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https://www.readbyqxmd.com/read/28421178/applying-precision-public-health-to-prevent-preterm-birth
#1
REVIEW
John P Newnham, Matthew W Kemp, Scott W White, Catherine A Arrese, Roger J Hart, Jeffrey A Keelan
Preterm birth (PTB) is one of the major health-care challenges of our time. Being born too early is associated with major risks to the child with potential for serious consequences in terms of life-long disability and health-care costs. Discovering how to prevent PTB needs to be one of our greatest priorities. Recent advances have provided hope that a percentage of cases known to be related to risk factors may be amenable to prevention; but the majority of cases remain of unknown cause, and there is little chance of prevention...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28411085/vaginal-myomectomy-using-d%C3%A3-hrssen-longitudinal-median-cervical-incision-a-case-series-of-19-patients
#2
Wai Yoong, Wei Zhao, Hong Cai, Robyn D'Cruz, Alessia Corrieri, John Hamilton, Abiodun Fakokunde
STUDY OBJECTIVE: To examine demographics and outcome measures of women having undergone vaginal excision of myoma through Dührssen (longitudinal median cervical) incision DESIGN: Prospective case series DESIGN CLASSIFICATION: The design of the study conforms to Canadian Task Force II3 ie evidence from timed series SETTING: A London teaching hospital PATIENTS: 19 patients with either a) submucus myoma (type 1) located near the cervix or b) pedunculated intracavity myoma (type 0), excised via Dührssen incision INTERVENTIONS: Dührssen (median longitudinal) incision on the anterior or posterior cervical lip MEASUREMENTS: Duration of procedure, intraoperative complications, estimated blood loss, length of stay, % 24 hour discharge, readmission rates RESULTS: Between 2009-16, 19 women had their myomas (submucus type 1, n=17; pedunculated intracavity type 0, n=2) removed vaginally via Dührssen incision...
April 11, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28398701/cervical-pessary-for-preventing-preterm-birth-in-singleton-pregnancies-with-short-cervical-length-a-systematic-review-and-meta-analysis
#3
Gabriele Saccone, Andrea Ciardulli, Serena Xodo, Lorraine Dugoff, Jack Ludmir, Giorgio Pagani, Silvia Visentin, Salvatore Gizzo, Nicola Volpe, Giuseppe Maria Maruotti, Giuseppe Rizzo, Pasquale Martinelli, Vincenzo Berghella
OBJECTIVES: To evaluate the effectiveness of cervical pessary for preventing spontaneous preterm birth (SPTB) in singleton gestations with a second trimester short cervix. METHODS: Electronic databases were searched from their inception until February 2016. We included randomized clinical trials (RCTs) comparing the use of the cervical pessary with expectant management in singletons pregnancies with transvaginal ultrasound cervical length (TVU CL) ≤25 mm. The primary outcome was incidence of SPTB <34 weeks...
April 11, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28371283/outcomes-in-patients-undergoing-robotic-reconstructive-uterovaginal-anastomosis-of-congenital-cervical-and-vaginal-atresia
#4
Ying Zhang, Yisong Chen, Keqin Hua
OBJECTIVE: To introduce our experience of robotic surgery of reconstructive uterovaginal anastomosis and operative outcomes in congenital cervical and vaginal atresia patients. METHODS: Clinical observation and follow-up of four patients with congenital cervical and vaginal atresia who underwent robotic reconstruction of cervix and vagina by SIS (small intestinal submucosa, SIS) graft. RESULTS: Average patient age was 13.8 ± 2.2. Patients complained of severe periodic abdominal pain...
March 29, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28370687/mid-trimester-sonographic-cervical-consistency-index-to-predict-spontaneous-preterm-birth-in-a-low-risk-population
#5
Núria Baños, Clara Murillo-Bravo, Carla Julià, Federico Migliorelli, Alvaro Perez-Moreno, Jose Ríos, Eduard Gratacos, Lil Valentin, Montse Palacio
OBJECTIVES: To estimate the ability of mid-trimester sonographic Cervical Consistency Index (CCI) to predict spontaneous preterm birth (sPTB) in low-risk pregnancies and to compare its performance with mid-trimester sonographic cervical length (CL). METHODS: This is a prospective cohort study including women with singleton pregnancies examined with ultrasound at 19 + 0 to 24 + 6 gestational weeks. All underwent transvaginal ultrasound examination of the cervix, but CCI and CL were measured off-line only in women without risk factors for sPTB...
March 31, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28358839/frequency-and-clinical-significance-of-short-cervix-in-patients-with-preterm-premature-rupture-of-membranes
#6
Seung Mi Lee, Kyo Hoon Park, Eun Young Jung, Ji Ae Jang, Ha-Na Yoo
OBJECTIVE: Cervical length measurement has been uggested as a useful tool for predicting intra-amniotic infection/inflammation in preterm labor, but little information is available in the setting of preterm premature rupture of membranes (pPROM). We aimed to determine whether a short cervical length is independently associated with an increased risk of intra-amniotic infection or inflammation and impending preterm delivery in women with pPROM. METHODS: This was a retrospective cohort study involving 171 consecutive singleton pregnant women with pPROM (21+0-33+6 weeks' gestation), who underwent amniocentesis...
