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Cervical cerclage

Martha A Monson, Karen J Gibbons, M Sean Esplin, Michael W Varner, Tracy A Manuck
OBJECTIVE: To characterize subsequent pregnancy outcomes among women with a history of previable, preterm prelabor rupture of membranes (PROM) and assess factors associated with recurrent preterm birth. METHODS: This was a retrospective cohort study of women cared for with a history of one or more singleton pregnancy complicated by preterm PROM at less than 24 weeks of gestation between 2002 and 2013 who were cared for in two tertiary care health systems by a single group of maternal-fetal medicine specialists...
October 6, 2016: Obstetrics and Gynecology
Jonathan H Rapp, Meggie Yuen, Teena Abraham
PURPOSE: There have been 3 published reports (4 cases) of symptomatic sinus bradycardia occurring after intravenous (IV) administration of the selective 5-hydroxytryptamine 3 (5-HT3) receptor antagonist ondansetron. We report a fifth case in which the patient developed asystole after rechallenge with ondansetron. SUMMARY: A 36-year-old pregnant patient with no cardiac history, status post cerclage for cervical insufficiency, experienced nausea in the post ambulatory care unit after administration of morphine and indomethacin for pain...
November 2015: Hospital Pharmacy
P M Frazzini Padilla, T Tam
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
E Xia, X Huang
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Kirstine Sneider, Ole Bjarne Christiansen, Iben Blaabjerg Sundtoft, Jens Langhoff-Roos
INTRODUCTION: The objective was to describe recurrence rates of second trimester miscarriage and extreme preterm delivery by phenotype and use of prophylactic cerclage in a register-based cohort. MATERIAL AND METHODS: We included women with a first second trimester miscarriage or extreme preterm delivery (16(+0) - 27(+6) gestational weeks) in Denmark in 1997-2012 (n=9602) by combined use of the Danish Medical Birth Register and the Danish National Patient Register...
September 24, 2016: Acta Obstetricia et Gynecologica Scandinavica
Eun Young Jung, Kyung Joon Oh, Joon-Seok Hong, Bo Ryoung Han, Jung Kyung Joo
AIM: The aim of this study was to assess the effect of vaginal progesterone as an adjuvant therapy to physical-exam-indicated cervical cerclage (PEICC). METHODS: This retrospective cohort study included 53 consecutive singleton women who underwent PEICC because of acute cervical insufficiency at 17-24 gestational weeks. The study population was divided into two groups: the adjuvant progesterone group (n = 18) and the non-adjuvant group (n = 35). A 200-mg dose of vaginal micronized natural progesterone was administered after cerclage in the adjuvant progesterone group...
September 19, 2016: Journal of Obstetrics and Gynaecology Research
Corrine Lu, Boon Lim, Stephen J Robson
OBJECTIVE: Data published from the United States have demonstrated that the use of cervical cerclage has fallen in the period 1998-2013. This is in contrast to recommendations in Australia. We examined this trend using data from the Australian Institute of Health and Welfare (AIHW). STUDY DESIGN: Retrospective population-based study. METHODS: Data from the Australian Institute of Health and Welfare procedural database were used to determine the total number of cervical cerclage sutures inserted during the period 2004 to 2013...
September 12, 2016: Healthcare (Basel, Switzerland)
Akira Shinohara, Koichi Sairyo, Takuya Mishiro, Takashi Chikawa, Shigeru Soshi
STUDY DESIGN: This is a prospective multicenter comparison study. OBJECTIVE: To measure the insertional torque (IT) for cervical vertebra lateral mass screw (LMS) fixation using the Magerl and Roy-Camille methods, at the discretion of the surgeon. SUMMARY OF BACKGROUND DATA: Current fixation methods for patients with preoperative cervical spine instability use LMSs; however, few studies have closely examined intraoperative IT. Patients' bone quality was not measured...
