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cervical ripening

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https://www.readbyqxmd.com/read/28920504/outpatient-cervical-ripening-in-a-district-general-hospital-a-five-year-retrospective-cohort-study
#1
Lauren Barnfield, Edmund Neale, Sarah Reynolds
The number of women undergoing induction of labour has risen steadily in recent years. Outpatient induction is becoming more common in the UK in response to the required increase in resources, although evidence supporting its safety is lacking. We reviewed the notes of low-risk women presenting for outpatient cervical ripening using prostaglandins over a five-year period, and compared our neonatal and maternal outcomes to local and national data. Of the 502 eligible women, 400 underwent outpatient treatment...
September 18, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28912192/mechanical-cervical-ripening-for-women-with-prolongedpregnancies-magpop-protocol-for-a-randomised-controlled-trial-of-a-silicone-double-balloon-catheter-versus-the-propess-system-for-the-slow-release-of-dinoprostone-for-cervical-ripening-of-prolonged-pregnancies
#2
Caroline Diguisto, Amélie Le Gouge, Bruno Giraudeau, Franck Perrotin
INTRODUCTION: Induction of labour for prolonged pregnancies (PP) when the cervix is unfavourable is a challenging situation. Cervical ripening by pharmacological or mechanical techniques before oxytocin administration is used to increase the likelihood of vaginal delivery. Both techniques are equally effective in achieving vaginal delivery but excessive uterine activity, which induces fetal heart rate (FHR) anomalies, is more frequent after the pharmacological intervention. We hypothesised that mechanical cervical ripening could reduce the caesarean rate for non-reassuring FHR especially in PP where fetuses are already susceptible to this...
September 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28901007/pharmacological-and-mechanical-interventions-for-labour-induction-in-outpatient-settings
#3
REVIEW
Joshua P Vogel, Alfred O Osoti, Anthony J Kelly, Stefania Livio, Jane E Norman, Zarko Alfirevic
BACKGROUND: Induction of labour is carried out for a variety of indications and using a range of methods. For women at low risk of pregnancy complications, some methods of induction of labour or cervical ripening may be suitable for use in outpatient settings. OBJECTIVES: To examine pharmacological and mechanical interventions to induce labour or ripen the cervix in outpatient settings in terms of effectiveness, maternal satisfaction, healthcare costs and, where information is available, safety...
September 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28898687/outcomes-of-mifepristone-usage-for-cervical-ripening-and-induction-of-labour-in-full-term-pregnancy-randomized-controlled-trial
#4
Oleg R Baev, Valentina P Rumyantseva, Oleg V Tysyachnyu, Olga A Kozlova, Gennady T Sukhikh
OBJECTIVE: The most commonly used approved indications for mifepristone in obstetrics include: termination of early pregnancy, cervical dilatation prior to abortion, labour induction in case of fetal death in utero. Fewer studies have been conducted on the effect of mifepristone on cervical ripening and induction of labour in term pregnancy with a live fetus. The aim of our study was to evaluate efficacy and safety of mifepristone use for cervical ripening and induction of labour versus expectant management in full-term pregnancy...
September 1, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28764579/foley-catheter-versus-intravaginal-prostaglandins-e2-for-cervical-ripening-in-women-at-term-with-an-unfavorable-cervix-a-randomized-controlled-trial
#5
Giulia Barda, Hadas Ganer Herman, Ron Sagiv, Jacob Bar
OBJECTIVE: The objective of this study is to compare the efficacy of labor induction by Foley catheter balloon (FCB) insertion to intravaginal dinoprostone tablet placement in women with an unfavorable cervix. MATERIALS AND METHODS: A prospective randomized controlled trial was conducted. Women were assigned to insertion of a FCB or placement of a vaginal dinoprostone tablets and their outcome were compared. RESULTS: The study comprised 300 women...
