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cervical ripening

Yun Chai, Miaomiao Qu, Meng Jin
This study was designed to evaluate the application effect of single balloon catheters and dinoprostone on promoting cervical ripening of pregnant women in late-term pregnancy and their influences on stress and inflammatory responses. A total of 160 pregnant women with indications of labor induction were included and randomly divided into the control (n=80) and observation (n=80) groups. Patients in the control group received labor induction by administration of dinoprostone at the vaginal vault, while those in the observation group received labor induction by domestic single balloon catheters...
April 2018: Experimental and Therapeutic Medicine
Joshua I Rosenbloom, Methodius G Tuuli, Molly J Stout, Omar M Young, Candice L Woolfolk, Julia D López, George A Macones, Alison G Cahill
OBJECTIVE:  To determine the factors associated with severe maternal morbidity in a modern cohort of women laboring at term and to create a prediction model. STUDY DESIGN:  This is a retrospective cohort study of all term, laboring patients with live births at a single tertiary care center from 2004 to 2014. The primary outcome was composite maternal morbidity including organ failure, amniotic fluid embolism, anesthesia complications, sepsis, shock, thrombotic events, transfusion, or hysterectomy...
February 8, 2018: American Journal of Perinatology
Molly R Altman, Karen Colorafi, Kenn B Daratha
BACKGROUND:  Hospital electronic health record (EHR) data are increasingly being called upon for research purposes, yet only recently has it been tested to examine its reliability. Studies that have examined reliability of EHR data for research purposes have varied widely in methods used and field of inquiry, with little reporting of the reliability of perinatal and obstetric variables in the current literature. OBJECTIVE:  To assess the reliability of data extracted from a commercially available inpatient EHR as compared with manually abstracted data for common attributes used in obstetrical research...
January 2018: Applied Clinical Informatics
Ashley N Battarbee, Anna Palatnik, Danielle A Peress, William A Grobman
OBJECTIVE:  Evaluate the association between cervical examination after ripening with Foley catheter and labor induction outcomes. MATERIALS AND METHODS:  In this retrospective cohort, nulliparous women with singleton, viable gestation undergoing cervical ripening with Foley catheter were compared based on cervical status after catheter removal or expulsion: favorable (modified Bishop score ≥ 5) or unfavorable (score < 5). Bivariable and multivariable analyses were performed to determine whether cervical examination postripening was associated with time to delivery and chance of vaginal delivery...
February 28, 2018: American Journal of Perinatology
Héctor Lajusticia, Samuel J Martínez-Domínguez, Gonzalo R Pérez-Roncero, Peter Chedraui, Faustino R Pérez-López
OBJECTIVE: To compare the efficacy of single- versus double-balloon catheter (SBC vs. DBC) for cervical ripening and labor induction with an unfavorable cervix. METHODS: Systematic review and meta-analysis of randomized controlled trials (RCTs) or quasi-RCTs (qRCT) regarding the use of SBC or DBC for labor induction of live singleton cephalic pregnancies (≥ 35 weeks) of any parity with an unripe cervix (Bishop score ≤ 6). Nine research databases were searched for original articles published in all languages up to November 2017 comparing both devices for labor induction...
February 14, 2018: Archives of Gynecology and Obstetrics
Mahnaz Kalati, Maryam Kashanian, Fereshteh Jahdi, Mohsen Naseri, Hamid Haghani, Narges Sheikhansari
The purpose of the present study was to evaluate the effects of evening primrose oil (EvPO) on the duration of pregnancy and labour. The study was performed as a triple blind placebo controlled randomised clinical trial on nulliparous low-risk women with a certain gestational age of 40 weeks of pregnancy and a Bishop score of less than 4. In the case group (EvPO group), EvPO capsules were administered, 1000 mg, twice daily, for 7 days, and in the control group, placebo was administered similarly. The women of the two groups were followed up to delivery...
