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Cervical incompetency

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https://www.readbyqxmd.com/read/29447720/no-257-ultrasonographic-cervical-length-assessment-in-predicting-preterm-birth-in-singleton-pregnancies
#1
Kenneth Lim, Kimberly Butt, Joan M Crane
OBJECTIVES: To review (1) the use of ultrasonographic-derived cervical length measurement in predicting preterm birth and (2) interventions associated with a short cervical length. OUTCOMES: Reduction in rates of prematurity and/or better identification of those at risk, as well as possible prevention of unnecessary interventions. EVIDENCE: Published literature was retrieved through searches of PubMed and The Cochrane Library up to December 2009, using appropriate controlled vocabulary and key words (preterm labour, ultrasound, cervix, incompetent cervix, transvaginal, transperineal, cervical length, fibronectin)...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29420400/customized-pessary-fabrication-using-three-dimensional-printing-technology
#2
Michael Barsky, Robert Kelley, Faiz Y Bhora, Anne Hardart
BACKGROUND: Pessaries are a treatment option for pelvic organ prolapse, stress urinary incontinence (SUI), and cervical incompetence. An effective pessary is comfortable, corrects the presenting problem, does not cause adverse effects, and is easy to remove. Discomfort and poor fit limit the usefulness of pessaries for many women. Each patient presents with unique anatomy and thus the effectiveness of commercially available pessaries may be limited by lack of customization. METHOD: A patient presenting with SUI and failed commercial pessary fittings desired nonsurgical treatment...
March 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29414522/don-t-be-short-sighted-cervical-incompetence-in-a-pregnant-patient-with-acute-appendicitis
#3
Lindsey M Negrete, Lucy B Spalluto
Delay in diagnosis of cervical incompetence can be detrimental to the fetus. Up to 20-25% of miscarriages in the second trimester can be attributed to the incompetent cervix. Given the profound impact of cervical incompetence on obstetric outcomes, careful attention should be given to evaluation of the cervix on MRI studies in pregnant patients. We present a case of incompetent cervix diagnosed incidentally at the time of MRI performed to evaluate for acute appendicitis.
January 31, 2018: Clinical Imaging
https://www.readbyqxmd.com/read/29302808/a-comparison-of-pregnancy-outcome-of-modified-transvaginal-cervicoisthmic-cerclage-performed-prior-to-and-during-pregnancy
#4
Minling Wei, Xiaoying Jin, T C Li, Cuiyu Yang, Dong Huang, Songying Zhang
PURPOSE: To compare the pregnancy outcome of the modified transvaginal cerclage performed preconception and during pregnancy. METHODS: A retrospective trial was carried out in the Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital in Zhejiang, China. A total of 604 women with cervical incompetence underwent the cerclage, and the time of the operation was decided by the patients or depended on when the patient presented. Main outcome measures were the gestational age and the fetal outcome...
March 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29275238/simultaneous-pregnancy-in-each-uterine-cavity-of-a-double-uterus-in-a-young-nigerian-multipara-who-presented-with-a-retained-second-twin-following-an-unsupervised-preterm-labor-at-home-case-report
#5
Emmanuel Oluchikwu Ani, Emmanuel Ajuluchukwu Ugwa, Aminu Bashir Taiye, Iwasam Elemi Agbor, Ibrahim Shaaibu Suleiman
INTRODUCTION: Simultaneous pregnancy in each uterine cavity of a double uterus is unusual but is a recognized risk factor for preterm labour and other poor obstetrics outcomes. The work has been reported in line with the SCARE criteria. PRESENTATION OF CASE: We report an unusual case of simultaneous pregnancy in each uterine cavity of a double uterus in a young African grand multipara who presented with a retained second twin following a preterm labour at home. DISCUSSION: A double or didelphys uterus as reported in the literatures is still uncommon even in Africa...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29259486/complications-and-outcomes-of-pregnant-women-with-adenomyosis-in-japan
#6
Hiroshi Tamura, Hiroshi Kishi, Mari Kitade, Mikiko Asai-Sato, Atsushi Tanaka, Takashi Murakami, Takashi Minegishi, Norihiro Sugino
Purpose: To investigate the impact of adenomyosis on the complications and outcomes of pregnancy in Japan. Methods: We carried out a multicenter retrospective questionnaire survey. A questionnaire regarding pregnancy complications and the outcomes of pregnancy was sent to 725 facilities. Results: Data were obtained on the cases of 272 pregnant women with adenomyosis from 65 facilities. The complications of pregnancy included miscarriage before 12 weeks of pregnancy (14...
