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short cervix treatment

E Azria
OBJECTIVES: To identify clinical situations in which progestatives used to reduce the risk of spontaneous preterm delivery and/or reduced adverse neonatal outcomes have been evaluated and identify situations in which 17OHPC or vaginal progesterone might be recommended. METHODS: Bibliographic searches were performed in the Medline and Cochrane databases with the use of a combination of keywords and text words related to "progesterone", "tocolysis", and "preterm labor" from 1956 through July 2016...
October 21, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Florence van Hunsel, Sonja van de Koppel, Eugène van Puijenbroek
Two 54-year-old women developed abdominal cramps and vaginal hemorrhage as a result of endometrial hyperplasia during treatment with a hop-containing phytotherapeutic product (MenoCool(®)) for post-menopausal complaints. The women used the hop-containing phytotherapeutic product (418 mg of hop per tablet) twice daily (1 and 0.5 tablets by both patient A and B). Patient A developed abdominal cramps and vaginal hemorrhage after 2 months of use. After gynecological examination, she was diagnosed with endometrial hyperplasia...
December 2015: Drug Saf Case Rep
Niloofar Karbasian, Mahdi Sheikh, Reihaneh Pirjani, Shahla Hazrati, Fatemeh Tara, Sedigheh Hantoushzadeh
AIM: We compared the effectiveness of a combined treatment involving cervical pessary plus vaginal progesterone to vaginal progesterone alone in decreasing the rate of preterm birth in women with short cervix in the second gestational trimester. METHODS: This prospective, open-label, randomized clinical trial was conducted on 144 pregnant women with singleton pregnancy who had a cervical length ≤ 25 mm, at 18-22 gestational weeks (GW). Seventy-three patients were assigned to receive 400 mg of daily vaginal progesterone (group A), and 73 to receive cervical pessary plus 400 mg of daily vaginal progesterone (group B), until the 37th GW...
October 8, 2016: Journal of Obstetrics and Gynaecology Research
J Hu, X Tao, L Yin, Y Shi
OBJECTIVE: The purpose of this retrospective study was to evaluate the safety and efficacy of uterine artery embolization (UAE) followed by curettage for conservative management of cervical pregnancy. DESIGN: Retrospective review. SETTING: Peking University First Hospital. SAMPLE: Patients with cervical pregnancy diagnosed by trans-vaginal ultrasound at Peking University First Hospital between January 2003 and December 2014...
September 2016: BJOG: An International Journal of Obstetrics and Gynaecology
L Wagner, G Meurette, A Vidart, S Warembourg, J-B Terassa, N Berrogain, E Ragni, L Le Normand
INTRODUCTION: Open sacrocolpopexy have demonstrated its efficiency in surgical treatment of pelvic organ prolapse with an important backward on a large number of patients. Laparoscopic sacrocolpopexy reproduced the same surgical technique with reduced morbidity and may benefits from the recent development of robotic. Numerous technical variants have been developped around the original procedure but results seems not ever equivalent. Our objectives are to establish practical recommendations issues from the data of the litterature on the various technical aspects of this technique...
July 2016: Progrès en Urologie
Lalit Kumar, Sudeep Gupta
The management of locally advanced cervix cancer has undergone a paradigm shift during the last decade. Concurrent chemoradiation (CCRT) (with cisplatin alone or in combination) is currently the standard treatment approach. CCRT results in a 5-year overall survival rate of 66% and a disease-free survival of 58%. About 30-40% of patients with locally advanced cervical cancer fail to achieve complete response to CCRT; alternative approaches are needed to improve the outcome for such patients. Weekly paclitaxel and carboplatin for 4-6 weeks as dose-dense chemotherapy prior to CCRT could be one such potential approach...
2016: Oncology
R Romero, K H Nicolaides, A Conde-Agudelo, J M O'Brien, E Cetingoz, E Da Fonseca, G W Creasy, S S Hassan
OBJECTIVE: To evaluate the efficacy of vaginal progesterone administration for preventing preterm birth and perinatal morbidity and mortality in asymptomatic women with a singleton gestation and a mid-trimester sonographic cervical length (CL) ≤ 25 mm. METHODS: This was an updated systematic review and meta-analysis of randomized controlled trials comparing the use of vaginal progesterone to placebo/no treatment in women with a singleton gestation and a mid-trimester sonographic CL ≤ 25 mm...