February 9, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Maria Jelinic, Sarah A Marshall, Dennis Stewart, Elaine Unemori, Laura J Parry, Chen Huei Leo
The peptide hormone relaxin has numerous roles both within and independent of pregnancy and is often thought of as a 'pleiotropic hormone'. Relaxin targets several tissues throughout the body, and has many functions associated with extracellular matrix remodeling and the vasculature. This review considers the potential therapeutic applications of relaxin in cervical ripening, in vitro fertilization, preeclampsia, acute heart failure, ischemia-reperfusion and cirrhosis. We first outline the animal models used in preclinical studies to progress relaxin into clinical trials and then discuss the findings from these studies...
February 7, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Ji Young Hwang, Seung Hun Song
STUDY OBJECTIVE: To evaluate the optimal dose of vaginal misoprostol (200 and 400 mcg) for cervical priming before operative hysteroscopy. DESIGN: Prospective, randomized, controlled, double-blind trial (Canadian Task Force classification I). SETTING: University hospital. PATIENTS: Sixty eight patients undergoing operative hysteroscopy. INTERVENTIONS: Patients were randomized to receive a low (200 mcg) or high (400 mcg) dose of misoprostol administered vaginally 8 hours before operative hysteroscopy...
January 30, 2018: Journal of Minimally Invasive Gynecology
A Dhanya Mackeen, Danielle E Durie, Monique Lin, Christopher K Huls, Emma Qureshey, Michael J Paglia, Haiyan Sun, Anthony Sciscione
OBJECTIVE: To evaluate the use of a transcervical Foley catheter plus oxytocin infusion compared with oxytocin infusion alone for labor induction and cervical ripening in women 34 weeks of gestation or greater with prelabor rupture of membranes. METHODS: This is a randomized, multicenter trial of women with a live, singleton gestation at 34 weeks of gestation or greater with prelabor rupture of membranes, an unfavorable cervical examination (less than 2 cm or 80% effaced), and no contraindication to labor...
January 2018: Obstetrics and Gynecology
Zainab Al-Ibraheemi, Lois Brustman, Brianne E Bimson, Natalie Porat, Barak Rosenn
OBJECTIVE: To test the hypothesis that cervical ripening using a combination of misoprostol and a transcervical Foley bulb leads to delivery within a shorter time compared with misoprostol alone. METHODS: This randomized controlled trial was offered to women admitted for cervical ripening. Inclusion criteria were gestational age 37 weeks or greater with intact membranes, singleton fetus, cephalic presentation, and Bishop score 6 or less. Exclusion criteria included, among others, prior uterine surgery, ruptured membranes, and any contraindication to vaginal delivery...
January 2018: Obstetrics and Gynecology
M Diederen, Jsm Gommers, C Wilkinson, D Turnbull, Bwj Mol
BACKGROUND: It has been suggested that cervical ripening with a balloon catheter for labour induction can be done in an outpatient setting in low-risk pregnancies. Introduction of such an approach needs to be accompanied with monitoring of potential complications. Therefore the existence and frequency of any associated adverse event during cervical ripening needs to be established. OBJECTIVE: To assess the complication rate during cervical ripening with balloon induction...
December 6, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
Raed Salim, Naama Schwartz, Noah Zafran, Sivan Zuarez-Easton, Gali Garmi, Shabtai Romano
OBJECTIVE: There is a paucity of head-to-head randomized trials that compare single- and double-balloon catheters, and the results of the available data in terms of time from catheter insertion to delivery and delivery mode are mixed. This meta-analysis of randomized controlled trials compares the efficacy of single- and double-balloon catheters in women undergoing labor induction. STUDY DESIGN: Searches were made in MEDLINE, EMBASE, PubMed,, and the Cochrane Library from inception through June 2016...
December 4, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
P Blanc-Petitjean, M Salomé, C Dupont, C Crenn-Hebert, A Gaudineau, F Perrotte, P Raynal, E Clouqueur, G Beucher, B Carbonne, F Goffinet, C Le Ray
INTRODUCTION: In 2016, 22.0% of deliveries in France were induced. The current lack of high level of evidence data about the methods and indications for induction of labour has promoted heterogeneous and non-recommended practices. The extent of these different practices is not adequately known in France today, although they may influence perinatal outcomes. The objective of this study was to report current practices of induction of labour in France. MATERIAL AND METHODS: This study surveyed 94 maternity units in seven perinatal networks...
