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Cervical length screening

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https://www.readbyqxmd.com/read/28170117/prevention-of-preterm-birth-with-pessary-in-twins-poppt-a-randomized-controlled-trial
#1
Vincenzo Berghella, Lorraine Dugoff, Jack Ludmir
OBJECTIVES: To evaluate if cervical pessary placement prevents PTB in twin gestations with a short midtrimester transvaginal ultrasound (TVU) cervical length (CL). METHODS: Multicenter randomized controlled trial of asymptomatic women with twin gestations with a TVU CL ≤30 mm at 18(0) -27(6) weeks. TVU CL screening was performed at the time of the anatomy scan at 18(0) -23(6) , and at subsequent scheduled ultrasounds prior to 28 weeks. Women with a TVU CL ≤30 mm at 18(0) -27(6) weeks were randomized to receive the Bioteque cup cervical pessary or no pessary...
February 7, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28166925/-is-universal-screening-for-cervical-length-among-singleton-pregnancies-with-no-history-of-preterm-birth-justified
#2
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/28153653/prenatal-diagnosis-and-management-of-vasa-previa-in-twin-pregnancies-a-case-series-and-systematic-review
#3
REVIEW
Eric Jauniaux, Yaakov Melcer, Ron Maymon
BACKGROUND: Twin pregnancies are at higher risks of velamentous cord insertion (VCI) and vasa previa. In-vitro fertilization (IVF) is an additional risk factor of abnormal cord insertion and thus the incidence of vasa previa is likely to increase over the next decades. OBJECTIVE: To evaluate the role of ultrasound imaging in optimizing the management of twins diagnosed with vasa previa antenatally. STUDY DESIGN: We searched our database for twin pregnancies diagnosed with vasa previa and managed antenatally using measurements of cervical length (CL) and performed a systematic review of articles which correlated prenatal diagnosis of vasa previa in twins and pregnancy outcome...
January 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28141949/ability-of-cervical-length-to-predict-spontaneous-preterm-delivery-in-twin-pregnancies-using-the-receiver-operating-characteristic-curve-analysis-and-an-a-priori-cut-off-value
#4
Lucia Pasquini, Giovanni Sisti, Dimitrios Nasioudis, Tomi Kanninen, Flavia Sorbi, Massimiliano Fambrini, Irene Turrini, Viola Seravalli, Mariarosaria Di Tommaso
In this retrospective study based on cervical length (CL) measurements between 20 and 24 + 6 weeks, we examined the ability of CL to predict spontaneous preterm birth (SPTB) in 222 twin pregnancies using the receiver-operating curve (ROC) analysis and an a priori cut-off. CL predicted SPTB before 34 weeks. Using the ROC the selected cut-off was 37.5 mm. Positive predictive value (PPV) and negative predictive value (NPV) regarding SPTB before 34 weeks for 37.5 mm were 15.7% and 5.3% respectively. Using the 5th percentile, PPV and NPV regarding SPTB before 34 weeks for 24 mm were 41...
January 31, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28128525/cervical-length-screening-will-we-truly-reap-economic-benefits-with-a-universal-screening-approach
#5
Aaron B Caughey
Preterm birth is a leading cause of perinatal morbidity and mortality. Despite extensive research utilizing a wide-range of approaches and public efforts, the rate of preterm birth has not changed substantially over the past two decades, other than a rise in late preterm births from the late 1990s that was most likely due to iatrogenic causes.(National Vital Statistics Reports 2010;58:1-32) Thus, preterm birth prevention remains one of the single most impactful ways to improve perinatal outcomes, but a successful approach has remained elusive...
January 27, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28099294/examination-of-pediatric-radiation-dose-delivered-after-cervical-spine-trauma
#6
Laura K Somppi, Kristin A Frenn, Anupam B Kharbanda
OBJECTIVES: Pediatric cervical spine injuries (CSIs) are rare but potentially fatal injuries. Plain radiographs (x-rays) and computed tomography (CT) are used to diagnose CSIs. Given concerns related to radiation exposure, the utility of x-rays in diagnosing CSIs compared with other forms of imaging must be examined. METHODS: Patients younger than 19 years presenting with possible CSI to an urban tertiary care hospital who received imaging for possible CSI between January 1, 2011, and December 31, 2013, were included...
