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https://www.readbyqxmd.com/read/28325126/trial-of-labour-after-caesarean-section-two-year-analysis-at-a-portuguese-centre
#1
Joao Abreu-Silva, Jorge Castro, Catarina Maia, Manuela Pinho, Claudina Carvalho
We conducted a retrospective study aimed at determining variables associated with a higher success rate for vaginal delivery after caesarean section, and assessing the impact of induction of labour. Secondarily, we aimed to describe our vaginal delivery and uterine rupture rates with the use of a controlled-release dinoprostone vaginal insert for cervical ripening. Of 292 women who met the inclusion criteria, induction of labour occurred in 48% (94% with dinoprostone). There was a non-significant difference between the vaginal delivery rate of spontaneous labour (57%) and induction of labour (33%), after adjusting for confounding variables...
March 21, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28321899/labor-induction-and-cesarean-delivery-a-prospective-cohort-study-of-first-births-in-pennsylvania-usa
#2
Kristen H Kjerulff, Laura B Attanasio, Joyce K Edmonds, Katy B Kozhimannil, John T Repke
BACKGROUND: Mode of delivery at first childbirth largely determines mode of delivery at subsequent births, so it is particularly important to understand risk factors for cesarean delivery at first childbirth. In this study, we investigated risk factors for cesarean delivery among nulliparous women, with focus on the association between labor induction and cesarean delivery. METHODS: A prospective cohort study of 2851 nulliparous women with singleton pregnancies who attempted vaginal delivery at hospitals in Pennsylvania, 2009-2011, was conducted...
March 21, 2017: Birth
https://www.readbyqxmd.com/read/28320233/does-cervical-cerclage-decrease-preterm-birth-in-twin-pregnancies-with-a-short-cervix
#3
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
#4
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
#5
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/28315935/double-balloon-catheter-for-induction-of-labour-in-women-with-a-previous-cesarean-section-could-it-be-the-best-choice
#6
Carlos De Bonrostro Torralba, Eva Lucía Tejero Cabrejas, Sabina Marti Gamboa, María Lapresta Moros, Jose Manuel Campillos Maza, Sergio Castán Mateo
INTRODUCTION: We analysed the efficacy and safety of double-balloon catheter for cervical ripening in women with a previous cesarean section and which were the most important variables associated with an increased risk of repeated cesarean delivery. MATERIALS AND METHODS: We designed an observational retrospective study of 418 women with unfavourable cervices (Bishop Score <5), a prior cesarean delivery, and induction of labour with a double-balloon catheter...
March 18, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28304416/gynecologic-malignancies-in-pregnancy-balancing-fetal-risks-with-oncologic-safety
#7
REVIEW
Christina N Cordeiro, Mary L Gemignani
Importance: Cancer occurs in 0.05% to 0.1% of all pregnancies. Despite literature reporting good oncologic and fetal outcomes in women treated for cancer during pregnancy, as many as 44% of gynecologists would offer termination, and 37% would not administer chemotherapy or radiotherapy in pregnancy. Objectives: The aims of this study were to summarize current recommendations for the treatment of cervical and ovarian cancers in pregnancy and to review updates on existing knowledge regarding the safety of surgical and chemotherapeutic treatments in pregnancy, including both oncologic and fetal outcomes...