February 2018: Journal of Gynecology Obstetrics and Human Reproduction
Eszter Ducza, Adrienn Csányi, Róbert Gáspár
Water is the major component of cells and tissues, and the movement of water across the cell membrane is a fundamental property of life. Until the discovery of the first water channel, aquaporin, it was long assumed that the transport of water was due to simple diffusion through the lipid bilayer membrane that encloses cells. Aquaporin (AQP) molecules were first discovered in the human uterus in 1994, and since then several studies have investigated these channels in the female reproductive system. The expressions of AQPs have been proven in the reproductive system...
December 1, 2017: International Journal of Molecular Sciences
Devin McGee, Arianna Smith, Sharra Poncil, Amanda Patterson, Alison I Bernstein, Karen Racicot
Preterm birth (PTB), or birth before 37 weeks gestation, is the leading cause of neonatal mortality worldwide. Cervical viral infections have been established as risk factors for PTB in women, although the mechanism leading to increased risk is unknown. Using a mouse model of pregnancy, we determined that intra-vaginal HSV2 infection caused increased rates of preterm birth following an intra-vaginal bacterial infection. HSV2 infection resulted in histological changes in the cervix mimicking cervical ripening, including significant collagen remodeling and increased hyaluronic acid synthesis...
2017: PloS One
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...
February 2018: Archives of Gynecology and Obstetrics
Shanmugasundaram Nallasamy, Meredith Akins, Breanna Tetreault, Kate Luby-Phelps, Mala Mahendroo
Previous work has identified divergent mechanisms by which cervical remodeling is achieved in preterm birth (PTB) induced by hormone withdrawal (mifepristone) or lipopolysaccharide (LPS). Our current study aims to document how collagen architecture is modified to achieve premature cervical remodeling in mice treated with LPS as a model of infection induced inflammation. Cervices were collected on gestation day (d) 15 from mice with premature cervical ripening induced by LPS and compared to d15 and d18 controls as well as a hormone withdrawal preterm birth model...
November 17, 2017: Biology of Reproduction
Lili Sheibani, Deborah A Wing
Induction of labour is a commonly performed procedure around the world. There are various medications used for induction including those commonly used for cervical ripening (prostaglandins) and oxytocin. The ideal agent is one that decreases the time to achieving delivery without compromising maternal or neonatal safety. The 'optimal safe agent' remains undetermined. Areas covered: This article reviews the safety of currently used induction agents. Prostaglandins and oxytocin have proven to be effective in labour induction, and their profiles will be reviewed in this article...
November 15, 2017: Expert Opinion on Drug Safety
William A Grobman, Jennifer Bailit, Yinglei Lai, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Kenneth J Leveno, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
BACKGROUND: While there are well-accepted standards for the diagnosis of arrested active-phase labor, the definition of a "failed" induction of labor remains less certain. One approach to diagnosing a failed induction is based on the duration of the latent phase. However, a standard for the minimum duration that the latent phase of a labor induction should continue, absent acute maternal or fetal indications for cesarean delivery, remains lacking. OBJECTIVE: The objective of this study was to determine the frequency of adverse maternal and perinatal outcomes as a function of the duration of the latent phase among nulliparous women undergoing labor induction...
November 11, 2017: American Journal of Obstetrics and Gynecology
Lynn M Yee, Maged M Costantine, Madeline Murguia Rice, Jennifer Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Steve N Caritis, Mona Prasad, Alan T N Tita, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To examine whether racial and ethnic differences exist in the frequency of and indications for cesarean delivery and to assess whether application of labor management strategies intended to reduce cesarean delivery rates is associated with patient's race and ethnicity. METHODS: This is a secondary analysis of a multicenter observational obstetric cohort. Trained research personnel abstracted maternal and neonatal records of greater than 115,000 pregnant women from 25 hospitals (2008-2011)...
December 2017: Obstetrics and Gynecology
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