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https://www.readbyqxmd.com/read/28079869/racial-and-social-predictors-of-longitudinal-cervical-measures-the-cervical-ultrasound-study
#1
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
#2
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
#3
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/28042992/are-rapidly-growing-cancers-more-lethal
#4
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...
December 30, 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/28029462/-prediction-of-preterm-delivery-in-symptomatic-women-preterm-labor
#5
G Benoist
OBJECTIVES: To evaluate the predictors of spontaneous preterm birth in case of preterm labor. MATERIALS AND METHODS: Literature search in Medline and Cochrane databases and recommendations of international societies. Selection of studies in symptomatic women (with preterm labor). RESULTS: Preterm labor is defined as a clinical situation occurring between 22 and 36 weeks + 6 days, in which cervical changes are observed associated with uterine contractions, evolving spontaneously or not to preterm delivery (Professional consensus)...
October 28, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28029461/-prevention-of-preterm-birth-by-uterine-cervical-cerclage
#6
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/28025684/utility-of-anterior-vaginal-wall-length-measurement-in-vaginal-reconstructive-surgery
#7
Amy F Collins, Paula J Doyle, Smitha Vilasagar, Gunhilde M Buchsbaum
INTRODUCTION AND HYPOTHESIS: The pelvic organ prolapse quantification system (POP-Q) is the most commonly used method to quantify the extent of pelvic organ prolapse. However, it does not include assessment of anterior vaginal wall length (AVL). The objectives of this study were to characterize AVL and distance to the sacrospinous ligament (SSL), and to examine associations between total vaginal length (TVL), AVL, body mass index (BMI) and age. METHODS: This was a retrospective chart review of 139 patients with cervix in situ presenting during an 8-month period for initial evaluation to the University of Rochester Medical Center Urogynecology practice...
December 26, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27992933/sonographic-cervical-shortening-after-labor-induction-is-a-predictor-of-vaginal-delivery
#8
Ugo Indraccolo, Gennaro Scutiero, Pantaleo Greco
Objective Analyzing if the sonographic evaluation of the cervix (cervical shortening) is a prognostic marker for vaginal delivery. Methods Women who underwent labor induction by using dinoprostone were enrolled. Before the induction and three hours after it, the cervical length was measured by ultrasonography to obtain the cervical shortening. The cervical shortening was introduced in logistic regression models among independent variables and for calculating receiver operating characteristic (ROC) curves...
December 19, 2016: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/27974821/tracking-the-impact-of-excisional-cervical-treatment-on-the-cervix-using-biospectroscopy
#9
Diane E Halliwell, Maria Kyrgiou, Anita Mitra, Ilkka Kalliala, Evangelos Paraskevaidis, Georgios Theophilou, Pierre L Martin-Hirsch, Francis L Martin
Local excisional treatment for cervical intra-epithelial neoplasia (CIN) is linked to significant adverse sequelae including preterm birth, with cone depth and radicality of treatment correlating to the frequency and severity of adverse events. Attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy can detect underlying cervical disease more accurately than conventional cytology. The chemical profile of cells pre- and post-treatment may differ as a result of altered biochemical processes due to excision, or treatment of the disease...
December 15, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27936911/bacterial-and-cytokine-mixtures-predict-the-length-of-gestation-and-are-associated-with-mirna-expression-in-the-cervix
#10
Alison P Sanders, Chris Gennings, Katherine Svensson, Valeria Motta, Adriana Mercado-Garcia, Maritsa Solano, Andrea A Baccarelli, Martha M Tellez-Rojo, Robert O Wright, Heather H Burris
AIM: Bacterial vaginosis may lead to preterm birth through epigenetic programming of the inflammatory response, specifically via miRNA expression. METHODS: We quantified bacterial 16S rRNA, cytokine mRNA and 800 miRNA from cervical swabs obtained from 80 women at 16-19 weeks' gestation. We generated bacterial and cytokine indices using weighted quantile sum regression and examined associations with miRNA and gestational age at delivery. RESULTS & DISCUSSION: Each decile of the bacterial and cytokine indices was associated with shorter gestations (p < 0...
