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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
#1
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
#2
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 (AIS) of the uterine cervix is a precursor to cervical adenocarcinoma and may co-exist with both adenocarcinoma and high-grade squamous dysplasia (cervical intraepithelial neoplasia (CIN) 2 and 3). Up to 60% of AIS lesions are detected incidentally following excisional biopsies performed for the treatment of CIN 2/3. To date there are no data regarding risk factors for persisting or progressive cervical neoplasia in these patients. OBJECTIVE: To investigate patient outcomes following incidentally detected cervical AIS after loop electrosurgical excision procedure (LEEP) or cold knife cone (CKC) biopsy performed for the treatment of high-grade cervical intraepithelial neoplasia (CIN)...
November 28, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27889000/not-transabdominal
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27836521/-does-post-operative-sonographic-position-of-preventive-cervical-cerclage-affect-gestational-age-at-birth
#10
L Melle, C Le Ray, P Delorme, O Anselem, F Goffinet, L Marcellin
OBJECTIVE: To evaluate whether the position of preventive cerclage determined by immediate postoperative transvaginal cervical ultrasound is predictive of preterm birth. METHODS: A single-center retrospective study conducted between 1 August 2007 and 31 December 2015 in a maternity type III who included women carrying out for a single pregnancy and who receive a McDonald preventive cerclage. Measurements of internal os-stitch, stitch-external os and the total length of the cervix were performed during immediate postoperative transvaginal cervical ultrasound...
December 2016: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/27836377/-prevention-of-spontaneous-preterm-birth-excluding-preterm-premature-rupture-of-membranes-guidelines-for-clinical-practice%C3%A2-%C3%A2-text-of-the-guidelines-short-text
#11
L Sentilhes, M-V Sénat, P-Y Ancel, E Azria, G Benoist, J Blanc, G Brabant, F Bretelle, S Brun, M Doret, C Ducroux-Schouwey, A Evrard, G Kayem, E Maisonneuve, L Marcellin, S Marret, N Mottet, S Paysant, D Riethmuller, P Rozenberg, T Schmitz, H Torchin, B Langer
OBJECTIVES: To determine the measures to prevent spontaneous preterm birth (excluding preterm premature rupture of membranes)and its consequences. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: In France, premature birth concerns 60,000 neonates every year (7.4 %), half of them are delivered after spontaneous onset of labor...
November 8, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27824745/regeneration-process-after-cervical-conization-for-cervical-intraepithelial-neoplasia
#12
Taejong Song, Seok Ju Seong, Byoung-Gie Kim
OBJECTIVE: To investigate whether there is a regeneration process after cervical conization and, if it exists, how much of the cervix will regenerate and when regeneration will be completed. METHODS: This was a prospective observational study of women undergoing conization for cervical intraepithelial neoplasia. Transvaginal ultrasonographic examinations of the cervical volume and length were performed just before conization and were repeated at 1, 3, 6, 9, and 12 months after conization...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27823998/role-of-cervical-cerclage-and-vaginal-progesterone-in-the-treatment-of-cervical-incompetence-with-without-preterm-birth-history
#13
Shao-Wei Wang, Lin-Lin Ma, Shuai Huang, Lin Liang, Jun-Rong Zhang
BACKGROUND: Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality worldwide, and its prevention is an important health-care priority. The cervical incompetence is a well-known risk factor for PTB and its incidence is about 0.1-2.0%, while there is no ideal optimum treatment recommended currently. The cervical incompetence causes about 15% of habitual abortion in 16-28 weeks. This study aimed to evaluate the effectiveness and safety of cervical cerclage and vaginal progesterone in the treatment of cervical incompetence with/without PTB history...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27776845/-the-use-of-progestatives-for-the-prevention-of-spontaneous-preterm-birth
#14
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
https://www.readbyqxmd.com/read/27775195/17-alpha-hydroxyprogesterone-caproate-versus-vaginal-progesterone-suppository-for-the-prevention-of-preterm-birth-in-women-with-a-sonographically-short-cervix-a-randomized-controlled-trial
#15
Reihaneh Pirjani, Reza Heidari, Abbas Rahimi-Foroushani, Seyedehsara Bayesh, Arezoo Esmailzadeh
AIM: The aim of this study was to compare 17-alpha-hydroxyprogesterone caproate (17OHP-C) with vaginal progesterone suppository for the prevention of preterm birth in women with a sonographically short cervix and to evaluate the changes of the cervical length (CL) over time. METHODS: In this prospective randomized controlled trial, eligible patients were asymptomatic pregnant women with a sonographically short cervix. The participants in group 1 (n = 147) received vaginal progesterone suppositories at a dose of 400 mg daily and the women in group 2 (n = 150) received an i...
October 24, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27718765/vaginal-alpha-lipoic-acid-shows-an-anti-inflammatory-effect-on-the-cervix-preventing-its-shortening-after-primary-tocolysis-a-pilot-randomized-placebo-controlled-study
#16
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
https://www.readbyqxmd.com/read/27718494/the-value-of-ultrasound-measurement-of-cervical-length-and-parity-in-prediction-of-cesarean-section-risk-in-term-premature-rupture-of-membranes-and-unfavorable-cervix
#17
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
https://www.readbyqxmd.com/read/27718293/rupture-of-the-cervix-during-pregnancy-after-cervical-pessary-insertion-for-preventing-preterm-birth
#18
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
https://www.readbyqxmd.com/read/27718280/combined-treatment-with-cervical-pessary-and-vaginal-progesterone-for-the-prevention-of-preterm-birth-a-randomized-clinical-trial
#19
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
https://www.readbyqxmd.com/read/27702705/robotic-assisted-reconstruction-of-cervix-and-vagina-by-sis-graft-and-fusion-of-hemi-uterus
#20
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
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