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cervix length

Giovanni Grandi, Lucrezia Pignatti, Francesca Ferrari, Giulia Dante, Isabella Neri, Fabio Facchinetti
INTRODUCTION: Inflammation might be an important underlying cause of preterm birth. Our aim is to explore whether vaginal administration α-lipoic acid reduces cervical inflammation and shortening after primary tocolysis. Matherials and Methods: Singleton pregnancies between 24-30 weeks remaining undelivered after hospitalization for preterm labor were randomly allocated to placebo (20 women, 15 analyzed) or vaginal ALA 400 mg daily (20 women, 17 analyzed) for 30 days. A cervical swab to quantify pro-inflammatory (IL1, IL2, IL6, IL8, TNFα) and anti-inflammatory (IL4, IL10) cytokines as well as transvaginal ultrasound cervical length measurement (CL) were performed before and after treatment...
October 9, 2016: Journal of Maternal-fetal & Neonatal Medicine
Nada Aracic, Ivica Stipic, Ivana Jakus Alujevic, Petar Poljak, Mario Stipic
AIM: To evaluate the influence of cervical length (CL) and parity as prediction factors for assessment of cesarean section (CS) risk in women with premature rupture of membranes (PROM) at term and unfavorable cervix, undergoing induction of labor (IOL) with dinoprostone intracervical gel. METHODS: A prospective study involved 50 nulliparous and 51 multiparous women admitted for IOL. Pre-induction CL was measured and delivery outcomes were recorded. RESULTS: Nulliparous women were younger than the multiparous (26...
October 8, 2016: Journal of Perinatal Medicine
Jaroslaw Kalinka, Elwira Agata Jasinska, Piotr Laudanski, Adam Bitner
We present a rare case of a complication after pessary insertion during pregnancy due to short cervix. A woman in the 35th week of gestation was admitted to the Department of Perinatology due to preterm labor. The patient's history revealed cervical pessary insertion during the 29th week of pregnancy due to a cervix of 18 mm in length. Because of threatened preterm labor, the pessary was removed. After pessary removal, a rupture of the cervix was diagnosed. Because of active labor and cervical rupture, a cesarean section was performed and a healthy newborn was delivered...
October 8, 2016: Journal of Obstetrics and Gynaecology Research
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
Ying Zhang, Yisong Chen, Keqin Hua
STUDY OBJECTIVE: To describe our technique of robotic assisted reconstruction of cervix and vagina by SIS (small intestinal sub-mucosa, SIS) graft and fusion of hemi-uterus. DESIGN: Step-by-step explanation of the procedure using video. SETTING: Congenital complete vaginal and cervical atresia is rare. Some patient has urinary system abnormality. No standardized surgical treatment guideline was available and the performance is varying for each patient...
October 1, 2016: Journal of Minimally Invasive Gynecology
D Farsetti, D Lo Presti, I Pisani, G M Tiralongo, G Gagliardi, B Vasapollo, G P Novelli, H Valensise
INTRODUCTION: The purpose of our study was to evaluate the maternal haemodynamic profile in women diagnosed with threatened preterm delivery (TPD) in order to understand the possible pathophysiologic mechanism leading to an increased lifetime risk for future cardiovascular disease. METHODS: Sixty-eight patients diagnosed with TPD were enrolled and assessed using a non-invasive method (USCOM®) to determine the haemodynamic parameters. Cervix length assessment, vaginal and rectal swabs, blood inflammatory indexes, foetal vessel Doppler velocimetry, gestational age at the delivery and neonatal outcomes were considered...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Fang Shen, Xu-Yin Zhang, Chu-Yang Yin, Jing-Xin Ding, Ke-Qin Hua
STUDY QUESTION: What is the difference in vaginal-length gain and resumption of menstruation following cervicovaginal reconstruction using split-thickness skin (STS) graft versus small intestinal submucosa (SIS) graft for patients with congenital vaginal and cervical aplasia? SUMMARY ANSWER: No difference was found in the number of patients who resumed menstruation between the two groups; however, significantly greater vaginal-length gain was found in the STS group...
