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Cervical length in pregnancy

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https://www.readbyqxmd.com/read/28166925/-is-universal-screening-for-cervical-length-among-singleton-pregnancies-with-no-history-of-preterm-birth-justified
#1
P Rozenberg
The ultrasonographic measurement of cervical length with a cutoff of 15mm is currently the best method to identify a group of asymptomatic women in the general population at risk of spontaneous preterm birth, especially among asymptomatic patients with a singleton pregnancy with no history of preterm birth. Cerclage and 17 alpha-hydroxyprogesterone caproate (17OHP-C) are ineffective to reduce the risk of preterm birth among asymptomatic patients with a short cervix in midtrimester. However, vaginal progesterone (200-mg capsules of micronized progesterone or gel containing 90mg progesterone) has been demonstrated effective in 2 large randomized trials to reduce the risk of preterm birth and possibly the composite morbidity and perinatal mortality associated among asymptomatic women with a short cervix in the general population screened by ultrasound of the cervix in midtrimester...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28153653/prenatal-diagnosis-and-management-of-vasa-previa-in-twin-pregnancies-a-case-series-and-systematic-review
#2
REVIEW
Eric Jauniaux, Yaakov Melcer, Ron Maymon
BACKGROUND: Twin pregnancies are at higher risks of velamentous cord insertion (VCI) and vasa previa. In-vitro fertilization (IVF) is an additional risk factor of abnormal cord insertion and thus the incidence of vasa previa is likely to increase over the next decades. OBJECTIVE: To evaluate the role of ultrasound imaging in optimizing the management of twins diagnosed with vasa previa antenatally. STUDY DESIGN: We searched our database for twin pregnancies diagnosed with vasa previa and managed antenatally using measurements of cervical length (CL) and performed a systematic review of articles which correlated prenatal diagnosis of vasa previa in twins and pregnancy outcome...
January 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28145653/maternal-characteristics-short-mid-trimester-cervical-length-and-preterm-delivery
#3
Soo Hyun Cho, Kyo Hoon Park, Eun Young Jung, Jung Kyung Joo, Ji Ae Jang, Ha Na Yoo
We aimed to determine the maternal characteristics (demographics, an obstetric history, and prior cervical excisional procedure) associated with a short mid-trimester cervical length (CL, defined as a CL of ≤ 25 mm) and whether having a short cervix explains the association between these maternal characteristics and spontaneous preterm delivery (SPTD, defined as a delivery before 34 weeks). This is a single-center retrospective cohort study of 3,296 consecutive women with a singleton pregnancy who underwent routine CL measurement between 20 and 24 weeks...
March 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28141949/ability-of-cervical-length-to-predict-spontaneous-preterm-delivery-in-twin-pregnancies-using-the-receiver-operating-characteristic-curve-analysis-and-an-a-priori-cut-off-value
#4
Lucia Pasquini, Giovanni Sisti, Dimitrios Nasioudis, Tomi Kanninen, Flavia Sorbi, Massimiliano Fambrini, Irene Turrini, Viola Seravalli, Mariarosaria Di Tommaso
In this retrospective study based on cervical length (CL) measurements between 20 and 24 + 6 weeks, we examined the ability of CL to predict spontaneous preterm birth (SPTB) in 222 twin pregnancies using the receiver-operating curve (ROC) analysis and an a priori cut-off. CL predicted SPTB before 34 weeks. Using the ROC the selected cut-off was 37.5 mm. Positive predictive value (PPV) and negative predictive value (NPV) regarding SPTB before 34 weeks for 37.5 mm were 15.7% and 5.3% respectively. Using the 5th percentile, PPV and NPV regarding SPTB before 34 weeks for 24 mm were 41...
January 31, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28139951/cervical-length-measured-before-delivery-and-the-success-rate-of-vaginal-birth-after-cesarean-vbac
#5
Ron Beloosesky, Nizar Khatib, Nadir Ganem, Emad Matanis, Yuval Ginsberg, Mike Divon, Zeev Weiner
OBJECTIVE: To test the hypothesis that measuring CL close to the time of delivery is a predictor of successful vaginal birth following a cesarean. METHODS: A prospective longitudinal study included women with singleton pregnancies at 38-41 weeks, who previously underwent a cesarean, and who were interested in trial of labor. Patients who did not have a spontaneous onset of labor were induced at 41 weeks gestation. CL measurements were performed prior to labor by transvaginal ultrasound, recorded, and blinded from the caring physicians...
January 31, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28103952/the-interaction-between-vaginal-microbiota-cervical-length-and-vaginal-progesterone-treatment-for-preterm-birth-risk
#6
Lindsay M Kindinger, Phillip R Bennett, Yun S Lee, Julian R Marchesi, Ann Smith, Stefano Cacciatore, Elaine Holmes, Jeremy K Nicholson, T G Teoh, David A MacIntyre
BACKGROUND: Preterm birth is the primary cause of infant death worldwide. A short cervix in the second trimester of pregnancy is a risk factor for preterm birth. In specific patient cohorts, vaginal progesterone reduces this risk. Using 16S rRNA gene sequencing, we undertook a prospective study in women at risk of preterm birth (n = 161) to assess (1) the relationship between vaginal microbiota and cervical length in the second trimester and preterm birth risk and (2) the impact of vaginal progesterone on vaginal bacterial communities in women with a short cervix...