September 2016: Ultrasound in Obstetrics & Gynecology
Frederik J R Hermans, Ewoud Schuit, Brent C Opmeer, Martijn A Oudijk, Mireille Bekker, Mallory Woiski, Caroline J Bax, Marieke Sueters, Hubertina C J Scheepers, Maureen T M Franssen, Eva Pajkrt, Ben Willem J Mol, Marjolein Kok
BACKGROUND: Preterm birth is a major cause of neonatal mortality and morbidity. As preventive strategies are largely ineffective, threatened preterm labor is a frequent problem that affects approximately 10 % of pregnancies. In recent years, risk assessment in these women has incorporated cervical length measurement and fetal fibronectin testing, and this has improved the capacity to identify women at increased risk for delivery within 14 days. Despite these improvements, risk for preterm birth continues to be increased in women who did not deliver after an episode of threatened preterm labor, as indicated by a preterm birth rate between 30 to 60 % in this group of women...
2016: BMC Pregnancy and Childbirth
Andrew R Willan
BACKGROUND: The Pessary for the Prevention of Preterm Birth Study (PS3) is an international, multicenter, randomized clinical trial designed to examine the effectiveness of the Arabin pessary in preventing preterm birth in pregnant women with a short cervix. During the design of the study two methodological issues regarding power and sample size were raised. Since treatment in the Standard Arm will vary between centers, it is anticipated that so too will the probability of preterm birth in that arm...
2016: Trials
William A Grobman, Yinglei Lai, Jay D Iams, Uma M Reddy, Brian M Mercer, George Saade, Alan T Tita, Dwight J Rouse, Yoram Sorokin, Ronald J Wapner, Kenneth J Leveno, Sean C Blackwell, M Sean Esplin, Jorge E Tolosa, John M Thorp, Steve N Caritis
OBJECTIVES: The purpose of this study was to evaluate whether demographic and sonographic factors associated with spontaneous preterm birth among nulliparous women with a cervical length of less than 30 mm could be combined into an accurate prediction model for spontaneous preterm birth. METHODS: We conducted a secondary analysis of a trial of nulliparous women with a singleton gestation and a cervical length of less than 30 mm on transvaginal sonography between 16 and 22 weeks who lacked other risk factors for spontaneous (eg, prior cervical excisional procedure) or medically indicated (eg, chronic hypertension) preterm birth, who were randomized to either 17α-hydroxyprogesterone caproate treatment or a placebo...
June 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Hana Jedlickova, Veronika Durčanská, Vladimír Vašků
Dear Editor, Scleroderma associated with neoplasia is rare, with only a small number of cases reported. We describe 4 patients with paraneoplastic scleroderma who were treated at the I. Department of Dermatovenereology, St. Anna Hospital, during the period between 2004 and 2014. The patients were diagnosed with cholangiogenic carcinoma, endometrial carcinoma, prostatic adenocarcinoma, and adenoma of the suprarenal gland. In the case of concurrent scleroderma and tumor, four situations may occur: they can develop independently of each other; scleroderma may be induced by the tumor; the tumor can develop in the scleroderma; or the tumor can be induced by immunosuppressive therapy...
April 2016: Acta Dermatovenerologica Croatica: ADC
G A Dastidar, P Gupta, B Basu, A Basu, J K Shah, S L Seal
OBJECTIVES: To explore alternate modality of treatment in patients of advanced cancer cervix by neo-adjuvant chemotherapy (NACT) followed by External Beam Radiotherapy (ERT) and Brachytherapy (BT). Short- (6 months) and long- (12 months) term follow-up data from these patients were compared with the retrospective data from an urban cancer centre, where standard protocol of concurrent chemo-radiotherapy is practiced. MATERIALS AND METHODS: Two hundred patients of advanced cervical cancer, treated at our rural cancer centre between January 2007 and December 2007, were included in the study arm (Group A)...
January 2016: Indian Journal of Cancer
Roberto Romero, Kypros Nicolaides, Agustin Conde-Agudelo, John M O'brien, Elcin Cetingoz, Eduardo Da Fonseca, George W Creasy, Sonia S Hassan
OBJECTIVE: To evaluate the efficacy of vaginal progesterone administration in preventing preterm birth and perinatal morbidity and mortality in asymptomatic women with a singleton gestation and a midtrimester sonographic cervical length ≤25 mm. METHODS: Updated systematic review and meta-analysis of randomized controlled trials comparing vaginal progesterone with placebo/no treatment in women with a singleton gestation and a midtrimester sonographic cervical length ≤25 mm...
