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Cervical length in pregnancy

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https://www.readbyqxmd.com/read/28320233/does-cervical-cerclage-decrease-preterm-birth-in-twin-pregnancies-with-a-short-cervix
#1
Tracy M Adams, Timothy J Rafael, Nadia B Kunzier, Supriya Mishra, Rose Calixte, Anthony M Vintzileos
PURPOSE: To determine if use of cerclage in twin gestations with mid-trimester short cervix is associated with decreased preterm birth rate. STUDY DESIGN: This is a retrospective cohort of twin gestations identified with cervical length of ≤2.5cm before 24 weeks gestation through the perinatal ultrasound database of two institutions from 2008-2014. Patients with and without cerclage were compared for a primary outcome of preterm birth at <35 weeks. A pre-planned sub-group analysis of patients with cervical length ≤1...
March 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28320033/is-the-relationship-between-short-interpregnancy-interval-and-preterm-birth-related-to-a-short-cervix
#2
S Govindappagari, N Zork, A Merriam, C Gyamfi-Bannerman
Objective Our objective was to determine if the relationship between interpregnancy interval (IPI) and preterm delivery was related to cervical shortening. Methods This is a secondary analysis of a prospective cohort study designed to assess the relationship between cervical length (CL) and preterm delivery. Multiparous patients, who had transvaginal CLs obtained at 22 to 24 weeks and complete pregnancy outcome data available were included. The women were divided into two groups: Group 1 with an IPI of ≤ 1 year and Group 2 with an IPI of > 1 year...
March 20, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28318214/preterm-labor-prevention-and-management
#3
Kristen Rundell, Bethany Panchal
In the United States, preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. The rate of preterm delivery (before 37 weeks' gestation) has been declining since 2007. Clinical diagnosis of preterm labor is made if there are regular contractions and concomitant cervical change. Less than 10% of women with a clinical diagnosis of preterm labor will deliver within seven days of initial presentation. Women with a history of spontaneous preterm delivery are 1...
March 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28303276/a-parameterized-ultrasound-based-finite-element-analysis-of-the-mechanical-environment-of-pregnancy
#4
Andrea R Westervelt, Michael Fernandez, Michael House, Joy Vink, Chia-Ling Nhan-Chang, Ronald Wapner, Kristin M Myers
Preterm birth is the leading cause of childhood mortality, and can lead to health risks in survivors. The mechanical function of the uterus, fetal membranes, and cervix have dynamic roles to protect the fetus during gestation. To understand their mechanical function and relation to preterm birth, we built a 3-dimensional parameterized finite element model of pregnancy. This model is generated by an automated procedure that is informed by maternal ultrasound measurements. A baseline model at 25 weeks of gestation was characterized, and to visualize the impact of cervical structural parameters on tissue stretch we evaluated the model sensitivity to: (1) anterior uterocervical angle, (2) cervical length, (3) posterior cervical offset, and (4) cervical stiffness...
March 17, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28295801/cervical-length-measurement-at-mid-gestation-to-predict-spontaneous-preterm-birth-in-asymptomatic-triplet-pregnancies
#5
A Fichera, G Pagani, V Stagnati, S Cascella, S Faiola, C Gaini, M Lanna, L Pasquini, R Raffaelli, T Stampalija, A Tommasini, F Prefumo
OBJECTIVE: To assess the predictive value of cervical length (CL) measured at mid gestation for spontaneous preterm birth (PTB) in triplet pregnancies. METHODS: Retrospective study on asymptomatic triplet pregnancies followed at five Italian tertiary referral centres, between 2002 and 2015. CL was measured transvaginally between 18-24 weeks of gestation. Pregnancies with a medically indicated PTB were excluded. Demographic and pregnancy characteristics of pregnancies complicated with PTB were analysed and the distributions of CL measurements in these patients were calculated...
