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Preterm labor

Reshama Navathe, Vincenzo Berghella
PURPOSE OF REVIEW: Tocolytic agents have been used for over 60 years in the fight against preterm labor, which ultimately can lead to preterm birth. Currently, clinicians can choose from a variety of drug classes to achieve the primary goal of delaying delivery by 48 h, thereby allowing time for administration of corticosteroids for fetal lung maturity, and if appropriate, starting magnesium sulfate for fetal neuroprotection. However, there are currently no known therapies to maintain the tocolytic effect beyond those initial 48 h...
October 18, 2016: Current Opinion in Obstetrics & Gynecology
Lydia F Edey, Kieran P O'Dea, Bronwen R Herbert, Renyi Hua, Simon N Waddington, David A MacIntyre, Philip R Bennett, Masao Takata, Mark R Johnson
Inflammation plays a key role in human term and preterm labor (PTL). Intrauterine LPS has been widely used to model inflammation induced complications of pregnancy including PTL. It has been shown to induce an intense myometrial inflammatory cell infiltration, but the role of LPS-induced inflammatory cell activation in labor onset and fetal demise is unclear. We investigated this using a mouse model of PTL, where an intrauterine injection of 10 µg of LPS (serotype 0111:B4) was given at E16 of CD1 mouse pregnancy...
October 19, 2016: Biology of Reproduction
Gözde Işik, Şayeste Demirezen, Hanife Güler Dönmez, Mehmet Sinan Beksaç
CONTEXT: Bacterial vaginosis (BV) is related to the increased risk of miscarriage, preterm labor, and postpartum endometritis. AIMS: The aim of this study was to evaluate the association between BV and the history of spontaneous abortion and recurrent pregnancy losses. We also examined periods of gestation, including the first and second trimester miscarriages. MATERIALS AND METHODS: The study population consisted of 200 fertile women. Sixty one (30...
July 2016: Journal of Cytology
Eran Ashwal, Shiri Shinar, Avital Wertheimer, Luciena Reina, Hadas Miremberg, Amir Aviram, Yariv Yogev, Liran Hiersch
BACKGROUND: To evaluate the association between gestational age at presentation and interval to delivery in women with early spontaneous preterm delivery (PTD). METHODS: A retrospective cohort study of women who presented with threatened preterm labor (tPTL) and intact membranes and had a spontaneous PTD <34 weeks in a university-affiliated hospital (2009-15). The interval from presentation to delivery was compared between different gestational age subgroups...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
Kim M J Verdurmen, Alexandra D J Hulsenboom, Judith O E H van Laar, S Guid Oei
INTRODUCTION: Tocolytics may cause changes in fetal heart rate pattern, while fetal heart rate variability is an important marker of fetal wellbeing. We aim to systematically review the literature on how tocolytic drugs affect fetal heart rate variability. MATERIAL AND METHODS: We searched CENTRAL, PubMed, and EMBASE up to June 2016. Studies published in English, using computerized or visual analysis to describe the effect of tocolytics on heart rate variability in human fetuses were included...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
Eugenio Baraldi, Giuseppe Giordano, Matteo Stocchero, Laura Moschino, Patrizia Zaramella, Maria Rosa Tran, Silvia Carraro, Roberto Romero, Maria Teresa Gervasi
OBJECTIVE: Bronchopulmonary dysplasia (BPD) is a serious complication associated with preterm birth. A growing body of evidence suggests a role for prenatal factors in its pathogenesis. Metabolomics allows simultaneous characterization of low molecular weight compounds and may provide a picture of such a complex condition. The aim of this study was to evaluate whether an unbiased metabolomic analysis of amniotic fluid (AF) can be used to investigate the risk of spontaneous preterm delivery (PTD) and BPD development in the offspring...
2016: PloS One
Su-A Kim, Jeong Bae Park
OBJECTIVE: Superimposed pre-eclampsia (SPE) is resolved only with the termination of the pregnancy. Therefore, the risk prediction and prevention is very important. We aimed to evaluate the characteristics of patients who develop SPE and their controllable risk factors during mid-trimester. DESIGN AND METHOD: A total of 283 pregnant women with chronic hypertension were included for the study. Blood pressure (BP) and body weight were recorded at 10, 20, 24, 28, and 32 weeks of gestation and pregnancy outcomes were evaluated...
