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https://www.readbyqxmd.com/read/29290215/predictors-for-dislodgment-of-vaginal-pessary-within-one-year-in-women-with-pelvic-organ-prolapse
#1
Rachel Y K Cheung, Loreta L L Lee, Tony K H Chung, Symphorosa S C Chan
OBJECTIVES: To identify clinical risk factors for dislodgment of vaginal pessary within one year in women with symptomatic pelvic organ prolapse. STUDY DESIGN: This was a prospective observational study which recruited consecutive women with symptomatic pelvic organ prolapse in a tertiary urogynecology center. Basic demographics, clinical symptoms and staging of pelvic organ prolapse were assessed. A vaginal pessary was offered where appropriate. MAIN OUTCOME MEASURES: Demographics and clinical parameters were compared between women who were able to use a vaginal pessary for one year and those whose pessaries were dislodged within one year...
February 2018: Maturitas
https://www.readbyqxmd.com/read/29260618/progesterone-for-preventing-pregnancy-termination-after-initiation-of-medical-abortion-with-mifepristone
#2
Deborah Garratt, Joseph V Turner
INTRODUCTION: Abortion is often a difficult and traumatic decision for a woman to make. Perhaps greater distress occurs when a woman commences a medical abortion but then changes her mind and wishes to keep the now-threatened pregnancy. One published case series detailed a potential method to counter/reverse the abortifacient effect of mifepristone by administering parenteral progesterone in such situations. OBJECTIVES: The present report details cases of women in similar circumstances who have been treated with progesterone...
December 20, 2017: European Journal of Contraception & Reproductive Health Care
https://www.readbyqxmd.com/read/29260226/effect-of-cervical-pessary-on-spontaneous-preterm-birth-in-women-with-singleton-pregnancies-and-short-cervical-length-a-randomized-clinical-trial
#3
Gabriele Saccone, Giuseppe Maria Maruotti, Antonia Giudicepietro, Pasquale Martinelli
Importance: Spontaneous preterm birth is a major cause of perinatal morbidity and mortality. It is unclear if a cervical pessary can reduce the risk of spontaneous preterm delivery. Objective: To test whether in asymptomatic women with singleton pregnancies and no prior spontaneous preterm birth but with short cervical length on transvaginal ultrasound, use of a cervical pessary would reduce the rate of spontaneous preterm birth at less than 34 weeks of gestation...
December 19, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29260206/cervical-pessary-to-prevent-preterm-birth
#4
EDITORIAL
Robert M Silver, D Ware Branch
No abstract text is available yet for this article.
December 19, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29233247/pelvic-organ-prolapse-in-a-fighter-pilot-with-alpha-1-antitrypsin-deficiency
#5
Kerry Buckley, Jami Gann, Heather Barbier, Joy Greer
BACKGROUND: Few researchers have studied symptomatic younger to middle-aged women with pelvic organ prolapse. The association between highly strenuous activity and prolapse symptoms is largely theoretical. It is also known that a genetic component likely contributes to early-onset pelvic organ prolapse, but prevention and treatment with respect to this has not been explored. Service restrictions differ for active duty women who are diagnosed with symptomatic pelvic organ prolapse. CASE REPORT: We present a case of a 33-yr-old Gravida 1 Para 1 fighter pilot who developed symptomatic pelvic organ prolapse after a vaginal delivery...
January 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29212400/cervical-pessaries-for-the-prevention-of-preterm-birth-a-systematic-review-and-meta-analysis
#6
Limei Zheng, Jun Dong, Yongdong Dai, Yanling Zhang, Libing Shi, Minling Wei, Xiaoying Jin, Chao Li, Songying Zhang
OBJECTIVE: The objective of this study is to evaluate the effectiveness and safety of cervical pessaries for the prevention of preterm birth. METHODS: We searched PubMed, Embase, Web of Science, and other sources from inception to July 2016. This analysis referred to pregnant women with singleton/multiple viable fetus/fetuses, with or without cervical pessary placement. RESULTS: Six randomized control trials and five cohort studies involving 3911 participants were included...
December 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29200474/personal-preference-of-mode-of-delivery-what-do-urogynaecologists-choose-preliminary-results-of-the-decision-study
#7
Julia Bihler, Ralf Tunn, Christl Reisenauer, Jan Pauluschke-Fröhlich, Philipp Wagner, Harald Abele, Katharina K Rall, Gert Naumann, Markus Wallwiener, Sara Y Brucker, Markus Hübner
Introduction: Currently, almost every third child in Germany is delivered by caesarean section. Apart from straightforward and clear indications for caesarean section which account for approx. 10%, the large proportion of relative indications in particular needs to be critically reviewed if the current C-section rate is to be effectively lowered. It is more than doubtful, however, whether this can be a realistic goal in Germany, especially in the context of international developments...