August 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28757105/-double-balloon-catheter-compared-to-vaginal-dinoprostone-for-cervical-ripening-in-obese-women-at-term
#6
J Grange, J Dimet, M Vital, A Le Thuaut, G Ducarme
OBJECTIVE: To compare the efficacy of a double-balloon catheter versus vaginal prostaglandin E2 (dinoprostone) for cervical ripening in obese patients with unfavorable cervix at term. METHODS: The study had an open-label, prospective combined with retrospective, observational design. From January 2013 until May 2016, a prospective cohort study of 46 women with pre-pregnancy BMI>30kg/m(2), live singleton term fetuses (>37 weeks) in vertex presentation and unfavorable cervix (Bishop score<6), who underwent labor induction for conventional indications using a double-balloon catheter...
July 27, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28754971/in-vivo-raman-spectral-analysis-of-impaired-cervical-remodeling-in-a-mouse-model-of-delayed-parturition
#7
Christine M O'Brien, Jennifer L Herington, Naoko Brown, Isaac J Pence, Bibhash C Paria, James C Slaughter, Jeff Reese, Anita Mahadevan-Jansen
Monitoring cervical structure and composition during pregnancy has high potential for prediction of preterm birth (PTB), a problem affecting 15 million newborns annually. We use in vivo Raman spectroscopy, a label-free, light-based method that provides a molecular fingerprint to non-invasively investigate normal and impaired cervical remodeling. Prostaglandins stimulate uterine contractions and are clinically used for cervical ripening during pregnancy. Deletion of cyclooxygenase-1 (Cox-1), an enzyme involved in production of these prostaglandins, results in delayed parturition in mice...
July 28, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28716915/prostaglandin-dehydrogenase-is-a-target-for-successful-induction-of-cervical-ripening
#8
Annavarapu Hari Kishore, Hanquan Liang, Mohammed Kanchwala, Chao Xing, Thota Ganesh, Yucel Akgul, Bruce Posner, Joseph M Ready, Sanford D Markowitz, Ruth Ann Word
The cervix represents a formidable structural barrier for successful induction of labor. Approximately 10% of pregnancies undergo induction of cervical ripening and labor with prostaglandin (PG) E2 or PGE analogs, often requiring many hours of hospitalization and monitoring. On the other hand, preterm cervical ripening in the second trimester predicts preterm birth. The regulatory mechanisms of this paradoxical function of the cervix are unknown. Here, we show that PGE2 uses cell-specific EP2 receptor-mediated increases in Ca(2+) to dephosphorylate and translocate histone deacetylase 4 (HDAC4) to the nucleus for repression of 15-hydroxy prostaglandin dehydrogenase (15-PGDH)...
August 1, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28698953/what-can-we-do-to-reduce-the-associated-costs-in-induction-of-labour-of-intrauterine-growth-restriction-foetuses-at-term-a-cost-analysis-study
#9
Jorge Duro-Gómez, María Fernanda Garrido-Oyarzún, Ana Belén Rodríguez-Marín, Antonio Jesús de la Torre González, José Eduardo Arjona-Berral, Camil Castelo-Branco
OBJECTIVE: To evaluate the costs associated with induction of labour in intrauterine growth restriction fetuses comparing different procedures. STUDY DESIGN: 150 pregnancies at term diagnosed with intrauterine growth restriction and indication for induction of labour were included. 24 were ripened with misoprostol 25 μg tablets, 24 with dinoprostone 10 mg vaginal insert, and 77 with Cook(®) cervical ripening balloon. To determine the costs of induction of labour, method of induction, intrapartum medication, epidural analgesia, type of delivery, and maternal and neonatal admissions were considered...
July 11, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28697540/three-doses-of-oral-misoprostol-versus-an-intra-cervical-foley-catheter-for-24-hours-for-pre-induction-cervical-ripening-in-post-dated-pregnancies-a-randomized-controlled-trial
#10
D Somirathne, Malik Goonewardene, L Dahanayake
Objectives: To compare three doses of oral misoprostol 50μg four hourly versus an intra-cervical Foley catheter for 24 hours, for pre-induction cervical ripening. Methods: Primary investigator blinded, randomised controlled trial conducted in 180 consecutive women with singleton uncomplicated pregnancies with Modified Bishop Score (MBS) 5 at 40 weeks + 6 days gestation, allocated by stratified (primigravida / multigravida) block randomization to receive three doses of oral misoprostol 50μg four hourly or an intra-cervical Foley catheter for 24 hours...