September 10, 2016: Clinical Spine Surgery
Luchin F Wong, Jacob Wilkes, Kent Korgenski, Michael W Varner, Tracy A Manuck
OBJECTIVE: The objective of this study was to describe pregnancy outcomes, including cervical insufficiency and preterm birth, in the subsequent pregnancy following an intrapartum cervical laceration. STUDY DESIGN: Retrospective cohort of women with their first two consecutive singleton pregnancies carried to ≥ 20(0/7) weeks' gestation within a tertiary health care system from 2002 to 2012. Cervical laceration cases were identified by ICD9 codes and included if suture repair was required...
July 2016: American Journal of Perinatology Reports
Estefania Moreno-Luna, Patricia Alonso, Javier De Santiago, Ignacio Zapardiel
Invasive cervical cancer is rare during a pregnancy, even though it is one of the most frequently diagnosed neoplasias during that time. It is noted that around 30% of women diagnosed with cervical cancer are of reproductive age. This means that up to 3% of cases of cervical cancer are found in pregnant women or those who are in the post-birth period. A cervicovaginal Pap smear is performed as part of the regular checkup for a pregnant woman during the first visit so that cervical cancer can easily be diagnosed early in these women, detecting it early in up to 70-80% of cases...
2016: Ecancermedicalscience
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
S V Barinov, I V Shamina, O V Lazareva, Yu I Tirskaya, V V Ralko, L L Shkabarnya, G B Dikke, D M Kochev, L L Klementyeva
OBJECTIVE: This study aimed to compare the efficacy of combined use of Arabin pessary, cervical cerclage and progesterone with progesterone-only management of pregnant women at high risk of preterm birth. MATERIALS AND METHODS: The study included 203 pregnant women at high risk of preterm birth who were randomised to receive Arabin pessary (Group 1, n = 82) and progesterone, circular cervical cerclage and progesterone (Group 2 = 121), or progesterone treatment only (Group3, controls, n = 50)...
August 23, 2016: Journal of Maternal-fetal & Neonatal Medicine
Kishwar Azad, Jiji Mathews
Preterm births (PTBs), defined as births before 37 weeks of gestation account for the majority of deaths in the newborn period. Prediction and prevention of PTB is challenging. A history of preterm labour or second trimester losses and accurate measurement of cervical length help to identify women who would benefit from progesterone and cerclage. Fibronectin estimation in the cervicovaginal secretions of a symptomatic woman with an undilated cervix can predict PTB within 10 days of testing. Antibiotics should be given to women with preterm prelabour rupture of membranes but tocolysis has a limited role in the management of preterm labour...
June 24, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
Ohad Gluck, Yossi Mizrachi, Shimon Ginath, Jacob Bar, Ron Sagiv
OBJECTIVE: To study obstetric outcomes of emergency cerclage compared with elective cerclage. STUDY DESIGN: Retrospective cohort study of pregnancy outcomes of patients who underwent cervical cerclage, performed according to ACOG guidelines, between January 2006 and December 2014. Patients who underwent emergency cerclage, due to cervical shortening or cervical dilation (emergency cerclage group) were compared with patients who underwent history-indicated cerclage (elective cerclage group)...
August 23, 2016: Journal of Maternal-fetal & Neonatal Medicine
Lindsay M Kindinger, David A MacIntyre, Yun S Lee, Julian R Marchesi, Ann Smith, Julie A K McDonald, Vasso Terzidou, Joanna R Cook, Christoph Lees, Fidan Israfil-Bayli, Yazmin Faiza, Philip Toozs-Hobson, Mark Slack, Stefano Cacciatore, Elaine Holmes, Jeremy K Nicholson, T G Teoh, Phillip R Bennett
Preterm birth, the leading cause of death in children under 5 years, may be caused by inflammation triggered by ascending vaginal infection. About 2 million cervical cerclages are performed annually to prevent preterm birth. The procedure is thought to provide structural support and maintain the endocervical mucus plug as a barrier to ascending infection. Two types of suture material are used for cerclage: monofilament or multifilament braided. Braided sutures are most frequently used, although no evidence exists to favor them over monofilament sutures...