November 2017: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/29197486/the-more-the-better-combining-interventions-to-prevent-preterm-birth-in-women-at-risk-a-systematic-review-and-meta-analysis
#8
REVIEW
Alexander Jarde, Anne-Mary Lewis-Mikhael, Jodie M Dodd, Jon Barrett, Shigeru Saito, Joseph Beyene, Sarah D McDonald
OBJECTIVES: To systematically examine the evidence around the combination of interventions to prevent preterm birth. METHODS: Without language restrictions, we searched clinicaltrials.gov and five electronic databases (Medline, EMBASE, CINAHL, Cochrane CENTRAL, and Web of Science) up to July 7, 2016. We included randomized and non-randomized studies where asymptomatic women at risk of preterm birth received any combination of progesterone, cerclage, or pessary compared with either one or no intervention...
December 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29191292/long-term-childhood-outcomes-after-interventions-for-prevention-and-management-of-preterm-birth
#9
REVIEW
Sarah R Murray, Sarah J Stock, Jane E Norman
Globally, preterm birth rates are rising and have a significant impact on neonatal morbidity and mortality. Preterm birth remains difficult to prevent and a number of strategies for preterm birth prevention (progesterone, cervical pessaries, cervical cerclage, tocolytics, and antibiotics) have been identified. While some of these show more promise, there is a paucity of evidence regarding the long-term effects of these strategies on childhood outcomes. Strategies used to improve the health of babies if born preterm, such as antenatal magnesium sulfate for fetal neuroprotection and antenatal corticosteroids for fetal lung maturation, show evidence of short-term benefit but lack large-scale follow-up data of long-term childhood outcomes...
December 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/29176014/cervical-pessary-combined-with-vaginal-progesterone-for-the-prevention-of-spontaneous-preterm-birth-is-the-evidence-sufficient
#10
Hugo Madar, Aurélien Mattuizzi, Loïc Sentilhes
No abstract text is available yet for this article.
November 27, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29103351/cervical-pessary-for-preventing-preterm-birth-a-meta-analysis
#11
Zhen Jin, Liqin Chen, Dongyan Qiao, Astha Tiwari, Chhavi Devi Jaunky, Baiyun Sun, Lina Wang, Hong Yu
OBJECTIVE: To evaluate the efficacy of cervical pessary in the prevention of preterm birth and its influence on pregnancy and maternal outcomes, so as to provide a clinical basis for cervical pessary to prevent premature delivery. METHODS: The databases of PubMed, Web of Science, CNKI, WanFang Data, etc, were used to search for the eligible articles. The relevant data were abstracted by two independent reviewers and performed with Stata 12.0. RESULTS: Pregnancy Result: the PTB rates of pessary and control group before 28, 32, 34, and 37 weeks were analyzed and the combined RR (95%CI) values were 0...
November 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29058493/induction-of-labour-clinical-predictive-factors-for-success-and-failure
#12
Laura Batinelli, Andrea Serafini, Nicola Nante, Felice Petraglia, Filiberto Maria Severi, Gabriele Messina
Induction of labour (IOL) is a widely-used practice in obstetrics. Our aim was to evaluate predictors of vaginal delivery in postdate pregnancies induced with prostaglandins. We conducted a retrospective cross-sectional study with analytic component. A total of 145 women, admitted for IOL after the 41st week of gestation, were induced with a vaginal pessary releasing prostaglandins. Type of delivery, whether vaginal or caesarean, was the outcome. Several maternal and foetal variables were investigated. The Kaplan-Maier curves, monovariate and a multivariate logistic regression were carried out...
October 23, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29055173/safety-and-efficacy-of-the-cervical-pessary-combined-with-vaginal-progesterone-for-the-prevention-of-spontaneous-preterm-birth
#13
Georgios Daskalakis, Dimitrios Zacharakis, Marianna Theodora, Panagiotis Antsaklis, Nikolaos Papantoniou, Dimitris Loutradis, Aris Antsaklis
INTRODUCTION: The aim of this study was to evaluate the safety and efficacy of the combined treatment of cervical pessary and endovaginal progesterone for the prevention of spontaneous preterm birth (SPB) in women with a short cervical length (CL) between 20 and 24 weeks of gestation. MATERIALS AND METHODS: This is a prospective study of women with a singleton pregnancy and a sonographically detected mid-trimester CL ≤25 mm. The primary outcome measure was spontaneous delivery before 34 weeks (238 days) of gestation...
October 21, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29049052/a-cost-utility-analysis-of-nonsurgical-treatments-for-stress-urinary-incontinence-in-women
#14
Andrea N Simpson, Alaina Garbens, Fahima Dossa, Peter C Coyte, Nancy N Baxter, Colleen D McDermott
OBJECTIVE: The objective of this study was to perform a cost-utility analysis of nonsurgical treatments for stress urinary incontinence (SUI) in healthy adult women with a health system perspective over a 1-year time horizon. METHODS: A decision tree model was constructed to evaluate the following nonsurgical treatment options for SUI in a simulated healthy adult female cohort who had failed Kegel exercises: pelvic floor muscle therapy (PFMT), a disposable tampon device (Impressa), a self-fitting intravaginal incontinence device (Uresta), and a traditional incontinence pessary...
