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Cervical cerclage

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https://www.readbyqxmd.com/read/28550430/robotic-transabdominal-cerclage-a-case-series-illustrating-costs
#1
Rebecca Lee, David Biats, Melissa Mancuso
The incidence of cervical insufficiency is 0.1-1% of all pregnancies and 8% of second trimester losses. After failed vaginal cerclages or in patients with amputated or congenitally abnormal cervices, transabdominal cerclages may be performed. Recent advances allow for use of the da Vinci robot to perform transabdominal cerclages. This case series presents three cases of robotically placed cerclages, performed prior to pregnancy. All patients had experienced prior second trimester losses. Two of the three had previously failed vaginal cerclage placement...
May 26, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28549981/early-pregnancy-vaginal-microbiome-trends-and-preterm-birth
#2
Molly J Stout, Yanjiao Zhou, Kristine M Wylie, Phillip I Tarr, George A Macones, Methodius G Tuuli
BACKGROUND: Despite decades of attempts to link infectious agents to preterm birth, an exact causative microbe or community of microbes remains elusive. Non-culture 16S ribosomal RNA gene sequencing suggests important racial differences and pregnancy specific changes in the vaginal microbial communities. A recent study examining the association of the vaginal microbiome and preterm birth documented important findings but was performed in a predominantly White cohort. Given the important racial differences in bacterial communities within the vagina as well as persistent racial disparities in preterm birth it is important to examine cohorts with varied demographic compositions...
May 23, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28508414/cervical-cerclage-placed-before-14%C3%A2-weeks-gestation-in-women-with-one-previous-midtrimester-loss-a-population-based-cohort-study
#3
Margaret E Harpham, Charles S Algert, Christine L Roberts, Jane B Ford, Antonia W Shand
BACKGROUND: Cervical cerclage is used in an attempt to reduce recurrence risk of preterm birth, but evidence for use is limited. AIMS: To compare pregnancy outcomes among women with a single previous midtrimester delivery when managed with or without a cervical cerclage. MATERIALS AND METHODS: Population-based cohort study of all women in New South Wales, Australia with a singleton pregnancy ending in birth/miscarriage ≥14 and <28 weeks, between 2003 and 2011...
May 16, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28502186/efectiveness-of-dydrogesterone-17-oh-progesterone-and-micronized-progesterone-in-prevention-of-preterm-birth-in-women-with-a-short-cervix
#4
Olga Anatolievna Pustotina
OBJECTIVE: to compare the efficacy of dydrogesterone, 17-OH progesterone (17OHP) and oral or vaginal micronized progesterone with cerclage for the prevention of preterm birth in women with a short cervix. METHODS: The study included 95 women with singleton gestation and cervical length (CL)≤ 25 mm. Among these, 35 women were asymptomatic at 15-24 weeks and 60 had symptoms of threatened late miscarriage (LM) or preterm delivery (PD). Patients were randomized to receive dydrogesterone, 17OHP or oral/vaginal micronized progesterone; after one week of therapy 15 women underwent cerclage...
May 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28475391/the-role-of-predictive-vaginal-biomarkers-in-women-with-cervical-cerclage
#5
Tomi T Kanninen, Giovanni Sisti, Mariarosaria Di Tommaso, Vincenzo Berghella
Cervical cerclage is presently one of the primary methods of treatment for cervical insufficiency (CI). Identifying methods in order to selectively apply cerclage may allow us to further limit unnecessary procedures. In this regard, a limited number of inflammatory and extracellular matrix biomarkers measurable non-invasively at the level of the cervix have been examined. In this review we summarize the current research on the use of cervical biomarkers in predicting cerclage failure and propose potential objectives for future research...
May 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28426126/actinomyces-in-pregnancy-a-review-of-the-literature
#6
Sarah M Estrada, Everett F Magann, Peter G Napolitano
Importance: Actinomyces is commonly found in many areas of the body where it derives a benefit without harming the host. When it does infect the host during pregnancy, is that infection a threat to the obstetric patient and does that infection cause adverse pregnancy outcomes? Objective: The aim of this study was to review what is known about Actinomyces infections and the impact of an Actinomyces infection on pregnancy outcomes. Evidence Acquisition: A PubMed search was undertaken with the search years unlimited to April 1, 2016, and restricted to articles in English...