March 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28303276/a-parameterized-ultrasound-based-finite-element-analysis-of-the-mechanical-environment-of-pregnancy
#8
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/28302659/clear-cell-adenocarcinoma-of-cervix-in-1-year-old-girl-without-in-utero-exposure-to-diethylstilbestrol-an-uncommon-tumour-at-an-uncommon-age-and-site
#9
Aditi Arora, Anurag Rastogi, Azfar Neyaz, Nuzhat Husain
Adenocarcinoma of cervix constitutes about 10-15% cases of carcinoma cervix. Clear cell variant is even a rarer variant of adenocarcinoma. It rarely occurs in the paediatric age group and a known risk factor is in utero exposure to diethylstilbestrol (DES). We report here a case of primary cervical tumour in a 1-year-old girl, which was initially suspected to be an embryonal rhabdomyosarcoma botryoides. Histopathology with immunohistochemical analysis revealed clear cell adenocarcinoma. There was no maternal history of DES intake during pregnancy...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28296959/estradiol-alters-the-immune-responsiveness-of-cervical-epithelial-cells-stimulated-with-ligands-of-toll-like-receptors-2-and-4
#10
Behnia S Lashkari, Dilly O C Anumba
The mucosa of the female reproductive tract plays a pivotal role in host defence. Pregnancy must alter immunological mechanisms at this interface to protect the conceptus. We sought to determine how estradiol (E2) alters the immune-responsiveness of cervical epithelial cells to ligand stimulation of Toll-like receptor (TLR)-2 and -4. Human ectocervical epithelial cells (HECECs) were cultured and co-incubated with two concentrations of E2 and peptidoglycan (PGN) or lipopolysaccharide (LPS) over durations that ranged between 10 minutes and 18 hours...
2017: PloS One
https://www.readbyqxmd.com/read/28295801/cervical-length-measurement-at-mid-gestation-to-predict-spontaneous-preterm-birth-in-asymptomatic-triplet-pregnancies
#11
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
#12
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
#13
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
#14
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/28288882/clinical-outcomes-of-patients-with-heterotopic-pregnancy-after-surgical-treatment
#15
Yiqi Guan, Caihong Ma
STUDY OBJECTIVE: This study aimed to review surgical management and clinical outcomes of patients with heterotopic pregnancy (HP) who underwent in vitro fertilization and embryo transfer (IVF-ET) and surgical treatment at the Assisted Reproductive Technology Center of Peking University Third Hospital from January 2010 to December 2015. DESIGN: We retrospectively analyzed 56 patients' general characteristics, diagnostic features, surgical management, and clinical outcomes according to medical records and follow-up telephone interviews...
March 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28286494/clinical-practice-evidence-based-recommendations-for-the-treatment-of-cervical-dystonia-with-botulinum-toxin
#16
REVIEW
Maria Fiorella Contarino, Joost Van Den Dool, Yacov Balash, Kailash Bhatia, Nir Giladi, Johannes H Koelman, Annemette Lokkegaard, Maria J Marti, Miranda Postma, Maja Relja, Matej Skorvanek, Johannes D Speelman, Evelien Zoons, Joaquim J Ferreira, Marie Vidailhet, Alberto Albanese, Marina A J Tijssen
Cervical dystonia (CD) is the most frequent form of focal dystonia. Symptoms often result in pain and functional disability. Local injections of botulinum neurotoxin are currently the treatment of choice for CD. Although this treatment has proven effective and is widely applied worldwide, many issues still remain open in the clinical practice. We performed a systematic review of the literature on botulinum toxin treatment for CD based on a question-oriented approach, with the aim to provide practical recommendations for the treating clinicians...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28286051/vasa-previa-with-an-intact-amniotic-membrane
#17
Shinya Matsuzaki, Masayuki Endo, Tadashi Kimura
This extremely rare image shows the positional relationship of the cord vessel, amniotic membrane, and cervical os during pregnancy.
March 9, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28285555/factors-affecting-the-rates-of-caesarean-sections-in-cases-with-premature-rupture-of-membranes-prom-at-term
#18
Muberra Namli Kalem, Aydın Köşüş, Zeynep Kamalak, Nermin Köşüş, Ziya Kalem
The aim of this retrospective study was to investigate the factors affecting the rates of caesarean section in cases with premature rupture of membranes (PROM) in term pregnancies. Eighty-two term PROM patients who presented to Turgut Ozal University and Erzurum Nene Hatun Hospitals between 2012 and 2014 were included. The effects of demographics, nulliparity, active-latent phase durations, presence of meconium and chorioamnionitis, requirement of oxytocin and cervical dilation at the initial examination on C/S rates were assessed...
March 13, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28281301/doppler-assessment-of-patients-with-twin-to-twin-transfusion-syndrome-and-survival-following-fetoscopic-laser-surgery
#19
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/28281278/retrospective-comparison-of-perinatal-outcomes-following-emergency-cervical-cerclage-with-or-without-prolapsed-membranes
#20
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
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