October 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29033106/current-options-for-mechanical-prevention-of-preterm-birth
#15
REVIEW
Rupsa C Boelig, Vincenzo Berghella
Cervical insufficiency can be defined by a combination of obstetric history, cervical dilation on exam, and/or short cervical length in women with prior preterm birth. Options for mechanical intervention include cerclage and pessary. There is evidence to support the benefit of a cervical cerclage in women with singleton gestations who have a diagnosis of cervical insufficiency either based on second trimester painless cervical dilatation leading to recurrent early preterm births, or a history of early spontaneous preterm birth and a second trimester transvaginal ultrasound short cervical length or cervical dilation on exam...
October 12, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28988725/prevention-of-preterm-birth-novel-interventions-for-the-cervix
#16
REVIEW
Bouchra Koullali, Andrea R Westervelt, Kristin M Myers, Michael D House
Preterm birth is the leading cause of neonatal mortality and morbidity worldwide. Spontaneous preterm birth is a complex, multifactorial condition in which cervical dysfunction plays an important role in some women. Current treatment options for cervical dysfunction include cerclage and supplemental progesterone. In addition, cervical pessary is being studied in research protocols. However, cerclage, supplemental progesterone and cervical pessary have well known limitations and there is a strong need for alternate treatment options...
December 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28967060/original-flow-chart-for-the-management-of-hydroureteronephrosis-caused-by-pessary-placement
#17
Matteo Balzarro, Emanuele Rubilotta, Antonio B Porcaro, Nicolò Trabacchin, Antonio D'Amico, Maria Angela Cerruto, Walter Artibani
INTRODUCTION: The use of a pessary to treat a pelvic organ prolapse (POP) is a valid non-invasive option. Severe complications are usually associated with neglected, oversized, or misplaced pessaries. Major complications include fistulas, bowel or bladder erosion, and hydroureteronephrosis (HUN). MATERIALS AND METHODS: We reviewed the literature and our experience in the management of HUN in the last decade, as a consequence of pessary placement. RESULTS: We used flow charts to take an accurate medical history of each patient...
October 25, 2017: Urologia
https://www.readbyqxmd.com/read/28959181/bacterial-biota-of-women-with-bacterial-vaginosis-treated-with-lactoferrin-an-open-prospective-randomized-trial
#18
Alessandra Pino, Giuliana Giunta, Cinzia L Randazzo, Salvatore Caruso, Cinzia Caggia, Antonio Cianci
Background: Bacterial vaginosis is the most frequent condition associated to the vaginal microbiota imbalance, affecting about the 40-50% of women in the world. Even if antibiotics are effcetive for bacterial vaginosis treatment a long-term recurrence rates, higher than 70%, is recorded. Lactoferrin is an iron-binding glycoprotein with bacteriostatic and bactericidal properties. It owns the ability to protect the host against infection, by binding and regulating the iron needed for the bacterial proliferation...
2017: Microbial Ecology in Health and Disease
https://www.readbyqxmd.com/read/28949973/vaginal-progesterone-pessaries-for-pregnant-women-with-a-previous-preterm-birth-to-prevent-neonatal-respiratory-distress-syndrome-the-progress-study-a-multicentre-randomised-placebo-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
Caroline A Crowther, Pat Ashwood, Andrew J McPhee, Vicki Flenady, Thach Tran, Jodie M Dodd, Jeffrey S Robinson
BACKGROUND: Neonatal respiratory distress syndrome, as a consequence of preterm birth, is a major cause of early mortality and morbidity. The withdrawal of progesterone, either actual or functional, is thought to be an antecedent to the onset of labour. There remains limited information on clinically relevant health outcomes as to whether vaginal progesterone may be of benefit for pregnant women with a history of a previous preterm birth, who are at high risk of a recurrence. Our primary aim was to assess whether the use of vaginal progesterone pessaries in women with a history of previous spontaneous preterm birth reduced the risk and severity of respiratory distress syndrome in their infants, with secondary aims of examining the effects on other neonatal morbidities and maternal health and assessing the adverse effects of treatment...
September 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28940481/prevention-of-preterm-birth-with-pessary-in-singletons-popps-a-randomized-controlled-trial
#20
Lorraine Dugoff, Vincenzo Berghella, Harish Sehdev, A Dhanya Mackeen, Laura Goetzl, Jack Ludmir
OBJECTIVE: To determine if pessary use prevents preterm birth in singleton gestations with a short transvaginal ultrasound cervical length and without a prior spontaneous preterm birth. METHODS: In this open-label multicenter randomized trial we enrolled asymptomatic women with singleton gestations with a transvaginal ultrasound cervical length ≤ 25 mm at 18(0) -23(6) weeks and no prior spontaneous preterm birth. Subjects were randomized to receive the Bioteque cup pessary or no pessary...
September 20, 2017: Ultrasound in Obstetrics & Gynecology
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