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https://www.readbyqxmd.com/read/28209998/cervical-pessary-for-prevention-of-preterm-birth-a-meta-analysis
#1
Xin-Hang Jin, Dan Li, Li-Li Huang
To investigate the efficacy of cervical pessary placement in preventing preterm birth and perinatal morbidity and mortality in asymptomatic women with a singleton pregnancy and a short cervix, we searched literature in relevant databases. The meta-analysis of the 3 included trials (1412 women) showed cervical pessary placement did not reduce the risk of spontaneous preterm birth <34 weeks in these women (risk ratio (RR), 0.71; 95% confidence interval (CI), 0.21-2.43, P = 0.59; I(2) = 90%). The sensitivity analyses by excluding one trial at one time showed the same results...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28209456/the-role-of-stereotactic-ablative-body-radiotherapy-in-gynaecological-cancers-a-systematic-review
#2
L C Mendez, E Leung, P Cheung, L Barbera
AIMS: To summarise and evaluate the current literature in gynaecological tumours treated with stereotactic ablative body radiotherapy (SABR) through a systematic review using the Preferred Reported Items for Systematic Reviews and Meta-analysis (PRISMA) guideline. MATERIALS AND METHODS: A literature search through Medline, EMBASE and Cochrane databases resulted in 22 pertinent manuscripts. Selected studies evaluated the locoregional role of SABR in gynaecological tumours, regardless of SABR clinical indication...
February 13, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28168568/purtscher-like-retinopathy-associated-with-squamous-cell-carcinoma-of-the-cervix
#3
Darren Shu Jeng Ting, Jonathan Smith, Stephen James Talks
PURPOSE: To describe a previously unreported case of Purtscher-like retinopathy secondary to severe acute renal failure associated with squamous cell carcinoma of the cervix. METHODS: This is a case report. RESULTS: A 31-year-old female presented with a week history of acute abdominal pain, vomiting and severe renal failure followed by a sudden onset of bilateral visual loss. Vision was hand movement in either eye with central scotoma. Ophthalmic examination demonstrated bilateral retinal thickening and whitening with intraretinal hemorrhages localized to the peripapillary area, consistent with the diagnosis of Purtscher-like retinopathy...
February 6, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28166925/-is-universal-screening-for-cervical-length-among-singleton-pregnancies-with-no-history-of-preterm-birth-justified
#4
P Rozenberg
The ultrasonographic measurement of cervical length with a cutoff of 15mm is currently the best method to identify a group of asymptomatic women in the general population at risk of spontaneous preterm birth, especially among asymptomatic patients with a singleton pregnancy with no history of preterm birth. Cerclage and 17 alpha-hydroxyprogesterone caproate (17OHP-C) are ineffective to reduce the risk of preterm birth among asymptomatic patients with a short cervix in midtrimester. However, vaginal progesterone (200-mg capsules of micronized progesterone or gel containing 90mg progesterone) has been demonstrated effective in 2 large randomized trials to reduce the risk of preterm birth and possibly the composite morbidity and perinatal mortality associated among asymptomatic women with a short cervix in the general population screened by ultrasound of the cervix in midtrimester...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28166924/-lifestyle-recommendations-for-prevention-of-spontaneous-preterm-birth-in-asymptomatic-pregnant-women
#5
E Maisonneuve
OBJECTIVES: To establish recommendations for lifestyle of pregnant women and its impact on spontaneous preterm births. MATERIAL AND METHODS: We searched Pubmed and Cochrane databases and checked reference lists of retrieved studies. This review of the literature concerns only women who have no symptoms for the ongoing pregnancy. RESULTS: Concerning maternal occupation during pregnancy, there is a mild increase of the risk of preterm birth only for women who work more than 40hours a week or who have hard working conditions according to a fatigue score (LE2)...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28145653/maternal-characteristics-short-mid-trimester-cervical-length-and-preterm-delivery
#6
Soo Hyun Cho, Kyo Hoon Park, Eun Young Jung, Jung Kyung Joo, Ji Ae Jang, Ha Na Yoo
We aimed to determine the maternal characteristics (demographics, an obstetric history, and prior cervical excisional procedure) associated with a short mid-trimester cervical length (CL, defined as a CL of ≤ 25 mm) and whether having a short cervix explains the association between these maternal characteristics and spontaneous preterm delivery (SPTD, defined as a delivery before 34 weeks). This is a single-center retrospective cohort study of 3,296 consecutive women with a singleton pregnancy who underwent routine CL measurement between 20 and 24 weeks...