May 4, 2016: Ultrasound in Obstetrics & Gynecology
Mohamed F Shaltout, Ahmed M Maged, Moutaz M Elsherbini, Rasha O Elkomy
OBJECTIVE: To evaluate efficiency and safety of the new approach of laparoscopic cerclage. STUDY DESIGN: fifteen women were operated with our new technique. Their age ranged from 22 years to 35 years. Inclusion criteria included those with history of two or more 2nd trimesteric abortions or early preterm labor. These women had at least two previous unsuccessful vaginal cerclage or vaginal insertion of cerclage is not possible because of congenitally short cervix, cervical conization or excessive cervical scarring...
April 20, 2016: Journal of Maternal-fetal & Neonatal Medicine
Liping Zhao, Tianmin Xu, Manhua Cui, Zeming Fu
Villoglandular papillary adenocarcinoma (VGPA) of the uterine cervix is a rare subtype of cervical adenocarcinoma (AC) that accounts for 3.7-4.8% of cervical AC. Compared with ordinary adenocarcinoma, VGPA is associated with a lower incidence, younger age and better prognosis. Treatment with fertility-preserving surgery is also possible. The present study analyzed cases treated in The Second Hospital of Jilin University (Changchun, Jilin, China) between January 2010 and December 2014. A total of 11 cases were selected; of these, 7 cases were pathologically confirmed...
March 2016: Oncology Letters
Christopher Houlihan, Liona C Y Poon, Michele Ciarlo, Eugene Kim, Edwin R Guzman, Kypros H Nicolaides
OBJECTIVE: To determine if cervical cerclage reduces the rate of spontaneous early preterm birth in cases of ultrasound detected short cervix in dichorionic/diamniotic (DC-DA) twins. METHODS: This was a retrospective cohort study on DC-DA twins. The cases were 40 consecutive DC-DA twins at Saint Peter's University Hospital from November 2006 through May 2012 where cervical cerclage was performed for ultrasound determined cervical length of 1-24 mm at 16-24 weeks' gestation...
March 16, 2016: Ultrasound in Obstetrics & Gynecology
Kypros H Nicolaides, Argyro Syngelaki, Liona C Poon, Gemma Picciarelli, Natasa Tul, Aikaterini Zamprakou, Evdoxia Skyfta, Mauro Parra-Cordero, Ricardo Palma-Dias, Jesus Rodriguez Calvo
BACKGROUND: Preterm birth is the leading cause of neonatal and infant death and of disability among survivors. It is unclear whether a pessary inserted around the cervix reduces the risk of preterm singleton birth. METHODS: We conducted a multicenter, randomized, controlled trial comparing pessary placement with expectant management (control) in girls and women who were pregnant with singletons (singleton pregnancies) and who had a cervical length of 25 mm or less at 20 weeks 0 days to 24 weeks 6 days of gestation...
March 17, 2016: New England Journal of Medicine
Ajeet Kumar Gandhi
BACKGROUND: Survival of patients with locally advanced carcinoma cervix (LACC) using the current standard of concurrent chemo-radiotherapy (CCRT) has reached a plateau over the last two decades. Loco-regional failure in first two years of treatment completion and distant metastasis in the subsequent years has put the survival curves at a halt. Strategies of induction and adjuvant chemotherapy have yielded little as has any advancement in techniques of delivery of radiation therapy. This article aims at discussing the current existing literature as well as promising novel strategies to enhance radiotherapeutic outcomes in carcinoma of the uterine cervix...
February 2016: Annals of Translational Medicine
Lorene A Temming, Jennifer K Durst, Methodius G Tuuli, Molly J Stout, Jeffrey M Dicke, George A Macones, Alison G Cahill
BACKGROUND: Transvaginal measurement of cervical length (CL) has been advocated as a screening tool to prevent preterm birth, but controversy remains regarding the overall utility of universal screening. OBJECTIVE: We aimed to evaluate the acceptability of a universal CL screening program. Additionally we evaluated risk factors associated with declining screening and subsequent delivery outcomes of women who accepted or declined screening. STUDY DESIGN: This was a retrospective cohort study of transvaginal CL screening at a single institution from July 1, 2011, through December 31, 2014...
April 2016: American Journal of Obstetrics and Gynecology
Qiyong Fan, Anamaria R Yeung, Robert Amdur, Richard Helmig, Justin Park, Jonathan Li, Darren Kahler, Chihray Liu, Bo Lu
PURPOSE: The efficacy of image-guided high-dose rate brachytherapy for cervical cancer is limited by the ineffective rectal sparing devices available commercially and the potential applicator movement. We developed a novel device using a balloon catheter and a belt immobilization system, serving for rectal dose reduction and applicator immobilization purposes, respectively. METHODS: The balloon catheter is constructed by gluing a short inflatable tube to a long regular open-end catheter...
February 10, 2016: Technology in Cancer Research & Treatment
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