in patients at risk and; emergency cerclage in case of threatening cervix at physical examination...
October 2015: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
C Reimers, J Staer-Jensen, F Siafarikas, J Saltyte-Benth, K Bø, M Ellström Engh
OBJECTIVE: To describe changes in pelvic organ support from mid pregnancy until 1 year postpartum among nulliparous pregnant women, and to examine whether delivery route affects changes in pelvic organ support. DESIGN: Prospective cohort study. SETTING: Akershus University Hospital in Norway. POPULATION: A cohort of 300 nulliparous pregnant women included at mid-pregnancy. METHODS: Pelvic organ support assessed at 21 and 37 weeks of gestation, and again at 6 weeks, 6 months, and 12 months postpartum, by the use of the Pelvic Organ Prolapse Quantification (POP-Q) system...
April 2016: BJOG: An International Journal of Obstetrics and Gynaecology
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