June 30, 2017: Ceylon Medical Journal
https://www.readbyqxmd.com/read/28672756/induction-of-labor-in-patients-with-an-unfavorable-cervix-after-a-cesarean-using-an-osmotic-dilator-versus-vaginal-prostaglandin
#11
Josefine T Maier, Melanie Metz, Nina Watermann, Linna Li, Elisabeth Schalinski, Ulrich Gauger, Werner Rath, Lars Hellmeyer
BACKGROUND: Trial of labor after cesarean (TOLAC) is a viable option for safe delivery. In some cases cervical ripening and subsequent labor induction is necessary. However, the commonly used prostaglandins are not licensed in this subgroup of patients and are associated with an increased risk of uterine rupture. METHODS: This cohort study compares maternal and neonatal outcomes of TOLAC in women (n=82) requiring cervical ripening agents (osmotic dilator vs. prostaglandins)...
June 26, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28667298/evolution-of-gene-expression-in-the-uterine-cervix-related-to-steroid-signaling-conserved-features-in-the-regulation-of-cervical-ripening
#12
Günter P Wagner, Mauris C Nnamani, Arun Rajendra Chavan, Jamie Maziarz, Stella Protopapas, Jennifer Condon, Roberto Romero
The uterine cervix is the boundary structure between the uterus and the vagina and is key for the maintenance of pregnancy and timing of parturition. Here we report on a comparative transcriptomic study of the cervix of four placental mammals, mouse, guinea pig, rabbit and armadillo, and one marsupial, opossum. Our aim is to investigate the evolution of cervical gene expression as related to putative mechanisms for functional progesterone withdrawal. Our findings are: 1) The patterns of gene expression in eutherian (placental) mammals are consistent with the notion that an increase in the E/P4 signaling ratio is critical for cervical ripening...
June 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28624988/mifepristone-vs-balloon-catheter-for-labor-induction-in-previous-cesarean-a-randomized-controlled-trial
#13
Chanderdeep Sharma, Anjali Soni, Amit Gupta, Ashok Verma, Suresh Verma
OBJECTIVE: To compare oral mifepristone (400 mg) with trans-cervical balloon catheter for induction of labor (IOL) in post date women with previous one cesarean section (CS). METHODS: In this randomized trial, post date pregnant women (gestation 40 weeks 5 days), with previous one low segment CS (no previous vaginal delivery) were induced either with oral mifepristone (400 mg) or balloon catheter [Foley's catheter (16 Fr); bulb filled with 30 ml normal saline]...
August 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28599068/methods-of-term-labour-induction-for-women-with-a-previous-caesarean-section
#14
REVIEW
Helen M West, Marta Jozwiak, Jodie M Dodd
BACKGROUND: Women with a prior caesarean delivery have an increased risk of uterine rupture and for women subsequently requiring induction of labour it is unclear which method is preferable to avoid adverse outcomes. This is an update of a review that was published in 2013. OBJECTIVES: To assess the benefits and harms associated with different methods used to induce labour in women who have had a previous caesarean birth. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register (31 August 2016) and reference lists of retrieved studies...
June 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28585102/the-role-of-prostaglandins-e1-and-e2-dinoprostone-and-misoprostol-in-cervical-ripening-and-the-induction-of-labor-a-mechanistic-approach
#15
Ronan Bakker, Stephanie Pierce, Dean Myers
PURPOSE: Prostaglandins play a critical role in cervical ripening by increasing inflammatory mediators in the cervix and inducing cervical remodeling. Prostaglandin E1 (PGE1) and prostaglandin E2 (PGE2) exert different effects on these processes and on myometrial contractility. These mechanistic differences may affect outcomes in women treated with dinoprostone, a formulation identical to endogenous PGE2, compared with misoprostol, a PGE1 analog. The objective of this review is to evaluate existing evidence regarding mechanistic differences between PGE1 and PGE2, and consider the clinical implications of these differences in patients requiring cervical ripening for labor induction...