2017: PloS One
https://www.readbyqxmd.com/read/28339114/cervical-length-in-patients-at-risk-for-placenta-accreta
#7
Martha W F Rac, Donald D McIntire, C Edward Wells, Elysia Moschos, Diane D Twickler
OBJECTIVES: To evaluate cervical length measurements in women with placenta accreta compared to women with a nonadherent low-lying placenta or placenta previa and evaluate this relationship in terms of vaginal bleeding, preterm labor, and preterm birth. METHODS: We conducted a retrospective cohort study between 1997 and 2011 of gravidas with more than 1 prior cesarean delivery who had a transvaginal ultrasound examination between 24 and 34 weeks for a low-lying placenta or placenta previa...
March 24, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28320233/does-cervical-cerclage-decrease-preterm-birth-in-twin-pregnancies-with-a-short-cervix
#8
Tracy M Adams, Timothy J Rafael, Nadia B Kunzier, Supriya Mishra, Rose Calixte, Anthony M Vintzileos
PURPOSE: To determine if use of cerclage in twin gestations with mid-trimester short cervix is associated with decreased preterm birth rate. STUDY DESIGN: This is a retrospective cohort of twin gestations identified with cervical length of ≤2.5 cm before 24 weeks of gestation through the perinatal ultrasound database of two institutions from 2008 to 2014. Patients with and without cerclage were compared for a primary outcome of preterm birth at <35 weeks...
April 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28320033/is-the-relationship-between-short-interpregnancy-interval-and-preterm-birth-related-to-a-short-cervix
#9
S Govindappagari, N Zork, A Merriam, C Gyamfi-Bannerman
Objective Our objective was to determine if the relationship between interpregnancy interval (IPI) and preterm delivery was related to cervical shortening. Methods This is a secondary analysis of a prospective cohort study designed to assess the relationship between cervical length (CL) and preterm delivery. Multiparous patients, who had transvaginal CLs obtained at 22 to 24 weeks and complete pregnancy outcome data available were included. The women were divided into two groups: Group 1 with an IPI of ≤ 1 year and Group 2 with an IPI of > 1 year...
March 20, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28318214/preterm-labor-prevention-and-management
#10
Kristen Rundell, Bethany Panchal
In the United States, preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. The rate of preterm delivery (before 37 weeks' gestation) has been declining since 2007. Clinical diagnosis of preterm labor is made if there are regular contractions and concomitant cervical change. Less than 10% of women with a clinical diagnosis of preterm labor will deliver within seven days of initial presentation. Women with a history of spontaneous preterm delivery are 1...
March 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28303276/a-parameterized-ultrasound-based-finite-element-analysis-of-the-mechanical-environment-of-pregnancy
#11
Andrea R Westervelt, Michael Fernandez, Michael House, Joy Vink, Chia-Ling Nhan-Chang, Ronald Wapner, Kristin M Myers
Preterm birth is the leading cause of childhood mortality and can lead to health risks in survivors. The mechanical functions of the uterus, fetal membranes, and cervix have dynamic roles to protect the fetus during gestation. To understand their mechanical function and relation to preterm birth, we built a three-dimensional parameterized finite element model of pregnancy. This model is generated by an automated procedure that is informed by maternal ultrasound measurements. A baseline model at 25 weeks of gestation was characterized, and to visualize the impact of cervical structural parameters on tissue stretch, we evaluated the model sensitivity to (1) anterior uterocervical angle, (2) cervical length, (3) posterior cervical offset, and (4) cervical stiffness...
May 1, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28295722/cerclage-for-short-cervix-on-ultrasound-in-singleton-gestations-without-prior-spontaneous-preterm-birth-a-systematic-review-and-meta-analysis-of-trials-using-individual-patient-level-data
#12
REVIEW
Vincenzo Berghella, Andrea Ciardulli, Orion A Rust, Meekai To, Katsufumi Otsuki, Sietske Althuisius, Kypros Nicolaides, Amanda Roman, Gabriele Saccone
OBJECTIVE: The aim of this systematic review and meta-analysis was to quantify the efficacy of cervical cerclage in preventing preterm birth (PTB) in asymptomatic singleton pregnancies with a mid-trimester short transvaginal ultrasound cervical length (TVU CL) and without prior spontaneous PTB. METHODS: Electronic databases were searched from inception of each database until February 2017. No language restrictions were applied. We included all randomized controlled trials (RCTs) of asymptomatic singleton pregnancies without prior spontaneous PTB screened with TVU CL, found to have a midtrimester short CL <25 mm, and then randomized to management with either cerclage (i...