September 2016: Journal of Hypertension
Sarah M Holmen, Tiki Bakhshi, Maria M Molina, Larissa F Weir
BACKGROUND: Chorioamniotic membrane separation (CMS) is a rare finding that is commonly preceded by invasive fetal procedures. The presence of CMS can also be associated with uncommon maternal or fetal conditions as well as preterm delivery, amniotic band syndrome, umbilical cord complications, and fetal and neonatal death. It is classified as a high-risk antepartum condition due to the significant fetal morbidity and mortality that may ensue. CASE REPORT: A 40-year-old gravida 5 para 1212 at 35 weeks presented for antepartum fetal testing...
October 2016: Military Medicine
Chen-Yu Wang, Yu-Ju Lai, Kwei-Shuai Hwang, Chi-Huang Chen, Mu-Hsien Yu, Huei-Tsung Chen, Her-Young Su
OBJECTIVE: Neutropenia developed after continuous intravenous infusion of ritodrine hydrochloride (Yutopar) for preterm uterine contractions in a twin pregnancy. We successfully returned the low neutrophil count to the normal range after discontinuation of infusion of ritodrine and treatment with granulocyte colony stimulating factor (G-CSF). CASE REPORT: A 34-year-old woman with twin pregnancy was treated with ritodrine for preterm uterine contractions at 27 weeks and 6 days gestation...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
Miha Lucovnik, Linda R Chambliss, Richard Blumrick, James Balducci, Ksenija Gersak, Robert E Garfield
OBJECTIVE: It has been shown that noninvasive uterine electromyography (EMG) can identify true preterm labor more accurately than methods available to clinicians today. The objective of this study was to evaluate the effect of body mass index (BMI) on the accuracy of uterine EMG in predicting preterm delivery. MATERIALS AND METHODS: Predictive values of uterine EMG for preterm delivery were compared in obese versus overweight/normal BMI patients. Hanley-McNeil test was used to compare receiver operator characteristics curves in these groups...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
Eric Lavigne, Antonio Gasparrini, David M Stieb, Hong Chen, Abdool S Yasseen, Eric Crighton, Teresa To, Scott Weichenthal, Paul J Villeneuve, Sabit Cakmak, Frances Coates, Mark Walker
BACKGROUND: Daily changes in aeroallergens during pregnancy could trigger early labor, but few investigations have evaluated this issue. This study aimed to investigate the association between exposure to aeroallergens during the week preceding birth and the risk of early delivery among preterm and term pregnancies. METHODS: We identified data on 225,234 singleton births that occurred in six large cities in the province of Ontario, Canada, from 2004 to 2011 (April to October) from a birth registry...
September 28, 2016: Epidemiology
Heléne E K Sundelin, Olof Stephansson, Kari Johansson, Jonas F Ludvigsson
INTRODUCTION: An increased risk of preterm birth in women with Joint Hypermobility Syndrome (JHS) or Ehlers-Danlos Syndrome (EDS) is suspected. MATERIAL AND METHODS: In this nationwide cohort study from 1997 through 2011, women with either JHS or EDS or both disorders were identified through the Swedish Patient Register, and linked to the Medical Birth Register. Thereby 314 singleton births to women with JHS/EDS before delivery were identified. These births were compared with 1,247,864 singleton births to women without a diagnosis of JHS/EDS...
October 14, 2016: Acta Obstetricia et Gynecologica Scandinavica
Montse Palacio, Stefania Ronzoni, Luis Sánchez-Ramos, Kellie E Murphy
OBJECTIVE: To evaluate the efficacy of maintenance tocolysis with progestogens compared with placebo or no treatment in women with singleton pregnancies and arrested preterm labor. DATA SOURCES: Studies without language restrictions were identified from MEDLINE, EMBASE, PubMed, Scopus, the Cochrane Pregnancy and Childbirth Group's Trials Register, the Cochrane Central Register of Controlled Trials, and from inception to June 2015. MeSH headings for progestogens were combined with terms regarding labor, tocolysis, or preterm birth...
October 6, 2016: Obstetrics and Gynecology
Val Catanzarite, Larry Cousins, Sean Daneshmand, Wade Schwendemann, Holly Casele, Joanna Adamczak, Tevy Tith, Ami Patel
OBJECTIVE: To describe outcomes for a large cohort of women with prenatally diagnosed vasa previa, determine the percentage in patients without risk factors, and compare delivery timing and indications for singletons and twins. METHODS: This was a retrospective case series of women with prenatally diagnosed vasa previa delivered at a single tertiary center over 12 years. Potential participants were identified using hospital records and perinatal databases. Patients were included if vasa previa was confirmed at delivery and by pathologic examination...