April 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28426125/cerclage-use-a-review-of-3-national-guidelines
#7
Jeffrey D Sperling, Joshua D Dahlke, Juan M Gonzalez
Importance: Preterm birth is a major contributor to perinatal morbidity and mortality. The most common intervention performed to improve perinatal outcomes for a woman experiencing cervical dilation in the second trimester without signs or symptoms of preterm labor is the cerclage. Objective: We sought to review and compare available national guidelines on cerclage use. Evidence Acquisition: We performed a descriptive review of 3 national guidelines on cerclage: The American Congress of Obstetricians and Gynecologists Practice Bulletin on "Cerclage for the Management of Cervical Insufficiency," Green-top Guideline from the Royal College of Obstetricians and Gynaecologists entitled "Cervical Cerclage," and the Society of Obstetricians and Gynaecologists of Canada Clinical Practice Bulletin entitled "Cervical Insufficiency and Cervical Cerclage...
April 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28418597/mid-trimester-residual-cervical-length-and-the-risk-of-preterm-birth-in-pregnancies-after-abdominal-radical-trachelectomy-a-retrospective-analysis
#8
Y Kasuga, K Miyakoshi, H Nishio, Y Akiba, T Otani, M Fukutake, S Ikenoue, D Ochiai, T Matsumoto, K Tanaka, K Minegishi, N Kuji, R Roberts, D Aoki, M Tanaka
OBJECTIVE: To investigate the association between mid-trimester residual cervical length (CL) and the risk of preterm birth in pregnancies after abdominal radical trachelectomy (RT). DESIGN: Retrospective cohort study. SETTING: University hospital. POPULATION: A total of 33 deliveries after 22 weeks' gestation in 30 women who underwent abdominal RT including prophylactic cervical cerclage and perinatal care between January 2002 and May 2016...
April 18, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28403957/effectiveness-of-elective-cervical-cerclage-according-to-obstetric-history
#9
D Korb, P Marzouk, J Deu, J-F Oury, O Sibony
OBJECTIVE: To assess the effectiveness of elective history-indicated cervical cerclage according to obstetrical history. STUDY DESIGN: We analyzed pregnancy outcome of a retrospective cohort of women who have had history-indicated McDonald's cerclage. Principal outcome was gestational age (GA) at delivery. RESULT: Between January 2003 and December 2013, 205 women were included. We analyzed population in two risk groups: 1- Low-risk (≤2 prior preterm birth (PTB)/second trimester loss (STL), or prior success of cerclage), 2- High risk (≥3 prior PTB/STL, or prior failure of cerclage)...
January 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28397052/pregnancy-outcomes-following-transvaginal-cerclage-for-cervical-insufficiency-results-from-a-single-center-retrospective-study
#10
Sheng Wang, Ying Wang, Ling Feng
To study maternal and perinatal outcomes after cervical cerclage in both singleton and twin pregnancies, we retrospectively reviewed women undergoing cervical cerclage for cervical insufficiency at Tongji Hospital, Wuhan, China from January 1, 2010 to July 31, 2015 to evaluate primary and secondary outcomes for subgroups with cervical length (CL) ≤15, >15 to <25, and ≥25 mm. Of 166 patients who underwent cervical cerclage, after exclusion of patients with missed abortion and continuing pregnancy, 141 patients (121 singleton and 20 twin pregnancies) were included in the analysis...
April 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28320233/does-cervical-cerclage-decrease-preterm-birth-in-twin-pregnancies-with-a-short-cervix
#11
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 ≤2.5 cm before 24 weeks of gestation through the perinatal ultrasound database of two institutions from 2008 to 2014. Patients with and without cerclage were compared for a primary outcome of preterm birth at <35 weeks...
April 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28318214/preterm-labor-prevention-and-management
#12
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
#13
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
#14
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...
June 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28255763/cervical-length-after-cerclage-comparison-between-laparoscopic-and-vaginal-approach
#15
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
#16
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
#17
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
#18
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 cerclage 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
#19
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
#20
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
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