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Cervical cerclage

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https://www.readbyqxmd.com/read/29222640/clinical-effect-of-emergency-cervical-cerclage-and-elective-cervical-cerclage-on-pregnancy-outcome-in-the-cervical-incompetent-pregnant-women
#1
Qin Chen, Guiying Chen, Nan Li
PURPOSE: To compare the clinical effect of emergency cervical cerclage and elective cervical cerclage on pregnancy outcome in the cervical-incompetent pregnant women. METHODS: Literature was searched from the databases of Pubmed, Embase and Google scholar. The fixed or random effects model was used to calculate pooled risk ratios on the basis of heterogeneity. Meta-regression, sensitive analysis, subgroup analysis, and publication bias assessment were also conducted to confirm the results according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009...
December 8, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29209482/the-place-for-prophylactic-cerclage-in-the-infertile-patient-with-established-cervical-incompetence-who-conceived-twins-after-septum-reduction
#2
Jennifer Deanna, Omar Abuzied, Fahmi Islam, Ivana Vettriano, Frederico Rocha, Mostafa Abuzeid
Introduction: It is well known that cervical incompetence and associated preterm birth confers greater morbidity and mortality on birth outcomes, with an additional increased risk of cervical incompetence in higher order gestations. While the pathophysiology of cervical incompetence has yet to be elucidated, research has identified risk factors and assessed outcomes of numerous interventions. Cervical cerclage has been shown, in certain situations involving singleton pregnancies, to improve outcomes...
June 2017: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/29191292/long-term-childhood-outcomes-after-interventions-for-prevention-and-management-of-preterm-birth
#3
REVIEW
Sarah R Murray, Sarah J Stock, Jane E Norman
Globally, preterm birth rates are rising and have a significant impact on neonatal morbidity and mortality. Preterm birth remains difficult to prevent and a number of strategies for preterm birth prevention (progesterone, cervical pessaries, cervical cerclage, tocolytics, and antibiotics) have been identified. While some of these show more promise, there is a paucity of evidence regarding the long-term effects of these strategies on childhood outcomes. Strategies used to improve the health of babies if born preterm, such as antenatal magnesium sulfate for fetal neuroprotection and antenatal corticosteroids for fetal lung maturation, show evidence of short-term benefit but lack large-scale follow-up data of long-term childhood outcomes...
December 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/29188370/predictors-of-cerclage-failure-in-patients-with-singleton-pregnancy-undergoing-prophylactic-cervical-cerclage
#4
K Taghavi, M L Gasparri, D Bolla, D Surbek
PURPOSE: The role of cervical cerclage to prevent preterm birth (PTB) remains controversial. The aim of this study was to identify prognostic factors for cerclage failure among singleton pregnant women following prophylactic cerclage (PC). METHODS: A retrospective analysis of PC was performed in a single center. The main outcome measure was cerclage failure, defined by spontaneous early PTB prior to 32 weeks' gestation. Age, BMI, history of instrumentation of the uterus, history of second trimester miscarriage, previous conization, positive vaginal swab prior cerclage, gestational age at time of cerclage, CRP 1 week after cerclage and post-cerclage US changes of cervical length were tested as predictive factors...
November 29, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29169582/history-of-cervical-insufficiency-increases-the-risk-of-pelvic-organ-prolapse-and-stress-urinary-incontinence-in-parous-women
#5
David Sheyn, Kateena L Addae-Konaedu, Alison M Bauer, Konyinsola I Dawodu, David N Hackney, Sherif A El-Nashar
OBJECTIVE: A likely contributor to pelvic floor disorders is injury and degradation of connective tissue components such as collagen and elastin, leading to weakening of the pelvic floor. Prior studies have found similar connective tissue component changes in women with cervical insufficiency (CI). However, the connection between pelvic floor disorders and cervical insufficiency has not previously been evaluated. Our objective was to determine whether a history of cervical insufficiency is associated with an increased risk of pelvic organ prolapse and stress urinary incontinence after controlling for confounders...