January 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28068594/prevention-of-spontaneous-preterm-birth-guidelines-for-clinical-practice-from-the-french-college-of-gynaecologists-and-obstetricians-cngof
#7
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/28029462/-prediction-of-preterm-delivery-in-symptomatic-women-preterm-labor
#8
G Benoist
OBJECTIVES: To evaluate the predictors of spontaneous preterm birth in case of preterm labor. MATERIALS AND METHODS: Literature search in Medline and Cochrane databases and recommendations of international societies. Selection of studies in symptomatic women (with preterm labor). RESULTS: Preterm labor is defined as a clinical situation occurring between 22 and 36 weeks + 6 days, in which cervical changes are observed associated with uterine contractions, evolving spontaneously or not to preterm delivery (Professional consensus)...
October 28, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28029461/-prevention-of-preterm-birth-by-uterine-cervical-cerclage
#9
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
#10
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/27997053/cervical-length-screening-for-prevention-of-preterm-birth-in-singleton-pregnancies-with-threatened-preterm-labor-a-cochrane-systematic-review-and-meta-analysis-of-randomized-controlled-trials-using-individual-patient-level-data
#11
REVIEW
Vincenzo Berghella, Montse Palacio, Amen Ness, Zarko Alfirevic, Kypros Nicolaides, Gabriele Saccone
OBJECTIVE: Cervical length screening by transvaginal ultrasound has been shown to be a good predictive test for spontaneous preterm birth (PTB) in symptomatic singleton pregnancies with threatened preterm labor (PTL). The aim of this Cochrane review and meta-analysis of individual participant data was to evaluate the effect of using knowledge of transvaginal ultrasound cervical length (TVU CL) in preventing PTB in singleton pregnancies presenting with threatened PTL. METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register and the Cochrane Complementary Medicine Field's Trials Register (May 2016) and reference lists of retrieved studies...
December 20, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27928435/a-debate-about-ultrasound-and-anatomic-aspects-of-the-cervix-in-spontaneous-preterm-birth
#12
REVIEW
Bohîlțea Re, Munteanu O, Turcan N, Baros A, Bodean O, Voicu D, Cîrstoiu Mm
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
https://www.readbyqxmd.com/read/27889000/not-transabdominal
#13
EDITORIAL
Adeeb Khalifeh, Vincenzo Berghella
Preterm birth remains a major cause of perinatal morbidity and mortality. A short cervix is strongly associated with spontaneous preterm birth. Professional organizations support cervical length screening for singleton gestations with a prior spontaneous preterm birth and second-trimester cervical length measurements between 16-24 weeks. All interventions used to decrease the risk of preterm birth in women with a short cervix are based on clinical trials that used transvaginal cervical length measurement, but transabdominal ultrasound has been shown to correlate well with transvaginal measurement in some observational studies...
December 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27888999/transabdominal-ultrasound-is-appropriate
#14
EDITORIAL
David Stamilio, Laura M Carlson
Preterm birth remains a major cause of perinatal morbidity and mortality. A short cervix is strongly associated with spontaneous preterm birth. Professional organizations support cervical length screening for singleton gestations with a prior spontaneous preterm birth and second-trimester cervical length measurements between 16-24 weeks. All interventions used to decrease the risk of preterm birth in women with a short cervix are based on clinical trials that used transvaginal cervical length measurement, but transabdominal ultrasound has been shown to correlate well with transvaginal measurement in some observational studies...
December 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27843353/prevention-of-preterm-delivery-current-challenges-and-future-prospects
#15
REVIEW
Maud D van Zijl, Bouchra Koullali, Ben Wj Mol, Eva Pajkrt, Martijn A Oudijk
Preterm birth (PTB), defined as delivery at <37 weeks of gestation, is the most important cause of neonatal morbidity and mortality. Therefore, preventing PTB is one of the main goals in obstetric care. In this review, we provide an overview of the current available literature on screening for risk factors for PTB and a summary of preventive strategies in both low-risk and high-risk women with singleton or multiple gestations. Furthermore, current challenges and future prospects on PTB are discussed. For an optimal prevention of PTB, risk stratification should be based on a combination of (maternal) risk factors, obstetric history, and screening tools...
