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Cervical cerclage

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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/28318214/preterm-labor-prevention-and-management
#2
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/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
#3
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/28281278/retrospective-comparison-of-perinatal-outcomes-following-emergency-cervical-cerclage-with-or-without-prolapsed-membranes
#4
Patricia Steenhaut, Corinne Hubinont, Pierre Bernard, Frédéric Debiève
OBJECTIVE: To compare perinatal outcomes following emergency cerclage between patients with singleton pregnancies with prolapsed and non-prolapsed membranes. METHODS: The present retrospective cohort study included data from women who underwent physical examination-indicated emergency cerclage at between 15 and 25 weeks of pregnancy at Saint Luc University Hospital, Brussels, Belgium, between January 1, 2000, and December 31, 2014. Outcomes were compared based on the presence of prolapsed or non-prolapsed membranes...
March 9, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28255763/cervical-length-after-cerclage-comparison-between-laparoscopic-and-vaginal-approach
#5
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/28254220/preliminary-preventive-protocol-from-first-trimester-of-pregnancy-to-reduce-preterm-birth-rate-for-dichorionic-diamniotic-twins
#6
Masako Matsui, Yuichiro Takahashi, Shigenori Iwagaki, Rika Chiaki, Kazuhiko Asai, Ichiro Kawabata
OBJECTIVE: The preterm birth rate of twins is reportedly higher than that of single pregnancies. We performed preliminary preventive interventions at our center focused on evaluating the risk of each case before 14 weeks of gestation to reduce the spontaneous preterm birth rate. MATERIALS AND METHODS: The participants included 184 dichorionic-diamniotic twins delivered at our center during the 8 years from 2006. We evaluated each patient regarding high-risk status (at least 1 additional factor as follows: threatened abortion, history of chorioamnionitis, cervicitis, and bacterial vaginosis), based on available evidence; patients deemed high risk gave their informed consent and underwent treatment for cervicitis and cerclage if indicated...
February 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28182768/clinical-validation-of-a-model-predicting-the-risk-of-preterm-delivery
#7
Yohann Dabi, Sophie Nedellec, Claire Bonneau, Blandine Trouchard, Roman Rouzier, Alexandra Benachi
OBJECTIVES: To validate a model predicting the risk of threatened preterm delivery and to establish the optimal threshold for this risk scoring system. MATERIALS AND METHODS: Two cohorts were studied: one of singleton pregnancies without preterm premature rupture of membranes (PPROM) and no cervical cerclage (cohort 1) and one of twin pregnancies without PPROM and no cervical cerclage (cohort 2). Patients were included from January 1st 2013 until December 31st 2013 by the Regional Perinatal Network of Ile de France with patients transferred because of threatened preterm delivery at 22 to 32 weeks of gestation...
2017: PloS One
https://www.readbyqxmd.com/read/28176305/what-is-the-impact-of-preconception-abdominal-cerclage-on-fertility-evidence-from-a-randomized-controlled-trial
#8
Nicola J Vousden, Jenny Carter, Paul T Seed, Andrew H Shennan
INTRODUCTION: There is documented concern that cerclage may cause cervical stenosis or changes to the cervical mucus, which may reduce fertility. The aim of this study is to determine whether placement of a preconception abdominal cerclage affects fertility. MATERIAL AND METHODS: This was a planned subgroup analysis of a randomized controlled trial comparing abdominal cerclage, high vaginal or low vaginal cerclage. Women with a history of previous second trimester miscarriage or preterm birth despite having a low vaginal cerclage, presenting to specialist preterm birth services in the UK, were eligible for inclusion...
February 7, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28166925/-is-universal-screening-for-cervical-length-among-singleton-pregnancies-with-no-history-of-preterm-birth-justified
#9
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/28141954/successful-management-of-intraoperative-haemorrhage-during-emergency-cervical-cerclage-using-balloon-tamponade
#10
Shota Kanbayashi, Eiji Kondoh, Koh Suginami, Shingo Io, Junzo Hamanishi, Ikuo Konishi
No abstract text is available yet for this article.
January 31, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28141950/rescue-cerclage-when-foetal-membranes-prolapse-into-the-vagina
#11
Mehmet Bayrak, Ahmet Gul, Gokhan Goynumer
A cross-sectional study was conducted to evaluate the efficacy of rescue cerclage in patients with a dilated cervix and prolapsed foetal membranes. Thirty-five patients presenting with cervical dilatation and prolapsed foetal membranes were included in the study. A McDonald cerclage was placed in 27 patients. The duration of pregnancy prolongation and the number of deliveries after 28 weeks were evaluated. The median prolongation of pregnancy after cerclage placement differed significantly between the cerclage and bed-rest groups (64 days versus 13...