January 2018: Maturitas
https://www.readbyqxmd.com/read/29146391/small-diameter-hysteroscopic-metroplasty-for-a-septate-uterus-after-open-assisted-laparoscopic-radical-trachelectomy
#6
Akimasa Takahashi, Hiroyuki Kanao, Nobuhiro Takeshima
STUDY OBJECTIVE: To describe a two-step fertility preservation technique for early-stage cervical cancer of a patient with a complete septate uterus. DESIGN: A step-by-step demonstration and explanation of the technique in a surgical video (Canadian Task Force Classification III). SETTING: Center for cancer, a tertiary referral center. The patient provided informed consent to use images and videos of the procedure. Institutional Review Board approval was not required for this kind of procedure...
November 13, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29142797/cervical-funneling-potential-pitfall-of-point-of-care-pelvic-ultrasound
#7
Lori A Stolz, Richard Amini, Elaine H Situ-LaCasse, Faryal Shareef, Heather A Reed, Srikar Adhikari
Though point-of-care ultrasound applications continue to expand, there are findings that are not within the scope of emergency ultrasound. It is important for emergency physicians to be aware of incidental findings that can be identified on comprehensive ultrasounds performed by other imaging departments in order to fully understand the limitations of bedside ultrasound. In this case, a gravid patient presented to the emergency department with pelvic cramping and vaginal bleeding. Point-of-care transabdominal pelvic ultrasound examination was performed and demonstrated cervical funneling...
September 3, 2017: Curēus
https://www.readbyqxmd.com/read/29135075/the-role-of-body-mind-and-environment-in-preterm-birth-mind-the-gap
#8
REVIEW
Shelby Yamamoto, Shahirose Premji
Preterm birth continues to be a problem affecting low-, middle-, and high-income countries, with rates increasing in some areas despite ongoing efforts to reduce the incidence. This emphasizes the need for more effective interventions, particularly if we aim to achieve the broad health targets of the Sustainable Development Goals (SDGs) by 2030. The current focus on medically-oriented interventions such as reducing nonmedically-indicated induction of labor, cesarean birth, and multiple embryo transfers associated with assisted reproductive technologies, as well as the application of cervical cerclage and use of progesterone therapy, though important, are likely only partial solutions to the complex phenomenon of preterm birth...
November 14, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29121417/transabdominal-cerclage-tac-for-patients-with-ultra-short-uterine-cervix-after-uterine-cervix-surgery-and-its-impact-on-pregnancy
#9
Shinichi Ishioka, Miseon Kim, Yuko Mizugaki, Saori Kon, Kyoko Isoyama, Masahito Mizuuchi, Miyuki Morishita, Tsuyoshi Baba, Takao Sekiya, Tsuyoshi Saito
AIM: Patients with an ultra-short uterine cervix as a result of large conization, repeated conization or radical trachelectomy (RT), are at high risk of preterm premature rupture of the membrane, which leads to preterm birth. We have commenced performing transabdominal cerclage (TAC) of the uterine cervix for these patients. In this study, we examined the safety of TAC and its impact on pregnancy. METHODS: We have performed TAC in 11 patients before pregnancy: in six after large cervical operations, such as repeated conization; and in five for difficulties with cervical cerclage after RT...
November 9, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29116935/outcomes-of-physical-examination-indicated-cerclage-in-twin-pregnancies-with-acute-cervical-insufficiency-compared-to-singleton-pregnancies
#10
Jee Yoon Park, Soo-Hyun Cho, Se Jeong Jeon, Song Yi Kook, Hyunsoo Park, Kyung Joon Oh, Joon-Seok Hong
OBJECTIVES: To compare pregnancy outcomes of physical examination-indicated cerclage in twin pregnancies with acute cervical insufficiency with that of singletons. METHODS: This retrospective cohort study included 88 consecutive women (17 twins and 71 singletons) who had undergone physical examination-indicated cerclage because of acute cervical insufficiency (defined as painless cervical dilation with (1) prolapsed and/or visible membranes at the external cervical os on speculum examination and (2) a functional cervical length of zero on transvaginal ultrasound) between 160/7 and 236/7 weeks...