2016: International Journal of Women's Health
https://www.readbyqxmd.com/read/27836377/-prevention-of-spontaneous-preterm-birth-excluding-preterm-premature-rupture-of-membranes-guidelines-for-clinical-practice%C3%A2-%C3%A2-text-of-the-guidelines-short-text
#16
L Sentilhes, M-V Sénat, P-Y Ancel, E Azria, G Benoist, J Blanc, G Brabant, F Bretelle, S Brun, M Doret, C Ducroux-Schouwey, A Evrard, G Kayem, E Maisonneuve, L Marcellin, S Marret, N Mottet, S Paysant, D Riethmuller, P Rozenberg, T Schmitz, H Torchin, B Langer
OBJECTIVES: To determine the measures to prevent spontaneous preterm birth (excluding preterm premature rupture of membranes)and its consequences. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: In France, premature birth concerns 60,000 neonates every year (7.4 %), half of them are delivered after spontaneous onset of labor...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27813278/universal-cervical-length-screening-for-singleton-pregnancies-with-no-history-of-preterm-delivery-or-the-inverse-of-the-pareto-principle
#17
REVIEW
P Rozenberg
: Ultrasound measurement of cervical length in the general population enables the identification of women at risk for spontaneous preterm delivery. Vaginal progesterone is effective in reducing the risk of preterm delivery in this population. This screening associated with treatment by vaginal progesterone is cost-effective. Universal screening of cervical length can therefore be considered justified. Nonetheless, this screening will not appreciably reduce the preterm birth prevalence: in France or UK, where the preterm delivery rate is around 7...
November 4, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27812088/preterm-birth-prevention-post-conization-a-model-of-cervical-length-screening-with-targeted-cerclage
#18
Lindsay M Kindinger, Maria Kyrgiou, David A MacIntyre, Stefano Cacciatore, Angela Yulia, Joanna Cook, Vasso Terzidou, T G Teoh, Phillip R Bennett
Women with a history of excisional treatment (conization) for cervical intra-epithelial neoplasia (CIN) are at increased risk of preterm birth, perinatal morbidity and mortality in subsequent pregnancy. We aimed to develop a screening model to effectively differentiate pregnancies post-conization into low- and high-risk for preterm birth, and to evaluate the impact of suture material on the efficacy of ultrasound indicated cervical cerclage. We analysed longitudinal cervical length (CL) data from 725 pregnant women post-conization attending preterm surveillance clinics at three London university Hospitals over a ten year period (2004-2014)...
2016: PloS One
https://www.readbyqxmd.com/read/27777928/cervicovaginal-fluid-acetate-a-metabolite-marker-of-preterm-birth-in-symptomatic-pregnant-women
#19
Emmanuel Amabebe, Steven Reynolds, Victoria Stern, Graham Stafford, Martyn Paley, Dilly O C Anumba
Changes in vaginal microbiota that is associated with preterm birth (PTB) leave specific metabolite fingerprints that can be detected in the cervicovaginal fluid (CVF) using metabolomics techniques. In this study, we characterize and validate the CVF metabolite profile of pregnant women presenting with symptoms of threatened preterm labor (PTL) by both (1)H-nuclear magnetic resonance spectroscopy (NMR) and enzyme-based spectrophotometry. We also determine their predictive capacity for PTB, singly, and in combination, with current clinical screening tools - cervicovaginal fetal fibronectin (FFN) and ultrasound cervical length (CL)...
2016: Frontiers in Medicine
https://www.readbyqxmd.com/read/27665313/unplanned-30-day-hospital-readmission-as-a-quality-measure-in-gynecologic-oncology
#20
MaryAnn B Wilbur, Diana B Mannschreck, Ana M Angarita, Rayna K Matsuno, Edward J Tanner, Rebecca L Stone, Kimberly L Levinson, Sarah M Temkin, Martin A Makary, Curtis A Leung, Amy Deutschendorf, Peter J Pronovost, Amy Brown, Amanda N Fader
OBJECTIVES: Thirty-day readmission is used as a quality measure for patient care and Medicare-based hospital reimbursement. The primary study objective was to describe the 30-day readmission rate to an academic gynecologic oncology service. Secondary objectives were to identify risk factors and costs related to readmission. METHODS: This was a retrospective, concurrent cohort study of all surgical admissions to an academic, high volume gynecologic oncology service during a two-year period (2013-2014)...
December 2016: Gynecologic Oncology
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