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https://www.readbyqxmd.com/read/28339114/cervical-length-in-patients-at-risk-for-placenta-accreta
#1
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
#2
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 ≤2.5cm before 24 weeks gestation through the perinatal ultrasound database of two institutions from 2008-2014. Patients with and without cerclage were compared for a primary outcome of preterm birth at <35 weeks. A pre-planned sub-group analysis of patients with cervical length ≤1...
March 20, 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
#3
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
#4
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
#5
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 function 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 3-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...
March 17, 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
#6
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
#7
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
#8
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
#9
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
#10
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...
February 4, 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
#11
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
#12
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...
January 19, 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
#13
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
#14
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
https://www.readbyqxmd.com/read/28103952/the-interaction-between-vaginal-microbiota-cervical-length-and-vaginal-progesterone-treatment-for-preterm-birth-risk
#15
Lindsay M Kindinger, Phillip R Bennett, Yun S Lee, Julian R Marchesi, Ann Smith, Stefano Cacciatore, Elaine Holmes, Jeremy K Nicholson, T G Teoh, David A MacIntyre
BACKGROUND: Preterm birth is the primary cause of infant death worldwide. A short cervix in the second trimester of pregnancy is a risk factor for preterm birth. In specific patient cohorts, vaginal progesterone reduces this risk. Using 16S rRNA gene sequencing, we undertook a prospective study in women at risk of preterm birth (n = 161) to assess (1) the relationship between vaginal microbiota and cervical length in the second trimester and preterm birth risk and (2) the impact of vaginal progesterone on vaginal bacterial communities in women with a short cervix...
January 19, 2017: Microbiome
https://www.readbyqxmd.com/read/28079869/racial-and-social-predictors-of-longitudinal-cervical-measures-the-cervical-ultrasound-study
#16
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
#17
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
#18
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
#19
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...
February 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28029462/-prediction-of-preterm-delivery-in-symptomatic-women-preterm-labor
#20
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
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