September 22, 2016: Human Reproduction
Melanie R L Meister, Siobhan Sutcliffe, Jerry L Lowder
OBJECTIVE: We sought to identify and summarize definitions of apical support loss utilized for inclusion, success, and failure in surgical trials for treatment of apical vaginal prolapse. STUDY DESIGN: A systematic literature search was performed in 8 search engines: PubMed 1946-, Embase 1947-, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Review Effects, Cochrane Central Register of Controlled Trials,, Proquest Dissertations and Theses, and FirstSearch Proceedings, using key words for apical pelvic organ prolapse and apical suspension procedures through April 2016...
September 15, 2016: American Journal of Obstetrics and Gynecology
David A Crosby, Jan Miletin, Jana Semberova, Sean Daly
INTRODUCTION: A recent meta-analysis has suggested that routine measurement of the cervical length should be performed in conjunction with the anomaly scan to identify a group of women at increased risk of preterm delivery. We decided to investigate whether this recommendation is justifiable in a population where the risk of preterm birth is low. MATERIAL AND METHODS: We reviewed 12 years of obstetric data from the Coombe Women and Infants University Hospital. Relative risks of adverse outcomes from the randomized controlled trial were applied and we extrapolated the possible numbers of women requiring intervention...
September 13, 2016: Acta Obstetricia et Gynecologica Scandinavica
Malipati Maerdan, Chunyan Shi, Xiaoxiao Zhang, Lixin Fan
OBJECTIVE: The objective of this study is to understand the prevalence of short cervical length between 20 and 24 weeks gestation in China and to evaluate the efficacy of micronized progesterone for prolonging gestation in nulliparous patients with a short cervix. METHODS: From May 2010 to May 2015, a total of 25 328 asymptomatic women with singleton pregnancies at Peking University First Hospital had their cervical length routinely measured between 20 and 24 weeks of gestation...
September 7, 2016: Journal of Maternal-fetal & Neonatal Medicine
Manel Mendoza, Maria Goya, Andrea Gascón, Laia Pratcorona, Carme Merced, Carlota Rodó, Leonor Valle, Azahar Romero, Miquel Juan, Alberto Rodríguez, Begoña Muñoz, Bele˜n Santacruz, Elena Carreras, Luis Cabero
OBJECTIVES: To observe the modifications in cervical length (CL) in patients with and without cervical pessary (Arabin® ASQ 65/25/32) and correlate these modifications with gestational age at delivery. STUDY DESIGN: Prospective study of asymptomatic singleton pregnancies (PECEP-Trial) between weeks 20 + 0 and 23 + 6 with maternal short cervix (<25 mm) randomised into two groups: expectant management and cervical pessary. RESULTS: This study included 380 pregnant women: 190 with pessary and 190 without pessary...
August 28, 2016: Journal of Maternal-fetal & Neonatal Medicine
Adam Bierut, Jadwiga Dowgiałło-Smolarczyk, Izabela Pieniążek, Jarosław Stelmachowski, Kinga Pacocha, Maciej Sobkowski, Oleg R Baev, Jacek Walczak
INTRODUCTION: The present study aimed to assess the costs and consequences of using an innovative medical technology, misoprostol vaginal insert (MVI), for the induction of labor (IOL), in place of alternative technologies used as a standard of care. METHODS: This was a retrospective study on cost and resource utilization connected with economic model development. Target population were women with an unfavorable cervix, from 36 weeks of gestation, for whom IOL is clinically indicated...
October 2016: Advances in Therapy
Kishwar Azad, Jiji Mathews
Preterm births (PTBs), defined as births before 37 weeks of gestation account for the majority of deaths in the newborn period. Prediction and prevention of PTB is challenging. A history of preterm labour or second trimester losses and accurate measurement of cervical length help to identify women who would benefit from progesterone and cerclage. Fibronectin estimation in the cervicovaginal secretions of a symptomatic woman with an undilated cervix can predict PTB within 10 days of testing. Antibiotics should be given to women with preterm prelabour rupture of membranes but tocolysis has a limited role in the management of preterm labour...