October 2017: Reproductive Medicine and Biology
https://www.readbyqxmd.com/read/29222640/clinical-effect-of-emergency-cervical-cerclage-and-elective-cervical-cerclage-on-pregnancy-outcome-in-the-cervical-incompetent-pregnant-women
#7
Qin Chen, Guiying Chen, Nan Li
PURPOSE: To compare the clinical effect of emergency cervical cerclage and elective cervical cerclage on pregnancy outcome in the cervical-incompetent pregnant women. METHODS: Literature was searched from the databases of Pubmed, Embase and Google scholar. The fixed or random effects model was used to calculate pooled risk ratios on the basis of heterogeneity. Meta-regression, sensitive analysis, subgroup analysis, and publication bias assessment were also conducted to confirm the results according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009...
February 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29209482/the-place-for-prophylactic-cerclage-in-the-infertile-patient-with-established-cervical-incompetence-who-conceived-twins-after-septum-reduction
#8
Jennifer Deanna, Omar Abuzied, Fahmi Islam, Ivana Vettriano, Frederico Rocha, Mostafa Abuzeid
Introduction: It is well known that cervical incompetence and associated preterm birth confers greater morbidity and mortality on birth outcomes, with an additional increased risk of cervical incompetence in higher order gestations. While the pathophysiology of cervical incompetence has yet to be elucidated, research has identified risk factors and assessed outcomes of numerous interventions. Cervical cerclage has been shown, in certain situations involving singleton pregnancies, to improve outcomes...
June 2017: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/29121417/transabdominal-cerclage-tac-for-patients-with-ultra-short-uterine-cervix-after-uterine-cervix-surgery-and-its-impact-on-pregnancy
#9
Shinichi Ishioka, Miseon Kim, Yuko Mizugaki, Saori Kon, Kyoko Isoyama, Masahito Mizuuchi, Miyuki Morishita, Tsuyoshi Baba, Takao Sekiya, Tsuyoshi Saito
AIM: Patients with an ultra-short uterine cervix as a result of large conization, repeated conization or radical trachelectomy (RT), are at high risk of preterm premature rupture of the membrane, which leads to preterm birth. We have commenced performing transabdominal cerclage (TAC) of the uterine cervix for these patients. In this study, we examined the safety of TAC and its impact on pregnancy. METHODS: We have performed TAC in 11 patients before pregnancy: in six after large cervical operations, such as repeated conization; and in five for difficulties with cervical cerclage after RT...
November 9, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29028104/the-influence-of-ovulation-induction-and-assisted-conception-on-maternal-and-perinatal-outcomes-of-twin-pregnancies
#10
G Bordi, A D'Ambrosio, I Gallotta, L Di Benedetto, A Frega, F Torcia, M Schimberni, M Bonito, D Caserta
OBJECTIVE: To compare obstetrical and neonatal outcomes of twin pregnancies conceived via assisted reproductive technology (ART) with those of naturally conceived ones and to investigate the influence of the ART procedure type on these parameters. PATIENTS AND METHODS: This observational study included 450 ART and 647 spontaneous twin pregnancies delivered over 15 years at a single university-based hospital of Rome, Italy. Logistic and linear regression models adjusted for confounding factors were used to evaluate the effect of ART and the type of assisted conception (IVF/ICSI, ovulation induction ± intrauterine insemination, egg/embryo donation) on maternal and perinatal outcomes...
September 2017: European Review for Medical and Pharmacological Sciences
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
#11
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/28739475/posterior-osteosynthesis-with-monoaxial-lateral-mass-screw-rod-system-for-unstable-c1-burst-fractures
#12
Yin-Shun Zhang, Jian-Xiang Zhang, Qing-Guo Yang, Wei Li, Hui Tao, Cai-Liang Shen
BACKGROUND CONTEXT: Surgical treatment for unstable atlas fractures has evolved in recent decades from C1-C2 or C0-C2 fusion to motion-preservation techniques of open reduction and internal fixation (ORIF). However, regardless of a transoral or a posterior approach, the reduction is still not satisfactory. PURPOSE: The article describes and evaluates a new technique for treating unstable atlas fractures by using a monoaxial screw-rod system. STUDY DESIGN: This is a retrospective study...
January 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28494269/medical-conditions-associated-with-recurrent-miscarriage-is-bmi-the-tip-of-the-iceberg
#13
Mushi J Matjila, Anne Hoffman, Zephne M van der Spuy
BACKGROUND: In contrast to sporadic miscarriage, recurrent miscarriage (RM) is a rare entity which affects 1% of couples attempting conception. It is distressing for couples and healthcare professionals as the aetiology is unclear with limited treatment options. Apart from anti-phospholipid syndrome (APS), the strength of associations between RM and commonly investigated endocrine, autoimmune, thrombophilic and uterine structural abnormalities remains uncertain and variable. OBJECTIVES: To assess the prevalence of commonly investigated medical conditions associated with RM...