October 6, 2016: Obstetrics and Gynecology
Amy C Hermesch, Amanda A Allshouse, Kent D Heyborne
OBJECTIVE: To investigate the relationship between body mass index (BMI) and the onset of parturition throughout gestation. METHODS: This was a secondary analysis of the Maternal-Fetal Medicine Units Network Preterm Prediction Study. Time-to-spontaneous-birth-event (ie, "survival") methods were used to study the association of BMI with the timing of spontaneous onset of labor throughout gestation with indicated births censored at delivery. A Kaplan-Meier estimate of the probability of spontaneous labor was compared with a log rank test across five categories of BMI (kg/m): underweight (less than 18...
October 6, 2016: Obstetrics and Gynecology
Eduardo Fernández-Martínez, Héctor Ponce-Monter, Luis E Soria-Jasso, Mario I Ortiz, José-Antonio Arias-Montaño, Guillermo Barragán-Ramírez, Cynthia Mayén-García
Uterine relaxation is crucial during preterm labor. Phosphodiesterase-4 (PDE-4) inhibitors have been proposed as tocolytics. Some thalidomide analogs are PDE-4 inhibitors. The aim of this study was to assess the uterus-relaxant properties of two thalidomide analogs, methyl 3-(4-nitrophthalimido)-3-(3,4-dimethoxyphenyl)-propanoate (4NO2PDPMe) and methyl 3-(4-aminophthalimido)-3-(3,4-dimethoxyphenyl)-propanoate (4APDPMe) and were compared to rolipram in functional studies of spontaneous phasic, K⁺-induced tonic, and Ca(2+)-induced contractions in isolated pregnant human myometrial tissues...
October 7, 2016: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
Cristina Faralla, Gabrielle A Rizzuto, David E Lowe, Byoungkwan Kim, Cara Cooke, Lawrence R Shiow, Anna I Bakardjiev
Intrauterine infection is a major detriment for maternal-child health and occurs despite local mechanisms that protect the maternal-fetal interface from a wide variety of pathogens. The bacterial pathogen Listeria monocytogenes causes spontaneous abortion, stillbirth, and preterm labor in humans, and serves as a model for placental pathogenesis. Given the unique immunological environment of the maternal-fetal interface we hypothesized that virulence determinants with placental tropism are required for infection of this tissue...
October 10, 2016: Infection and Immunity
E B Carter, M G Tuuli, A O Odibo, G A Macones, A G Cahill
OBJECTIVE: To investigate the association between the number of prenatal visits (PNVs) and pregnancy outcomes in women with gestational diabetes (GDM) and Type 2 diabetes mellitus (DM). STUDY DESIGN: A 4-year prospective cohort study of women with GDM and DM and was conducted. Patients ⩾75th percentile for number of PNVs were compared with those ⩽25th percentile. The primary outcomes were large for gestational age (LGA) with birth weight >90% and neonatal intensive care unit (NICU) admission for >24 h...
October 13, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Kenna Degner, Ronald R Magness, Dinesh M Shah
The uterine vasculature undergoes marked changes during pregnancy in order to provide the necessary increase in blood flow to support growth and nutrition of the uterus, placenta, and developing fetus. Pregnancy-associated uterine vascular transformations are orchestrated by a complex array of endocrine and cellular mechanisms to bring about structural modifications at the maternal-fetal interface, which collectively lead to development of the uteroplacental circulation. Understanding intrinsic uterine vascular remodeling in pregnancy is essential for understanding the physiologic and pathophysiologic regulation of maternal uterine blood flow...
October 12, 2016: Reproductive Sciences
Eun Hui Bae, Jong Woon Kim, Hong Sang Choi, Seong Kwon Ma, Soo Wan Kim
Background/Aims: Proteinuria is associated with hypertension and preeclampsia in pregnancy. However, the impact of random urine proteinuria on fetal and maternal outcomes has not been established. We investigated the influence of random urine proteinuria on the clinical outcomes of pregnancy. Methods: From January 2008 to December 2010, 2,822 patients were retrospectively studied. A total of 536 pregnant women with proteinuria in random urine and matched controls without proteinuria via propensity score matching were analyzed...
October 13, 2016: Korean Journal of Internal Medicine
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