March 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28103952/the-interaction-between-vaginal-microbiota-cervical-length-and-vaginal-progesterone-treatment-for-preterm-birth-risk
#7
Lindsay M Kindinger, Phillip R Bennett, Yun S Lee, Julian R Marchesi, Ann Smith, Stefano Cacciatore, Elaine Holmes, Jeremy K Nicholson, T G Teoh, David A MacIntyre
BACKGROUND: Preterm birth is the primary cause of infant death worldwide. A short cervix in the second trimester of pregnancy is a risk factor for preterm birth. In specific patient cohorts, vaginal progesterone reduces this risk. Using 16S rRNA gene sequencing, we undertook a prospective study in women at risk of preterm birth (n = 161) to assess (1) the relationship between vaginal microbiota and cervical length in the second trimester and preterm birth risk and (2) the impact of vaginal progesterone on vaginal bacterial communities in women with a short cervix...
January 19, 2017: Microbiome
https://www.readbyqxmd.com/read/28079869/racial-and-social-predictors-of-longitudinal-cervical-measures-the-cervical-ultrasound-study
#8
E W Harville, K S Miller, L R Knoepp
OBJECTIVE: To evaluate whether the racial and socioeconomic disparities are present in adverse cervical parameters, and, if so, when such disparities develop. STUDY DESIGN: A prospective cohort study was conducted. 175 women with a prior preterm birth had up to four endovaginal ultrasounds between gestational weeks 16 and 24 (Cervical Ultrasound Trial of the MFMU). Each sociodemographic factor (race/ethnicity, marital status, insurance funding and education) was examined as a predictor of short cervix or U/funnel shape, using multiple logistic and linear regression...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28068594/prevention-of-spontaneous-preterm-birth-guidelines-for-clinical-practice-from-the-french-college-of-gynaecologists-and-obstetricians-cngof
#9
REVIEW
Loïc Sentilhes, Marie-Victoire Sénat, Pierre-Yves Ancel, Elie Azria, Guillaume Benoist, Julie Blanc, Gilles Brabant, Florence Bretelle, Stéphanie Brun, Muriel Doret, Chantal Ducroux-Schouwey, Anne Evrard, Gilles Kayem, Emeline Maisonneuve, Louis Marcellin, Stéphane Marret, Nicolas Mottet, Sabine Paysant, Didier Riethmuller, Patrick Rozenberg, Thomas Schmitz, Héloïse Torchin, Bruno Langer
In France, 60,000 neonates are born preterm every year (7.4%), half of them after the spontaneous onset of labor. Among preventable risk factors of spontaneous prematurity, only cessation of smoking is associated with decreased prematurity (level of evidence [LE]1). It is therefore recommended (Grade A). Routine screening and treatment of vaginal bacteriosis is not recommended in the general population (Grade A). The only population for which vaginal progesterone is recommended is that comprising asymptomatic women with singleton pregnancies, no history of preterm delivery, and a short cervix at 16-24 weeks of gestation (Grade B)...