January 19, 2017: Microbiome
https://www.readbyqxmd.com/read/28079869/racial-and-social-predictors-of-longitudinal-cervical-measures-the-cervical-ultrasound-study
#7
E W Harville, K S Miller, L R Knoepp
OBJECTIVE: To evaluate whether the racial and socioeconomic disparities are present in adverse cervical parameters, and, if so, when such disparities develop. STUDY DESIGN: A prospective cohort study was conducted. 175 women with a prior preterm birth had up to four endovaginal ultrasounds between gestational weeks 16 and 24 (Cervical Ultrasound Trial of the MFMU). Each sociodemographic factor (race/ethnicity, marital status, insurance funding and education) was examined as a predictor of short cervix or U/funnel shape, using multiple logistic and linear regression...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28068849/maternal-serum-calponin-1-level-as-a-biomarker-for-the-short-term-prediction-of-preterm-birth-in-women-with-threatened-preterm-labor
#8
Orkun Cetin, Erbil Karaman, Baris Boza, Numan Cim, Hanım Guler Sahin
PURPOSE: To assess the utility of maternal serum calponin 1 level in the prediction of delivery within 7 days among pregnancies complicated with threatened preterm labor. MATERIALS AND METHODS: Eligible women who presented at 24-34 weeks of gestation with threatened preterm labor underwent sampling for serum calponin 1 level and cervical length measurement. They were followed-up until delivery prospectively and the perinatal outcomes of the patients were recorded...
January 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28068594/prevention-of-spontaneous-preterm-birth-guidelines-for-clinical-practice-from-the-french-college-of-gynaecologists-and-obstetricians-cngof
#9
REVIEW
Loïc Sentilhes, Marie-Victoire Sénat, Pierre-Yves Ancel, Elie Azria, Guillaume Benoist, Julie Blanc, Gilles Brabant, Florence Bretelle, Stéphanie Brun, Muriel Doret, Chantal Ducroux-Schouwey, Anne Evrard, Gilles Kayem, Emeline Maisonneuve, Louis Marcellin, Stéphane Marret, Nicolas Mottet, Sabine Paysant, Didier Riethmuller, Patrick Rozenberg, Thomas Schmitz, Héloïse Torchin, Bruno Langer
In France, 60,000 neonates are born preterm every year (7.4%), half of them after the spontaneous onset of labor. Among preventable risk factors of spontaneous prematurity, only cessation of smoking is associated with decreased prematurity (level of evidence [LE]1). It is therefore recommended (Grade A). Routine screening and treatment of vaginal bacteriosis is not recommended in the general population (Grade A). The only population for which vaginal progesterone is recommended is that comprising asymptomatic women with singleton pregnancies, no history of preterm delivery, and a short cervix at 16-24 weeks of gestation (Grade B)...
December 30, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28029461/-prevention-of-preterm-birth-by-uterine-cervical-cerclage
#10
L Marcellin
OBJECTIVE: To review the scientific literature on cervical insufficiency and indications of cervical cerclage cervix. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and international obstetrical societies between 1972 and June 2016 have been consulted. RESULTS: Cervical insufficiency is a pathophysiological concept and to date no consensual definition is available: the diagnosis is clinical and discussed retrospectively in case of patients with a history of late miscarriages and/or spontaneous preterm delivery, with asymptomatic dilatation of the cervix (professional consensus)...
October 29, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28029460/-predictive-tools-of-preterm-birth-in-asymptomatic-high-risk-pregnancy
#11
J Blanc, F Bretelle
OBJECTIVE: Describe tools designed to predict preterm birth in asymptomatic high-risk pregnancy and determine their predictive value. METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Obstetric history particularly spontaneous preterm birth identifies a population at risk for preterm birth for the current pregnancy (LE3). This risk is related to the number of prior preterm birth and is even higher than the term of the prior event is more premature and that the event concerns the last pregnancy (LE3)...
October 29, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27997053/cervical-length-screening-for-prevention-of-preterm-birth-in-singleton-pregnancies-with-threatened-preterm-labor-a-cochrane-systematic-review-and-meta-analysis-of-randomized-controlled-trials-using-individual-patient-level-data
#12
REVIEW
Vincenzo Berghella, Montse Palacio, Amen Ness, Zarko Alfirevic, Kypros Nicolaides, Gabriele Saccone
OBJECTIVE: Cervical length screening by transvaginal ultrasound has been shown to be a good predictive test for spontaneous preterm birth (PTB) in symptomatic singleton pregnancies with threatened preterm labor (PTL). The aim of this Cochrane review and meta-analysis of individual participant data was to evaluate the effect of using knowledge of transvaginal ultrasound cervical length (TVU CL) in preventing PTB in singleton pregnancies presenting with threatened PTL. METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register and the Cochrane Complementary Medicine Field's Trials Register (May 2016) and reference lists of retrieved studies...