December 12, 2016: Epigenomics
https://www.readbyqxmd.com/read/27928435/a-debate-about-ultrasound-and-anatomic-aspects-of-the-cervix-in-spontaneous-preterm-birth
#11
REVIEW
Bohîlțea Re, Munteanu O, Turcan N, Baros A, Bodean O, Voicu D, Cîrstoiu Mm
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/27915496/cervical-pessary-for-preventing-preterm-birth-in-twin-pregnancies-with-short-cervical-length-a-systematic-review-and-meta-analysis
#12
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. RESULTS: Three trials, including 481 twin pregnancies with short cervix, were analyzed...
December 5, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27908632/risk-of-persistent-and-recurrent-cervical-neoplasia-following-incidentally-detected-adenocarcinoma-in-situ
#13
Aime Munro, Jim Codde, Katrina Spilsbury, Nerida Steel, Colin J R Stewart, Stuart G Salfinger, Jason Tan, Ganendra R Mohan, Yee Leung, James Semmens, Peter O'Leary, Vincent Williams, Paul A Cohen
BACKGROUND: Adenocarcinoma in situ of the uterine cervix is a precursor to cervical adenocarcinoma and may coexist with both adenocarcinoma and high-grade squamous dysplasia (cervical intraepithelial neoplasia 2 and 3). Up to 60% of adenocarcinoma in situ lesions are detected incidentally following excisional biopsies performed for the treatment of cervical intraepithelial neoplasia 2/3. To date there are no data regarding risk factors for persisting or progressive cervical neoplasia in these patients...
November 28, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27889000/not-transabdominal
#14
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
#15
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/27872420/role-of-cervical-length-measurement-for-preterm-delivery-prediction-in-women-with-threatened-preterm-labor-and-cervical-dilatation
#16
Liran Hiersch, Nir Melamed, Amir Aviram, Ron Bardin, Yariv Yogev, Eran Ashwal
OBJECTIVES: To compare the accuracy and cutoff points for cervical length for predicting preterm delivery in women with threatened preterm labor between those with a closed cervix and cervical dilatation. METHODS: We conducted a retrospective cohort study of women with singleton pregnancies with threatened preterm labor before 34 weeks. The accuracy of cervical length for predicting preterm delivery was compared between women with cervical dilatation (0.5-3 cm) and those with a closed cervix...
December 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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
#17
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/27868465/comparison-of-elastosonography-and-digital-examination-of-cervix-for-consistency-to-predict-successful-vaginal-delivery-after-induction-of-labor-with-oxytocin
#18
Serap Gultekin, Ismail Burak Gultekin, Bilal Icer, Elif Yilmaz, Afra Alkan, Tuncay Kucukozkan
OBJECTIVE: To compare elastosonography and digital examination of cervix for consistency in the prediction of successful vaginal delivery. METHODS: A total of 64 pregnant women with the indication of induction of labor (IOL) were enrolled to the study. The uterine cervix is evaluated before and after the IOL with elastosonography and digital examination for consistency and sonography for length. Methods were compared in regard to the prediction of successful vaginal delivery...
December 1, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27867048/feasibiility-and-learning-curve-of-robotic-laparo-endoscopic-single-site-surgery-in-gynecology
#19
Alexandre Buckley de Meritens, Julia Kim, Helen Dinkelspiel, Eloise Chapman-Davis, Thomas Caputo, Kevin Holcomb
Single-site laparoscopy has proven to be a desirable option for patients undergoing gynecologic surgery with some studies indicating improved cosmesis and less perioperative pain compared to standard approaches. This study describes the safety and feasibility of a novel robotic laparo-endoscopic single-site surgery (R-LESS) platform as it is incorporated into a surgeon's practice with extensive multiport robotic surgical experience but limited laparo-endoscopic single-site experience. We reviewed 83 women undergoing R-LESS by a single surgeon from September 2013 through August 2015...
November 17, 2016: Journal of Minimally Invasive 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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