December 30, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28067007/vaginal-progesterone-decreases-preterm-birth-and-neonatal-morbidity-and-mortality-in-women-with-a-twin-gestation-and-a-short-cervix-an-updated-meta-analysis-of-individual-patient-data
#10
REVIEW
Roberto Romero, Agustin Conde-Agudelo, Waleed El-Refaie, Line Rode, Maria L Brizot, Elcin Cetingoz, Vicente Serra, Eduardo Da Fonseca, Mohamed S Abdelhafez, Ann Tabor, Alfredo Perales, Sonia S Hassan, Kypros H Nicolaides
OBJECTIVE: To assess the efficacy of vaginal progesterone for the prevention of preterm birth and neonatal morbidity and mortality in asymptomatic women with a twin gestation and a sonographic short cervix (cervical length ≤25 mm) in the midtrimester. METHODS: Updated systematic review and meta-analysis of individual patient data from randomized controlled trials comparing vaginal progesterone with placebo/no treatment in women with a twin gestation and a midtrimester sonographic cervical length ≤25 mm...
January 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28066118/seizure-following-chemotherapy-paclitaxel-and-cisplatin-in-a-patient-of-carcinoma-cervix
#11
Rohitashwa Dana, R K Spartacus, Shweta Mutha, Prashanth Bhat
Cisplatin and paclitaxel both can cause peripheral neurotoxicity as an adverse effect; however, central nervous system neurotoxicity in the form of seizures is rare. We report a case of a 36-year-old female patient of metastatic carcinoma cervix, who developed seizure shortly after cisplatin infusion. Her laboratory investigations were within normal limits. Computed tomography scan and magnetic resonance imaging of the brain did not reveal brain primary metastasis or meningeal carcinomatosis. She had no complaints of fever, no signs and symptoms of infection, and no history of seizure nor was she on any medication predisposing to such an event...
November 2016: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/28042992/are-rapidly-growing-cancers-more-lethal
#12
Hans-Olov Adami, Peter Csermely, Daniel V Veres, Louise Emilsson, Magnus Løberg, Michael Bretthauer, Mette Kalager
The view, that rapidly growing tumours are more likely than slow-growing tumours to metastasize and become lethal, has remained almost axiomatic for decades. Unaware of any solid evidence supporting this view, we undertook an exhaustive system-level analysis of intra- and intercellular signalling networks. This analysis indicated that rapid growth and metastasis are often different outcomes of complex integrated molecular events. Evidence from humans can be derived chiefly from screening interventions because interval cancers that surface clinically shortly after a negative screening test are, on average, more rapidly growing than cancers not detected by screening...
February 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28029461/-prevention-of-preterm-birth-by-uterine-cervical-cerclage
#13
L Marcellin
OBJECTIVE: To review the scientific literature on cervical insufficiency and indications of cervical cerclage cervix. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and international obstetrical societies between 1972 and June 2016 have been consulted. RESULTS: Cervical insufficiency is a pathophysiological concept and to date no consensual definition is available: the diagnosis is clinical and discussed retrospectively in case of patients with a history of late miscarriages and/or spontaneous preterm delivery, with asymptomatic dilatation of the cervix (professional consensus)...
October 29, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27933401/improvement-of-abnormal-vaginal-flora-in-ugandan-women-by-self-testing-and-short-use-of-intravaginal-antimicrobials
#14
G Donders, G Bellen, F Donders, J Pinget, I Vandevelde, T Michiels, J Byamughisa
The vaginal composition of African women is more often lactobacillus-deficient compared to that of women from other areas around the world. Lactobacillus-deficient microflora is a known risk factor for serious health problems, such as preterm birth, cervix cancer, and entrapment of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). The aim of this study was to assess the effect of local vaginal antibiotic or antiseptic treatment on abnormal vaginal flora (AVF), aerobic vaginitis (AV), and bacterial vaginosis (BV) among women in rural, semi-urban, and urban areas in Uganda, as compared to placebo...
December 8, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27915496/cervical-pessary-for-preventing-preterm-birth-in-twin-pregnancies-with-short-cervical-length-a-systematic-review-and-meta-analysis
#15
Gabriele Saccone, Andrea Ciardulli, Serena Xodo, Lorraine Dugoff, Jack Ludmir, Francesco D'Antonio, Simona Boito, Elena Olearo, Carmela Votino, Giuseppe Maria Maruotti, Giuseppe Rizzo, Pasquale Martinelli, Vincenzo Berghella
OBJECTIVE: To evaluate the effectiveness of cervical pessary for preventing spontaneous preterm birth (SPTB) in twin pregnancies with an asymptomatic transvaginal ultrasound cervical length (TVU CL) in the second trimester. METHODS: We performed a meta-analysis including all randomized clinical trials (RCTs) comparing the use of cervical pessary (i.e. intervention group) with expectant management (i.e. control group). The primary outcome was incidence of SPTB <34 weeks...
