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Cervical length in pregnancy

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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
#1
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
#2
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
#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/27818117/-induced-abortion-guidelines-for-clinical-practice%C3%A2-%C3%A2-text-of-the-guidelines-short-text
#8
C Vayssière, A Gaudineau, L Attali, K Bettahar, S Eyraud, P Faucher, P Fournet, D Hassoun, M Hatchuel, C Jamin, B Letombe, T Linet, M Msika Razon, A Ohanessian, H Segain, S Vigoureux, N Winer, S Wylomanski, A Agostini
OBJECTIVE: Develop recommendations for the practice of induced abortion. MATERIALS AND METHODS: The Pubmed database, the Cochrane Library and the recommendations from the French and foreign Gyn-Obs societies or colleges have been consulted. RESULTS: The number of induced abortions (IA) has been stable for several decades. There are a lot of factors explaining the choice of abortion when there is an unplanned pregnancy (UPP). Early initiation and choice of contraception in connection to the woman's life are associated with lower NSP...
November 3, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
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
#9
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
#10
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/27760480/body-mass-index-is-linked-to-cervical-length-and-duration-of-pregnancy-an-observational-study-in-low-risk-pregnancy
#11
Mohamed Kandil, Zakaria Sanad, Tarek Sayyed, Hamed Ellakwa
In this prospective cohort study, one hundred participants were allocated into four groups according to their body mass indices. Vaginal ultrasound was performed at enrolment to measure cervical length. The shortest cervical measurement was recorded. Overweight and obese groups had significantly longer mean cervical length than women in the normal weight group when measured at 20-22 weeks of gestation (p < .001). Underweight women had the shortest mean cervical length. The incidence of preterm delivery was the highest in underweight women (RR; 1...
October 20, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27729253/association-between-change-in-cervical-length-and-spontaneous-preterm-birth-in-twin-pregnancies
#12
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
#13
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
#14
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
#15
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
#16
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/27664210/comparison-of-small-intestinal-submucosa-graft-with-split-thickness-skin-graft-for-cervicovaginal-reconstruction-of-congenital-vaginal-and-cervical-aplasia
#17
Fang Shen, Xu-Yin Zhang, Chu-Yang Yin, Jing-Xin Ding, Ke-Qin Hua
STUDY QUESTION: What is the difference in vaginal-length gain and resumption of menstruation following cervicovaginal reconstruction using split-thickness skin (STS) graft versus small intestinal submucosa (SIS) graft for patients with congenital vaginal and cervical aplasia? SUMMARY ANSWER: No difference was found in the number of patients who resumed menstruation between the two groups; however, significantly greater vaginal-length gain was found in the STS group...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27661402/placental-implantation-abnormalities-a-modern-approach
#18
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
https://www.readbyqxmd.com/read/27638185/cervical-length-at-11-40-weeks-unconditional-and-conditional-longitudinal-reference-ranges
#19
Ioannis Papastefanou, Athanasios Pilalis, Dimitra Kappou, Athena P Souka
INTRODUCTION: Our aim was to establish unconditional and conditional longitudinal reference ranges for cervical length throughout pregnancy. MATERIAL AND METHODS: Prospective longitudinal study. In singleton pregnancies repeated cervical length measurements were carried out by transvaginal ultrasound throughout gestation. Multilevel modeling was applied to establish cervical length reference ranges from 11 to 40 weeks. RESULTS: In all, 4397 women contributed to 13 765 cervical length measurements...
September 16, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27600865/the-prevalence-of-short-cervix-between-20-and-24-weeks-of-gestation-and-vaginal-progesterone-for-prolonging-of-gestation
#20
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
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