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295722/cerclage-for-short-cervix-on-ultrasound-in-singleton-gestations-without-prior-spontaneous-preterm-birth-a-systematic-review-and-meta-analysis-of-trials-using-individual-patient-level-data
#6
REVIEW
Vincenzo Berghella, Andrea Ciardulli, Orion A Rust, Meekai To, Katsufumi Otsuki, Sietske Althuisius, Kypros Nicolaides, Amanda Roman, Gabriele Saccone
OBJECTIVE: The aim of this systematic review and meta-analysis was to quantify the efficacy of cervical cerclage in preventing preterm birth (PTB) in asymptomatic singleton pregnancies with a mid-trimester short transvaginal ultrasound cervical length (TVU CL) and without prior spontaneous PTB. METHODS: Electronic databases were searched from inception of each database until February 2017. No language restrictions were applied. We included all randomized controlled trials (RCTs) of asymptomatic singleton pregnancies without prior spontaneous PTB screened with TVU CL, found to have a midtrimester short CL <25 mm, and then randomized to management with either cerclage (i...
March 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295170/implementing-universal-cervical-length-screening-in-asymptomatic-women-with-singleton-pregnancies-challenges-and-opportunities
#7
Michelle K Pedretti, Brenda M Kazemier, Jan E Dickinson, Ben W J Mol
Cervical length (CL) screening has been successfully utilised to identify asymptomatic women, with a singleton pregnancy, at risk of preterm birth (PTB), thereby providing an opportunity to offer interventions that may reduce that risk. Cervical length screening with ultrasound is most effectively performed with a transvaginal approach. Universal cervical length screening, encompassing all singleton pregnancies rather than restricting screening to those considered at increased risk of PTB, is currently not widely used, despite a growing body of evidence in support of its utility for PTB prevention...
March 10, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28291893/predictive-accuracy-of-serial-transvaginal-cervical-lengths-and-quantitative-vaginal-fetal-fibronectin-levels-for-spontaneous-preterm-birth-among-nulliparous-women
#8
M Sean Esplin, Michal A Elovitz, Jay D Iams, Corette B Parker, Ronald J Wapner, William A Grobman, Hyagriv N Simhan, Deborah A Wing, David M Haas, Robert M Silver, Matthew K Hoffman, Alan M Peaceman, Steve N Caritis, Samuel Parry, Pathik Wadhwa, Tatiana Foroud, Brian M Mercer, Shannon M Hunter, George R Saade, Uma M Reddy
Importance: Spontaneous preterm birth is a leading cause of infant mortality. Prediction, largely based on prior pregnancy outcomes, is not possible in women pregnant for the first time. Objective: To assess the accuracy of universal screening to predict spontaneous preterm birth in nulliparous women using serial measurements of vaginal fetal fibronectin levels and cervical length. Design, Settings, and Participants: A prospective observational cohort study of nulliparous women with singleton pregnancies, from 8 clinical sites across the United States between October 2010 and May 2014...
March 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28281301/doppler-assessment-of-patients-with-twin-to-twin-transfusion-syndrome-and-survival-following-fetoscopic-laser-surgery
#9
Enrique Gil Guevara, Andrea Pazos, Otilia Gonzalez, Pilar Carretero, Francisca S Molina
OBJECTIVE: To investigate fetal-survival rates following laser surgery for twin-to-twin transfusion syndrome (TTTS) and the impact of Doppler analysis. METHODS: The present retrospective single-center study included data from patients with pregnancies exhibiting TTTS treated with fetoscopic laser surgery between January 1, 2007, and December 31, 2016. Perinatal outcomes were examined and variables were compared between the donor and recipient fetuses that survived and died, respectively...
March 9, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28277920/the-role-of-serial-measurements-of-cervical-length-in-asymptomatic-women-with-triplet-pregnancy
#10
Hadar Rosen, Liran Hiersch, Howie Freeman, Jon Barrett, Nir Melamed
OBJECTIVE: To assess the predictive accuracy of serial measurements of cervical length (CL) for preterm birth in asymptomatic women with triplet pregnancy. METHODS: A retrospective study of women with triplets who underwent serial sonographic measurements of CL until 28-32 weeks of gestation. The predictive accuracy of CL for preterm birth was determined at 4 periods along gestation: 18-20 weeks (period 1), 21-24 weeks (period 2), 25-27 weeks (period 3) and 28-32 weeks (period 4)...