July 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28139506/reproductive-outcome-of-transcervical-uterine-incision-in-unicornuate-uterus
#14
En-Lan Xia, Tin-Chiu Li, Sze-Ngar Sylvia Choi, Qiao-Yun Zhou
BACKGROUND: The pregnancy outcome of the unicornuate uterus is associated with an increased risk of miscarriage, cervical incompetence, and a number of obstetric complications. However, at present, there is no accepted treatment method for women with unicornuate uterus, other than expectant measures. The aim of this study was to evaluate the reproductive outcome of transcervical uterine incision (TCUI) in patients with unicornuate uterus. METHODS: Thirty-three patients with unicornuate uterus presented to our tertiary center for infertility or miscarriage...
February 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28114513/risk-factors-and-risk-stratification-for-adverse-obstetrical-outcomes-after-appendectomy-or-cholecystectomy-during-pregnancy
#15
Adam Sachs, Jean Guglielminotti, Russell Miller, Ruth Landau, Richard Smiley, Guohua Li
Importance: Identification of risk factors for adverse obstetrical outcomes after appendectomy and cholecystectomy during pregnancy is necessary for evidence-based risk reduction and adequate patient counseling. Objectives: To identify risk factors for adverse obstetrical outcomes after appendectomy and cholecystectomy during pregnancy and stratify the risk of such outcomes. Design, Setting, and Participants: A cohort study was conducted using the Nationwide Inpatient Sample, a nationally representative sample of patients discharged from community hospitals in the United States, from January 1, 2003, to December 31, 2012...
May 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28063549/insuffisance-cervicale-et-cerclage-cervical
#16
Richard Brown, Robert Gagnon, Marie-France Delisle
OBJECTIF: La présente directive clinique a pour but de fournir un cadre de référence que les cliniciens pourront utiliser pour identifier les femmes qui sont exposées aux plus grands risques de connaître une insuffisance cervicale, ainsi que pour déterminer les circonstances en présence desquelles la mise en place d'un cerclage pourrait s'avérer souhaitable. RéSULTATS: La littérature publiée a été récupérée par l'intermédiaire de recherches menées dans PubMed ou MEDLINE, CINAHL et The Cochrane Library en 2012 au moyen d'un vocabulaire contrôlé (p...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27974918/cervical-cerclage-in-advanced-prolapsed-fetal-membranes-case-presentation
#17
C F Tufan, R E Bohîlţea, A Tufan, A Marinescu, A Baros, M M Cîrstoiu
The case presentation of a transvaginal cervical cerclage performed at a 7 cm dilation in a patient in the 22nd week of pregnancy, followed by a prolongation of the pregnancy until the gestational age of 38 weeks, was reported in the context of many similar cases managed by the authors of the article during a program of screening and prevention of preterm birth. The particularity of the case was the lack of a preterm birth in the medical history of the patient and the installation of the isthmus-cervix incompetence in the second pregnancy, after an on term pregnancy...
January 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27928435/a-debate-about-ultrasound-and-anatomic-aspects-of-the-cervix-in-spontaneous-preterm-birth
#18
REVIEW
R E Bohîlțea, O Munteanu, N Turcan, A Baros, O Bodean, D Voicu, M M Cîrstoiu
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/27904169/lean-umbilical-cord-a-case-report
#19
N Rippinger, M Elsässer, P Sinn, C Sohn, H Fluhr
The "lean" umbilical cord (also known as thin-cord syndrome) is a comparatively rare anomaly of the umbilical cord, which has seldom been described in the medical literature. We report on a 35-year-old women who presented to us at 29 + 4 weeks gestation with vaginal bleeding and cervical incompetence subsequently complicated not only by premature rupture of membranes but also acute placental insufficiency requiring emergency caesarean section under general anaesthesia at 31 + 2 weeks gestation. At surgery no obvious cause for the acute placental insufficiency - such as placental abruption, cord prolapse or true knot of the umbilical cord - was found...
November 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/27903074/bicornuate-uterus-is-an-independent-risk-factor-for-cervical-os-insufficiency-a-retrospective-population-based-cohort-study
#20
Salvatore Andrea Mastrolia, Yael Baumfeld, Reli Hershkovitz, Giuseppe Loverro, Edoardo Di Naro, David Yohai, Polina Schwarzman, Adi Yehuda Weintraub
INTRODUCTION: The purpose of our study was to explore maternal and fetal outcomes in the second and third trimester in women with bicornuate uterus. METHODS: A total of 280,106 pregnancies met the inclusion criteria and were divided in two study groups: (1) pregnancies in women with bicornuate uterus (n = 444); and (2) controls (n = 279,662). The diagnosis of bicornuate uterus was performed in all patients during the workup for infertility or recurrent pregnancy loss, during pregnancy, or at the time of cesarean delivery...
December 1, 2016: Journal of Maternal-fetal & Neonatal Medicine
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