December 20, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27928435/a-debate-about-ultrasound-and-anatomic-aspects-of-the-cervix-in-spontaneous-preterm-birth
#13
REVIEW
Bohîlțea Re, Munteanu O, Turcan N, Baros A, Bodean O, Voicu D, Cîrstoiu Mm
Preterm birth is the legal first global cause of neonatal death. The cervix has two roles: it has to stay closed to allow the fetus to undergo a normal development during gestation, and at term, the cervix has to dilate under the pressure of uterine contractions to allow the delivery. The purpose of this article is to establish if the ultrasound measured length of the cervix and its appearance are predictive for the spontaneous preterm birth. Cervical insufficiency can be described by painless cervical dilatation leading to pregnancy losses/ births, with no other risk factors present...
October 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27925148/a-comparison-of-vaginal-ultrasound-and-digital-examination-in-predicting-preterm-delivery-in-women-with-threatened-preterm-labor-a-cohort-study
#14
Anne Pinton, François Severac, Nicolas Meyer, Cherif Y Akladios, Adrien Gaudineau, Romain Favre, Bruno Langer, Nicolas Sananes
INTRODUCTION: The aim of this study is to evaluate the utility of digital examination in addition to ultrasonic measurement of cervical length for predicting spontaneous preterm delivery in women with threatened preterm labor. MATERIAL AND METHODS: This was a prospective cohort study in Strasbourg University Hospital, France, between January 2013 and January 2015. All women with a singleton pregnancy hospitalized with threatened preterm labor between 23 and 34 weeks of gestation were included...
December 7, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27924659/foetal-fibronectin-and-cervical-length-measurement-following-arabin-pessary-insertion-in-a-high-risk-twin-pregnancy-a-case-report
#15
Emily Watts, Natasha L Hezelgrave, Eugene Oteng-Ntim, Andrew H Shennan
No abstract text is available yet for this article.
December 7, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27924657/sonographical-predictive-markers-of-failure-of-induction-of-labour-in-term-pregnancy
#16
Maia Brik, Silvia Mateos, Irene Fernandez-Buhigas, Paloma Garbayo, Gloria Costa, Belen Santacruz
Predictive markers of failure of induction of labour in term pregnancy were evaluated. A prospective study including 245 women attending induction of labour was performed. The inclusion criteria were singleton pregnancies, gestational age 37-42 weeks and the main outcomes were failure of induction, induction to delivery interval and mode of delivery. Women with a longer cervical length prior to induction (CLpi) had a higher rate of failure of induction (30.9 ± 6.8 vs. 23.9 ± 9.3, p < .001)...
December 7, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27915496/cervical-pessary-for-preventing-preterm-birth-in-twin-pregnancies-with-short-cervical-length-a-systematic-review-and-meta-analysis
#17
Gabriele Saccone, Andrea Ciardulli, Serena Xodo, Lorraine Dugoff, Jack Ludmir, Francesco D'Antonio, Simona Boito, Elena Olearo, Carmela Votino, Giuseppe Maria Maruotti, Giuseppe Rizzo, Pasquale Martinelli, Vincenzo Berghella
OBJECTIVE: To evaluate the effectiveness of cervical pessary for preventing spontaneous preterm birth (SPTB) in twin pregnancies with an asymptomatic transvaginal ultrasound cervical length (TVU CL) in the second trimester. METHODS: We performed a meta-analysis including all randomized clinical trials (RCTs) comparing the use of cervical pessary (i.e. intervention group) with expectant management (i.e. control group). The primary outcome was incidence of SPTB <34 weeks...
January 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27884038/is-there-an-association-between-body-mass-index-and-cervical-length-implications-for-obesity-and-cervical-length-management-in-pregnancy
#18
Kartik K Venkatesh, David E Cantonwine, Chloe Zera, Melanie Arjona, Nicole A Smith, Julian N Robinson, Thomas F McElrath
Objective Obesity and cervical insufficiency are leading causes of morbidity in pregnancy. We assess the relationship between maternal body mass index (BMI) and second-trimester cervical length. Methods A secondary analysis of a nested case-control study of women with singleton gestations enrolled from 2006 to 2008. The primary exposure was first-trimester BMI, categorized per World Health Organization criteria: normal (18.5 to ≤ 25 kg/m(2)), overweight (25 to ≤ 30 kg/m(2)), and obese (> 30 kg/m(2))...
November 24, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27872420/role-of-cervical-length-measurement-for-preterm-delivery-prediction-in-women-with-threatened-preterm-labor-and-cervical-dilatation
#19
Liran Hiersch, Nir Melamed, Amir Aviram, Ron Bardin, Yariv Yogev, Eran Ashwal
OBJECTIVES: To compare the accuracy and cutoff points for cervical length for predicting preterm delivery in women with threatened preterm labor between those with a closed cervix and cervical dilatation. METHODS: We conducted a retrospective cohort study of women with singleton pregnancies with threatened preterm labor before 34 weeks. The accuracy of cervical length for predicting preterm delivery was compared between women with cervical dilatation (0.5-3 cm) and those with a closed cervix...
December 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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
#20
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
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