January 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27889000/not-transabdominal
#16
EDITORIAL
Adeeb Khalifeh, Vincenzo Berghella
Preterm birth remains a major cause of perinatal morbidity and mortality. A short cervix is strongly associated with spontaneous preterm birth. Professional organizations support cervical length screening for singleton gestations with a prior spontaneous preterm birth and second-trimester cervical length measurements between 16-24 weeks. All interventions used to decrease the risk of preterm birth in women with a short cervix are based on clinical trials that used transvaginal cervical length measurement, but transabdominal ultrasound has been shown to correlate well with transvaginal measurement in some observational studies...
December 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27888999/transabdominal-ultrasound-is-appropriate
#17
EDITORIAL
David Stamilio, Laura M Carlson
Preterm birth remains a major cause of perinatal morbidity and mortality. A short cervix is strongly associated with spontaneous preterm birth. Professional organizations support cervical length screening for singleton gestations with a prior spontaneous preterm birth and second-trimester cervical length measurements between 16-24 weeks. All interventions used to decrease the risk of preterm birth in women with a short cervix are based on clinical trials that used transvaginal cervical length measurement, but transabdominal ultrasound has been shown to correlate well with transvaginal measurement in some observational studies...
December 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27871275/rationale-and-design-of-support-a-multi-centre-randomised-controlled-trial-to-compare-three-treatments-cervical-cerclage-cervical-pessary-and-vaginal-progesterone-for-the-prevention-of-preterm-birth-in-women-who-develop-a-short-cervix
#18
Natasha L Hezelgrave, Helena A Watson, Alexandra Ridout, Falak Diab, Paul T Seed, Evonne Chin-Smith, Rachel M Tribe, Andrew H Shennan
BACKGROUND: Clinically, once a woman has been identified as being at risk of spontaneous preterm birth (sPTB) due to a short cervical length, a decision regarding prophylactic treatment must be made. Three interventions have the potential to improve outcomes: cervical cerclage (stitch), vaginal progesterone and cervical pessary. Each has been shown to have similar benefit in reduction of sPTB, but there have been no randomised control trials (RCTs) to compare them. METHODS: This open label multi-centre UK RCT trial, will evaluate whether the three interventions are equally efficacious to prevent premature birth in women who develop a short cervix (<25 mm on transvaginal ultrasound)...
November 21, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27854378/interventions-for-women-with-mid-trimester-short-cervix-are-they-effective-which-ones-work
#19
EDITORIAL
Anthony M Vintzileos, Gerard H A Visser
The aim of this Editorial is to review Level I evidence regarding the effectiveness of interventions in women identified as having short cervix on mid-trimester ultrasound, discuss some of the remaining challenges and outline areas for future research.
November 11, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27843353/prevention-of-preterm-delivery-current-challenges-and-future-prospects
#20
REVIEW
Maud D van Zijl, Bouchra Koullali, Ben Wj Mol, Eva Pajkrt, Martijn A Oudijk
Preterm birth (PTB), defined as delivery at <37 weeks of gestation, is the most important cause of neonatal morbidity and mortality. Therefore, preventing PTB is one of the main goals in obstetric care. In this review, we provide an overview of the current available literature on screening for risk factors for PTB and a summary of preventive strategies in both low-risk and high-risk women with singleton or multiple gestations. Furthermore, current challenges and future prospects on PTB are discussed. For an optimal prevention of PTB, risk stratification should be based on a combination of (maternal) risk factors, obstetric history, and screening tools...
2016: International Journal of Women's Health
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