March 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28258974/assessment-of-cervical-elastography-strain-pattern-and-its-association-with-preterm-birth
#13
Vera Oturina, Kerstin Hammer, Mareike Möllers, Janina Braun, Maria Karina Falkenberg, Kathrin Oelmeier de Murcia, Ute Möllmann, Maria Eveslage, Arrigo Fruscalzo, Walter Klockenbusch, Ralf Schmitz
OBJECTIVE: The aim of the study was to assess the cervical strain pattern by an ultrasound elastography cervix examination and to determine its association with preterm delivery. METHODS: In this study, 30 cases resulting in preterm birth and 30 gestational age-matched controls were included. A vaginal ultrasound examination with cervical length and elastography measurement was performed. We calculated four strain ratios (SR1-SR4) of the regions of interest (ROIs) arranged in pairs in four different positions on the anterior cervical lip...
March 4, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28217665/elastographic-measurement-of-the-cervix-during-pregnancy-current-status-and-future-challenges
#14
REVIEW
Hyunjung Kim, Han Sung Hwang
The cervix is a cylindrical structure that is proximally connected to the uterus and distally to the vaginal cavity. The Bishop score has been used to evaluate the cervix during pregnancy. However, alternatives have been evaluated because the Bishop score is uncomfortable for patients, relies on a subjective examination, and lacks internal os data. Elastography has been used to assess the cervix, as it can estimate tissue stiffness. Recent articles on elastography for cervical assessment during pregnancy have focused on its usefulness for prediction of preterm birth and successful labor induction...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28178045/assessment-of-transvaginal-ultrasound-cervical-length-image-quality
#15
Rupsa C Boelig, Helen Feltovich, Jean Lea Spitz, Gregory Toland, Vincenzo Berghella, Jay D Iams
OBJECTIVE: To use data from the Cervical Length Education and Review program to evaluate the quality of transvaginal cervical length ultrasonography by trained imagers (ie, ultrasonographers, radiologists, perinatologists). METHODS: This is a retrospective observational study of data from the Cervical Length Education and Review program. Candidates underwent an online lecture series, examination, and submitted a batch of images for review. For a candidate's batch of images to pass, all images must meet at least seven of the nine criteria assessed, the overall batch score needs to be 80% or greater, correct caliper placement must be met for all images, and the same criterion cannot be consistently missed...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28169196/patterns-of-care-of-cervical-cancer-in-the-elderly-a-qualitative-literature-review
#16
Bhanu Prasad Venkatesulu, Supriya Mallick, Goura K Rath
INTRODUCTION: Cancer of the uterine cervix is the fourth most common cancer worldwide among women. However, there is limited data about elderly patients with cervical cancer and gross underrepresentation of elderly patients in clinical trials. Hence, the optimal therapy of such patients is not well formulated. METHODOLOGY: We conducted this systematic review of evidence to assess patterns of care in elderly patients with cervical cancer. RESULTS: A total of 17,338 publications are reported in PubMed until July, 2016 pertaining to cervical cancer...
March 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28166925/-is-universal-screening-for-cervical-length-among-singleton-pregnancies-with-no-history-of-preterm-birth-justified
#17
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/28157642/cervicovaginal-agenesis-treated-with-modified-yang-monti-technique-in-two-steps-case-report-and-literature-review
#18
J Acosta-León, A Pantoja-Rojas, J R Corona-Rivera, E López-Marure, C F Ploneda-Valencia
INTRODUCTION: Müllerian duct anomalies are rare with less than 200 cases published in the literature. Recently, the implementation of the Yang-Monti principle for the creation of the neovagina has been used in 10 previous published cases. Here, we report the first case of cervicovaginal agenesis treated with the modified Yang-Monti technique in two steps in México. PRESENTATION OF CASE: A 14-year-old female presented to the pediatric consult with a history of primary amenorrhea and a chronic-cyclic pelvic pain...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28153654/reduction-of-total-labor-length-through-the-addition-of%C3%A2-parenteral-dextrose-solution-in-induction-of-labor-in%C3%A2-nulliparous-results-of-dextrons-prospective-randomized-controlled-trial
#19
Josianne Paré, Jean-Charles Pasquier, Antoine Lewin, William Fraser, Yves-André Bureau
BACKGROUND: Prolonged labor is a significant cause of maternal and fetal morbidity and very few interventions are known to shorten labor course. Skeletal muscle physiology suggests that glucose supplementation might improve muscle performance in case of prolonged exercise and this situation is analogous to the gravid uterus during delivery. Therefore, it seemed imperative to evaluate the impact of adding carbohydrate supplements on the course of labor. OBJECTIVE: We sought to provide evidence as to whether intravenous glucose supplementation during labor induction in nulliparous women can reduce total duration of active labor...
January 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28145653/maternal-characteristics-short-mid-trimester-cervical-length-and-preterm-delivery
#20
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
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