August 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28498646/cook-cervical-ripening-balloon-successfully-prevents-excessive-hemorrhage-combined-with-ultrasound-guided-suction-curettage-in-the-treatment-of-cesarean-scar-pregnancy
#16
Chaoying Wu, Yong Li, Wenfeng Ye, Wenqin Ma, Danmei Zhao
AIM: Cesarean scar pregnancy (CSP) is a rare occurrence of ectopic pregnancy. CSP incidence has increased significantly as a result of the increase in cesarean section rates. At present, there are no standard treatment guidelines for CSP; therefore, we report a minimally invasive treatment method for patients diagnosed with CSP. METHODS: This study included 15 women who were diagnosed with CSP. Ultrasound-guided suction curettage was performed on all patients. The Cook Cervical Ripening Balloon was used to tamponade and prevent hemorrhage during the procedure...
May 12, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28486381/intracervical-foley-catheter-with-and-without-oxytocin-for-labor-induction-a-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Corina N Schoen, Gwendolyn Grant, Vincenzo Berghella, Matthew K Hoffman, Anthony Sciscione
OBJECTIVE: To evaluate whether adding oxytocin to preinduction cervical ripening with a Foley catheter increases the rate of delivery within 24 hours. METHODS: This was a randomized, multicenter, parallel trial of women with a singleton pregnancy at 24 weeks of gestation or greater undergoing labor induction. Women were randomly allocated to an intracervical Foley catheter followed by oxytocin or Foley with concurrent oxytocin infusion. Nulliparous and multiparous women were randomized and analyzed separately based on parallel design...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28479288/a-randomized-trial-of-foley-bulb-for-labor-induction-in%C3%A2-premature-rupture-of-membranes-in-nulliparas-flip
#18
RANDOMIZED CONTROLLED TRIAL
Jennifer M H Amorosa, Joanne Stone, Stephanie H Factor, Whitney Booker, Meredith Newland, Angela Bianco
BACKGROUND: In premature rupture of membranes (PROM), the risk of chorioamnionitis increases with increasing duration of membrane rupture. Decreasing the time from PROM to delivery is associated with lower rates of maternal infection. The American College of Obstetricians and Gynecologists suggests that all women with PROM who do not have a contraindication to vaginal delivery have their labor induced instead of being managed expectantly. Although the use of oxytocin for labor induction has been demonstrated to decrease the time to delivery compared with expectant management, no studies have evaluated the effectiveness of cervical ripening with a Foley bulb to additionally decrease the time to delivery...
September 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28475392/is-nitric-oxide-an-essential-mediator-in-cervical-inflammation-and-preterm-birth
#19
Christopher Nold, Julie Stone, Maura Graham, Jennifer Trinh, Alex Blanchette, Todd Jensen
OBJECTIVE: Cervical ripening is an obligatory step in the process of preterm birth. We hypothesize an inflammatory challenge to the cervix leads to an increase in nitric oxide production disrupting the cervical epithelial barrier leading to preterm birth. STUDY DESIGN: For this study, three experiments were performed: (1) Using a mouse model, pregnant mice were treated with an intrauterine injection of saline or lipopolysaccharide (LPS). Mice were sacrificed and cervices were collected for molecular analysis...
May 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28461768/cervical-elastography-during-pregnancy-clinical-perspectives
#20
REVIEW
Malgorzata Swiatkowska-Freund, Krzysztof Preis
Uterine cervix is a part of the uterus responsible for maintaining pregnancy till term. As long as the cervix remains long and firm and its internal orifice (os) is closed, it can withstand enlargement of the uterine contents and resultant growing pressure. Mechanical properties of the cervix change during pregnancy; the cervix ripens prior to delivery, then effaces and dilates with contractions of the uterus. Ripening of the cervix can be assessed using the Bishop score and ultrasonographically determined length of the cervical canal and internal os...
2017: International Journal of Women's Health
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