November 8, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29108444/outcomes-after-periviable-ultrasound-indicated-cerclage
#11
Daphnie Drassinower, Elizabeth Coviello, Helain J Landy, Cynthia Gyamfi-Bannerman, Annette Perez-Delboy, Alexander M Friedman
BACKGROUND: Cerclage placed for a sonographically short cervix has been shown to reduce the risk of preterm delivery in women with a history of prior preterm birth. While short cervix is traditionally placed before viability, the threshold gestational age at which viability is achieved continues to decrease, and, as a result, a larger subset of women may be ineligible to receive this potentially beneficial procedure. OBJECTIVE: To evaluate the association between obstetric outcomes and perioperative complications after placement of an ultrasound-indicated cerclage at periviability compared to placement in the previable period...
November 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29095502/obstetric-outcomes-after-conservative-treatment-for-cervical-intraepithelial-lesions-and-early-invasive-disease
#12
REVIEW
Maria Kyrgiou, Antonios Athanasiou, Ilkka E J Kalliala, Maria Paraskevaidi, Anita Mitra, Pierre Pl Martin-Hirsch, Marc Arbyn, Phillip Bennett, Evangelos Paraskevaidis
BACKGROUND: The mean age of women undergoing local treatment for pre-invasive cervical disease (cervical intra-epithelial neoplasia; CIN) or early cervical cancer (stage IA1) is around their 30s and similar to the age of women having their first child. Local cervical treatment has been correlated to adverse reproductive morbidity in a subsequent pregnancy, however, published studies and meta-analyses have reached contradictory conclusions. OBJECTIVES: To assess the effect of local cervical treatment for CIN and early cervical cancer on obstetric outcomes (after 24 weeks of gestation) and to correlate these to the cone depth and comparison group used...
November 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29062554/effectiveness-of-prophylactic-cervical-cerclage-in-prolonging-higher-order-multiple-pregnancies
#13
Nail Obeidat, Haifa Alchalabi, Maha Obeidat, Bahauddin Sallout, Shereen Hamadneh, Jehan Hamadneh, Yousef Khader, Zouhair Amarin
OBJECTIVES: This study aimed to assess the value of prophylactic cervical cerclage in prolonging higher-order multiple pregnancies. METHODS: This retrospective study included all women with higher-order multiple pregnancies beyond 24 gestational weeks treated at the King Abdullah University Hospital in Irbid, Jordan, and King Fahad Medical City in Riyadh, Saudi Arabia, between February 2014 and January 2015. Selected maternal characteristics and obstetric outcomes were compared between women who received prophylactic cervical cerclage and those who did not...
August 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29033106/current-options-for-mechanical-prevention-of-preterm-birth
#14
REVIEW
Rupsa C Boelig, Vincenzo Berghella
Cervical insufficiency can be defined by a combination of obstetric history, cervical dilation on exam, and/or short cervical length in women with prior preterm birth. Options for mechanical intervention include cerclage and pessary. There is evidence to support the benefit of a cervical cerclage in women with singleton gestations who have a diagnosis of cervical insufficiency either based on second trimester painless cervical dilatation leading to recurrent early preterm births, or a history of early spontaneous preterm birth and a second trimester transvaginal ultrasound short cervical length or cervical dilation on exam...
October 12, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28988725/prevention-of-preterm-birth-novel-interventions-for-the-cervix
#15
REVIEW
Bouchra Koullali, Andrea R Westervelt, Kristin M Myers, Michael D House
Preterm birth is the leading cause of neonatal mortality and morbidity worldwide. Spontaneous preterm birth is a complex, multifactorial condition in which cervical dysfunction plays an important role in some women. Current treatment options for cervical dysfunction include cerclage and supplemental progesterone. In addition, cervical pessary is being studied in research protocols. However, cerclage, supplemental progesterone and cervical pessary have well known limitations and there is a strong need for alternate treatment options...