June 24, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
Merel Mc Bruijn, Esme I Kamphuis, Irene M Hoesli, Begoña Martinez De Tejada, Anne R Loccufier, Maritta Kühnert, Hanns Helmer, Marie Franz, Martina M Porath, Martijn A Oudijk, Yves Jacquemyn, Sven M Schulzke, Grit Vetter, Griet Hoste, Jolande Y Vis, Marjolein Kok, Ben Wj Mol, Gert-Jan van Baaren
BACKGROUND: The combination of the qualitative fetal fibronectin test and cervical length measurement has a high negative predictive value for preterm birth within seven days, but positive prediction is poor. A new bedside quantitative fetal fibronectin test showed potential additional value over the conventional qualitative test, but there is limited evidence on the combination with cervical length measurement. OBJECTIVE: To compare quantitative fetal fibronectin and qualitative fetal fibronectin testing in the prediction of spontaneous preterm birth within seven days in symptomatic women undergoing cervical length measurement...
August 16, 2016: American Journal of Obstetrics and Gynecology
Núria Baños, Alvaro Perez-Moreno, Federico Migliorelli, Laura Triginer, Teresa Cobo, Elisenda Bonet-Carne, Eduard Gratacos, Montse Palacio
OBJECTIVES: Quantitative texture analysis has been proposed to extract robust features from the ultrasound image to detect subtle changes in the textures of the images. The aim of this study was to evaluate the feasibility of quantitative cervical texture analysis to assess cervical tissue changes throughout pregnancy. METHODS: This was a cross-sectional study including singleton pregnancies between 20.0 and 41.6 weeks of gestation from women who delivered at term...
August 11, 2016: Fetal Diagnosis and Therapy
Ziv Tsafrir, Joelle Aoun, Rabbie Hanna, Eleni Papalekas, Lauren Schiff, Evan Theoharis, David Eisenstein
BACKGROUND AND OBJECTIVES: A renewed interest in the supra cervical approach to hysterectomy has created a cohort of patients with a retained cervix at risk of persistent symptoms requiring a subsequent trachelectomy. The objective of this study was to evaluate the efficacy of robotic trachelectomy after a previous supracervical hysterectomy. METHODS: This is a retrospective chart review of women who had robotic trachelectomy after supracervical hysterectomy for benign gynecologic disease from January 2009 through October 2014...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Kiattisak Kongwattanakul, Piyamas Saksiriwuttho, Ratana Komwilaisak, Pisake Lumbiganon
PURPOSE: This study aimed to evaluate the diagnostic properties of transabdominal sonography with the post-void technique for cervical length measurement. METHODS: This study was a prospective cohort study. The inclusion criteria were pregnant women aged 18-40 years with gestational age of 18-23 completed weeks. Transabdominal sonography with vertical bladder depth of less than 5 cm and transvaginal cervical length measurements were carried out by a single experienced sonographer...
October 2016: Journal of Medical Ultrasonics
Kartik K Venkatesh, David E Cantonwine, Kelly Ferguson, Melanie Arjona, John D Meeker, Thomas F McElrath
PROBLEM: We assess whether inflammatory and oxidative stress markers early in pregnancy are associated with decreasing cervical length in the second trimester. METHOD OF STUDY: This is a secondary analysis of a nested case-control study of preterm birth conducted at a tertiary care center from 2006 to 2008. Plasma inflammatory markers included the following: interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-1 beta (IL-1β), tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP); and urine oxidative stress markers included the following: 8-hydroxydeoxyguanosine (8-OHdG) and 8-isoprostane, measured at two study visits (median 10 and 18 weeks of gestation)...
November 2016: American Journal of Reproductive Immunology: AJRI
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
Jessica Spiegelman, Whitney Booker, Simi Gupta, Jennifer Lam-Rochlin, Andrei Rebarber, Daniel H Saltzman, Ana Monteagudo, Nathan S Fox
Objective To estimate the independent association of a short cervical length (CL), positive fetal fibronectin (fFN), amniotic fluid (AF) sludge, and cervical funneling with spontaneous preterm birth in twin pregnancies. Methods Retrospective cohort study of twin pregnancies managed by a single maternal-fetal medicine practice from June 2005 to February 2014. All patients underwent transvaginal sonographic CL and fFN testing. We reviewed all images from the first CL at 22(0/7) to 25(6/7) weeks for the presence of (1) a short CL, which is defined as ≤25 mm, (2) AF sludge, and (3) cervical funneling, and also recorded (4) the fFN result from that time...
October 2016: American Journal of Perinatology
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