January 31, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28072695/acute-pulmonary-edema-caused-by-takotsubo-cardiomyopathy-in-a-pregnant-woman-undergoing-transvaginal-cervical-cerclage-a-case-report
#12
Jae-Young Lee, Hyun-Jung Kwon, Sang-Wook Park, Yu-Mi Lee
BACKGROUND: The physiological changes associated with pregnancy may predispose pregnant women to pulmonary edema. Other known causes of pulmonary edema during pregnancy include tocolytic drugs, preeclampsia, eclampsia, and peripartum cardiomyopathy. METHODS: We describe a rare case of pulmonary edema caused by takotsubo cardiomyopathy in a pregnant woman at 14 weeks of gestation who was undergoing emergency transvaginal cervical cerclage. RESULTS: Intraoperative chest radiography revealed severe pulmonary edema and echocardiography indicated moderate left ventricular dysfunction with akinesia of the mid to apical left ventricular wall segment, which is reflective of takotsubo cardiomyopathy...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28068594/prevention-of-spontaneous-preterm-birth-guidelines-for-clinical-practice-from-the-french-college-of-gynaecologists-and-obstetricians-cngof
#13
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/28063549/insuffisance-cervicale-et-cerclage-cervical
#14
Richard Brown, Robert Gagnon, Marie-France Delisle
OBJECTIF: La présente directive clinique a pour but de fournir un cadre de référence que les cliniciens pourront utiliser pour identifier les femmes qui sont exposées aux plus grands risques de connaître une insuffisance cervicale, ainsi que pour déterminer les circonstances en présence desquelles la mise en place d'un cerclage pourrait s'avérer souhaitable. RéSULTATS: La littérature publiée a été récupérée par l'intermédiaire de recherches menées dans PubMed ou MEDLINE, CINAHL et The Cochrane Library en 2012 au moyen d'un vocabulaire contrôlé (p...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28055026/anterior-uterocervical-angle-measurement-improves-prediction-of-cerclage-failure
#15
J C Knight, E Tenbrink, J Sheng, A S Patil
OBJECTIVE: To compare the anterior uterocervical angle and cervical length as predictors of spontaneous preterm delivery in patients with transvaginal cerclage. STUDY DESIGN: We retrospectively evaluated a cohort of 142 pregnant women with transvaginal cerclage placed over a 5-year period (2010 to 2015) were evaluated. Cervical morphology characteristics were measured from endovaginal imaging, including cervical length, cerclage height, funnel volume and anterior uterocervical angle prior to cerclage placement (UCA 1), shortly after cerclage placement (UCA 2) and the last image prior to delivery (UCA 3)...
January 5, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28029461/-prevention-of-preterm-birth-by-uterine-cervical-cerclage
#16
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
#17
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/28012405/an-assessment-of-mode-of-delivery-in-history-indicated-versus-ultrasound-indicated-vaginally-placed-cervical-cerclage
#18
Lisa Story, Andrew Shennan
OBJECTIVE: Treatment modalities to reduce the incidence of preterm birth are currently limited. Cerclage, is a common and established intervention in most obstetrics units worldwide, however, many questions regarding its efficacy, with respect to pregnancy outcomes remain unanswered. This study aims to investigate whether an antenatal placed cerclage affects the subsequent mode of delivery in women at high risk of preterm birth who labour. STUDY DESIGN: A retrospective case controlled study was performed at St Thomas's Hospital London...
November 27, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27974918/cervical-cerclage-in-advanced-prolapsed-fetal-membranes-case-presentation
#19
C F Tufan, R E Bohîlţea, A Tufan, A Marinescu, A Baros, M M Cîrstoiu
The case presentation of a transvaginal cervical cerclage performed at a 7 cm dilation in a patient in the 22nd week of pregnancy, followed by a prolongation of the pregnancy until the gestational age of 38 weeks, was reported in the context of many similar cases managed by the authors of the article during a program of screening and prevention of preterm birth. The particularity of the case was the lack of a preterm birth in the medical history of the patient and the installation of the isthmus-cervix incompetence in the second pregnancy, after an on term pregnancy...
January 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27928435/a-debate-about-ultrasound-and-anatomic-aspects-of-the-cervix-in-spontaneous-preterm-birth
#20
REVIEW
R E Bohîlțea, O Munteanu, N Turcan, A Baros, O Bodean, D Voicu, M M Cîrstoiu
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
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