August 3, 2016: Science Translational Medicine
Maria Kyrgiou, Antonios Athanasiou, Maria Paraskevaidi, Anita Mitra, Ilkka Kalliala, Pierre Martin-Hirsch, Marc Arbyn, Phillip Bennett, Evangelos Paraskevaidis
OBJECTIVE:  To assess the effect of treatment for cervical intraepithelial neoplasia (CIN) on obstetric outcomes and to correlate this with cone depth and comparison group used. DESIGN:  Systematic review and meta-analysis. DATA SOURCES:  CENTRAL, Medline, Embase from 1948 to April 2016 were searched for studies assessing obstetric outcomes in women with or without previous local cervical treatment. DATA EXTRACTION AND SYNTHESIS:  Independent reviewers extracted the data and performed quality assessment using the Newcastle-Ottawa criteria...
2016: BMJ: British Medical Journal
Eun-Joo Joung, Eun-Byeol Go, Jae Young Kwack, Yong Soon Kwon
A 38-year-old nulliparous woman was referred to our clinic because of cervical incompetence at 19 weeks of gestation. Trans-abdominal cervicoisthmic cerclage was performed after failure of modified Shirodkar cerclage operation in the patient at 21 weeks of gestation via a laparotomic approach. Another 38-year-old patient, who underwent loop electrosurgical excision procedure conization for treatment of cervical dysplasia 4 years ago, presented for cervical incompetence. At 18 weeks of gestation, we performed trans-abdominal laparotomic cervicoisthmic cerclage without any post-operative complications...
July 2016: Obstetrics & Gynecology Science
Jessica Spiegelman, Whitney Booker, Simi Gupta, Jennifer Lam-Rochlin, Andrei Rebarber, Daniel H Saltzman, Ana Monteagudo, Nathan S Fox
Objective To estimate the independent association of a short cervical length (CL), positive fetal fibronectin (fFN), amniotic fluid (AF) sludge, and cervical funneling with spontaneous preterm birth in twin pregnancies. Methods Retrospective cohort study of twin pregnancies managed by a single maternal-fetal medicine practice from June 2005 to February 2014. All patients underwent transvaginal sonographic CL and fFN testing. We reviewed all images from the first CL at 22(0/7) to 25(6/7) weeks for the presence of (1) a short CL, which is defined as ≤25 mm, (2) AF sludge, and (3) cervical funneling, and also recorded (4) the fFN result from that time...
October 2016: American Journal of Perinatology
Claire Grace Scrivener, Robert Gornall, Philip Rolland
A 34-year-old nullipara, wishing to start a family, presented to colposcopy clinic. Her most recent cervical cytology result showed high-grade dyskaryosis. Having undergone four large loop excisions of the transformation zone during the past 6 years, this woman had no remaining vaginal cervix. In order to excise presumed high-grade cervical intraepithelial neoplasia while mitigating obstetric risk, she underwent a simple vaginal trachelectomy and isthmic cerclage. 6 months later, the patient had a negative test of cure...
2016: BMJ Case Reports
Jessica S Sheng, Frank P Schubert, Avinash S Patil
OBJECTIVE: To assess the utility of cervical funnel volume as a predictor of cerclage failure. METHODS: We performed a retrospective cohort study of pregnant women with a McDonald cerclage and sonographic evidence of cervical funneling between 1/2008 and 2/2014. Funnel volume (FV) was calculated and used as a correction factor for cervical length (CL) or cerclage height (CH). Receiver operating characteristic (ROC) curves were used to compare the predictive value of CL, CL:FV, CH and CH:FV for cerclage failure at <28 or <34 weeks...
July 6, 2016: Journal of Maternal-fetal & Neonatal Medicine
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