October 5, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28926726/fertility-and-pregnancy-outcomes-after-transvaginal-cervico-isthmic-cerclage
#16
Marie-Emmanuelle Neveu, Hervé Fernandez, Xavier Deffieux, Marie-Victoire Senat, Marie Houllier, Perrine Capmas
INTRODUCTION: Prematurity is the leading cause of neonatal morbidity and mortality. Cervical insufficiency seems to be the main risk factor. Treatment is cervical cerclage. In case of failure, a cervico-isthmic cerclage by Fernandez' technique, with the placement of a polypropylene sling by vaginal approach during the first trimester of pregnancy, has proven its effectiveness. The aim of our study is to report effectiveness of Fernandez' cervico-isthmic cerclage in subsequent pregnancies...
November 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28889776/risk-of-spontaneous-preterm-birth-in-ivf-conceived-twin-pregnancies
#17
Gabriele Saccone, Fabrizio Zullo, Amanda Roman, Andrew Ward, Giuseppe Maruotti, Pasquale Martinelli, Vincenzo Berghella
OBJECTIVE: To compare the mean transvaginal ultrasound (TVU) cervical length (CL) at midtrimester in screening for preterm birth in in vitro (IVF)-conceived twin pregnancies versus spontaneously-conceived twin pregnancies. METHODS: This was a retrospective cohort study. Potential study subjects were identified at the time of a routine second trimester fetal ultrasound exam at 18 0/7 to 23 6/7-week gestation. All women with twin diamniotic pregnancies screened with a single TVU CL for this trial were included...
September 21, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28889767/delayed-interval-delivery-in-twin-pregnancies-report-of-three-cases-and-literature-review
#18
Marta Benito Vielba, Carlos De Bonrostro Torralba, Victoria Pallares Arnal, Rebeca Herrero Serrano, Eva Lucía Tejero Cabrejas, Jose Manuel Campillos Maza
INTRODUCTION: Delayed delivery is sometimes performed in selected multifetal pregnancies when the first twin birth occurs inevitably. The aim of this procedure is to improve the prognosis and decrease the morbidity and mortality of the second twin. We report three cases of delayed-interval delivery of dichorionic-diamniotic twin pregnancies assisted in our center between 2015 and 2017. After the first twin delivery, the second twin was left in utero and the patient received tocolytic therapy and antibiotics...
October 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28797657/systematic-review-of-transabdominal-cerclage-placed-via-laparoscopy-for-the-prevention-of-preterm-birth
#19
REVIEW
Gaby N Moawad, Paul Tyan, Tracey Bracke, Elias D Abi Khalil, Vicky Vargas, Alexis Gimovsky, Cherie Marfori
Preterm birth is the leading cause of neonatal mortality and morbidity. Multiple interventions have been put in place to minimize this occurrence. Despite current recommendations including medical management, cervical length screening, and transvaginal cerclage a substantial number of women still experience preterm birth. For those patients, experts recommend a transabdominal cerclage. In our systematic review, we compare 26 studies (1116 patients) on transabdominal cerclage placed via laparotomy (TAC-lap) to 15 studies (728 patients) on transabdominal cerclage placed via laparoscopy (TAC-lsc)...
August 7, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28753545/adjuvant-administration-of-17-%C3%AE-hydroxy-progesterone-caproate-in-women-with-three-or-more-second-trimester-pregnancy-losses-undergoing-cervical-cerclage-is-no-more-effective-than-cerclage-alone
#20
Fernand D Samson, Amanda L Merriman, Danielle L Tate, Katherine Apostolakis-Kyrus, Luis M Gomez
OBJECTIVE: To investigate the role of adjuvant 17-α-hydroxy-progesterone caproate (17OHP-C) in reducing the risk of preterm delivery <34 weeks and adverse perinatal outcomes in women with ≥3 second trimester pregnancy losses attributed to cervical insufficiency undergoing prophylactic cerclage. MATERIAL AND METHODS: Retrospective cohort study of women with prophylactic cerclage placed between 2006 and 2014 divided into a cohort of (i) those receiving adjuvant 17OHP-C (n=43), and (ii) controls with cerclage alone (n=59)...
July 28, 2017: Journal of Perinatal Medicine
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