February 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28277132/maternal-serum-cytokine-levels-in-pregnancies-complicated-with-threatened-preterm-labour
#11
Alejandra Herrera-Muñoz, Ana M Fernández-Alonso, Natalia Fischer-Suárez, Peter Chedraui, Faustino R Pérez-López
OBJECTIVE: To investigate serum inflammatory markers in singleton gestations complicated with threatened preterm labour (TPL). METHODS: Pregnant women complicated with TPL (n = 61) were recruited to measure maternal serum levels of a panel of cytokines and C-reactive protein and then compared to controls without TPL, matched for gestational age (n = 64) and term pregnancies in the prodromal phase of labour (PPL) (n = 31). In addition, baseline cytokine levels were compared among cases and controls according to the outcome...
February 21, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28266156/re-cervical-length-screening-for-prevention-of-preterm-birth-in-singleton-pregnancy-with-threatened-preterm-labor-systematic-review-and-meta-analysis-of-randomized-controlled-trials-using-individual-patient-level-data-v-berghella-m-palacio-a-ness-z-alfirevic
#12
COMMENT
https://www.readbyqxmd.com/read/28255763/cervical-length-after-cerclage-comparison-between-laparoscopic-and-vaginal-approach
#13
Daniele Bolla, Maria Luisa Gasparri, Sabrina Badir, Michael Bajka, Michael D Mueller, Andrea Papadia, Luigi Raio
PURPOSE: The aim of our study was to investigate the sonographic changes of the cervical length during pregnancy after the placement of a transvaginal cervical cerclage (TVC) or a laparoscopic abdominal cerclage (LAC) in patients with cervical insufficiency (CI). METHODS: Between January 2008 and March 2015, a retrospective analysis of all women undergoing a prophylactic laparoscopic (LAC group) or transvaginal (TVC group) cerclage due to cervical insufficiency was conducted...
March 3, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28237336/effect-of-numbers-of-sperm-and-timing-of-a-single-post-cervical-insemination-on-the-fertility-of-weaned-sows-treated-with-ovugel-%C3%A2
#14
R V Knox, K C Esparza-Harris, M E Johnston, S K Webel
Variability in estrus and ovulation requires multiple inseminations during estrus to ensure one AI occurs close to ovulation. Induction of ovulation after weaning improves synchrony of ovulation and allows for fixed time AI. However, the interaction between number of sperm in the AI dose and the timing of insemination has not been fully investigated. The objective of this study was to determine the effects of sperm numbers used in a single post-cervical insemination (PCAI) and the timing of insemination following induced ovulation in weaned sows...
April 1, 2017: Theriogenology
https://www.readbyqxmd.com/read/28217665/elastographic-measurement-of-the-cervix-during-pregnancy-current-status-and-future-challenges
#15
REVIEW
Hyunjung Kim, Han Sung Hwang
The cervix is a cylindrical structure that is proximally connected to the uterus and distally to the vaginal cavity. The Bishop score has been used to evaluate the cervix during pregnancy. However, alternatives have been evaluated because the Bishop score is uncomfortable for patients, relies on a subjective examination, and lacks internal os data. Elastography has been used to assess the cervix, as it can estimate tissue stiffness. Recent articles on elastography for cervical assessment during pregnancy have focused on its usefulness for prediction of preterm birth and successful labor induction...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28166925/-is-universal-screening-for-cervical-length-among-singleton-pregnancies-with-no-history-of-preterm-birth-justified
#16
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%C3%A2-case-series-and%C3%A2-systematic-review
#17
REVIEW
Eric Jauniaux, Yaakov Melcer, Ron Maymon
BACKGROUND: Twin pregnancies are at higher risks of velamentous cord insertion and vasa previa. In vitro fertilization 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: We sought 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 and performed a systematic review of articles that 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
#18
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
#19
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
#20
Ron Beloosesky, Nizar Khatib, Nadir Ganem, Emad Matanes, Yuval Ginsberg, Mike Divon, Zeev Weiner
OBJECTIVE: To test the hypothesis that measuring cervical length (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...
February 21, 2017: Journal of Maternal-fetal & Neonatal Medicine
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