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cervical length preterm delivery

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https://www.readbyqxmd.com/read/29344987/prior-uterine-evacuation-and-the-risk-of-short-cervical-length-a-retrospective-cohort-study
#1
Rupsa C Boelig, Michela Villani, Eva Jiang, Kelly M Orzechowski, Vincenzo Berghella
OBJECTIVES: To determine whether a prior uterine evacuation procedure is associated with an increased risk of short cervical length (≤20 mm) in women without prior spontaneous preterm birth. METHODS: This work was a retrospective cohort study from January 2012 to December 2014 of singletons without prior spontaneous preterm birth with cervical length screening between 18 weeks and 23 weeks 6 days. Women with a prior miscarriage/abortion were excluded if management (medical, surgical, or expectant) was not specified...
January 18, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29310480/can-sonographic-measurements-and-changes-in-cervical-length-during-pregnancy-predict-preterm-labour-in-an-asymptomatic-low-risk-population
#2
Omer Weitzner, Tal Biron-Shental, Yair Daykan, Osnat Ezra, Ofer Markovitch
OBJECTIVE: This study measured cervical length (CL) at 14-16 and 21-24 weeks of gestation and assessed whether the difference between measurements is predictive of preterm delivery (PTD). METHOD: This retrospective, cohort study included patients with two consecutive CL measured with transvaginal sonography at 14-16 weeks of gestation (CL1) and 21-24 weeks (CL2). Electronic medical records were reviewed for demographic, medical and obstetric history; complications during the current pregnancy and delivery data...
January 8, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29303014/decrease-in-the-incidence-of-threatened-preterm-labor-after-implementation-of-transvaginal-ultrasound-cervical-length-universal-screening
#3
Reshama Navathe, Gabriele Saccone, Michela Villani, Jacquelyn Knapp, Yury Cruz, Rupsa Boelig, Amanda Roman, Vincenzo Berghella
BACKGROUND: It is unknown if universal second-trimester transvaginal ultrasound (TVU) cervical length (CL) screening in asymptomatic women with singleton gestations and no prior spontaneous preterm birth (SPTB) affects the incidence of symptoms of preterm labor (PTL) later in pregnancy. OBJECTIVE: To evaluate the incidence of threatened PTL before and after the implementation of universal second trimester TVU CL screening. STUDY DESIGN: This was a retrospective cohort study of all consecutive singleton gestations without prior SPTB presenting to obstetric triage for threatened PTL between 23 0/7 and 33 6/7 week in 2011 (1 January-31 December), and in 2014 (1 January-31 December) at Thomas Jefferson University Hospital (TJU) (Philadelphia, PA)...
January 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29295659/optimal-timing-of-antenatal-corticosteroids-in-women-with-bleeding-placenta-previa-or-low-lying-placenta
#4
Eman Alsayegh, Jon Barrett, Nir Melamed
BACKGROUND: Administrating a single course of antenatal corticosteroids to women at risk of preterm birth between 24 and 34 weeks of gestation has been shown to decrease neonatal morbidity and mortality. There is evidence that the optimal timing for the administration of antenatal corticosteroids is within 1-7 days before birth as the effect of antenatal corticosteroids has been shown to decline 7 days after administration. Therefore, given that antenatal corticosteroids are the single most effective intervention in cases of preterm birth, efforts should be made to optimize the timing of administration of antenatal corticosteroids...
January 2, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29260226/effect-of-cervical-pessary-on-spontaneous-preterm-birth-in-women-with-singleton-pregnancies-and-short-cervical-length-a-randomized-clinical-trial
#5
RANDOMIZED CONTROLLED TRIAL
Gabriele Saccone, Giuseppe Maria Maruotti, Antonia Giudicepietro, Pasquale Martinelli
Importance: Spontaneous preterm birth is a major cause of perinatal morbidity and mortality. It is unclear if a cervical pessary can reduce the risk of spontaneous preterm delivery. Objective: To test whether in asymptomatic women with singleton pregnancies and no prior spontaneous preterm birth but with short cervical length on transvaginal ultrasound, use of a cervical pessary would reduce the rate of spontaneous preterm birth at less than 34 weeks of gestation...
December 19, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29212400/cervical-pessaries-for-the-prevention-of-preterm-birth-a-systematic-review-and-meta-analysis
#6
Limei Zheng, Jun Dong, Yongdong Dai, Yanling Zhang, Libing Shi, Minling Wei, Xiaoying Jin, Chao Li, Songying Zhang
OBJECTIVE: The objective of this study is to evaluate the effectiveness and safety of cervical pessaries for the prevention of preterm birth. METHODS: We searched PubMed, Embase, Web of Science, and other sources from inception to July 2016. This analysis referred to pregnant women with singleton/multiple viable fetus/fetuses, with or without cervical pessary placement. RESULTS: Six randomized control trials and five cohort studies involving 3911 participants were included...
December 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29207782/prediction-of-delivery-in-women-with-threatening-preterm-labour-using-phosphorylated-insulin-like-growth-factor-binding-protein-1-and-cervical-length-using-transvaginal-ultrasound
#7
Amrita Kumari, Vandana Saini, P K Jain, Mamta Gupta
Introduction: Preterm delivery remains a challenge in Obstetrics as it is responsible for significant cause of perinatal morbidity and mortality. At present there is no standard test for prediction of preterm labour for timely referral to a center with NICU facilities. Aim: To evaluate the effectiveness of the cervical phosphorylated insulin like growth factor binding protein-1(phIGFBP-1), cervical length measurement and combination of phIGFBP-1 with cervical length for Predicting Preterm Labour (PTL)...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29116935/outcomes-of-physical-examination-indicated-cerclage-in-twin-pregnancies-with-acute-cervical-insufficiency-compared-to-singleton-pregnancies
#8
Jee Yoon Park, Soo-Hyun Cho, Se Jeong Jeon, Song Yi Kook, Hyunsoo Park, Kyung Joon Oh, Joon-Seok Hong
OBJECTIVES: To compare pregnancy outcomes of physical examination-indicated cerclage in twin pregnancies with acute cervical insufficiency with that of singletons. METHODS: This retrospective cohort study included 88 consecutive women (17 twins and 71 singletons) who had undergone physical examination-indicated cerclage because of acute cervical insufficiency (defined as painless cervical dilation with (1) prolapsed and/or visible membranes at the external cervical os on speculum examination and (2) a functional cervical length of zero on transvaginal ultrasound) between 160/7 and 236/7 weeks...
November 8, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29108444/outcomes-after-periviable-ultrasound-indicated-cerclage
#9
Daphnie Drassinower, Elizabeth Coviello, Helain J Landy, Cynthia Gyamfi-Bannerman, Annette Perez-Delboy, Alexander M Friedman
BACKGROUND: Cerclage placed for a sonographically short cervix has been shown to reduce the risk of preterm delivery in women with a history of prior preterm birth. While short cervix is traditionally placed before viability, the threshold gestational age at which viability is achieved continues to decrease, and, as a result, a larger subset of women may be ineligible to receive this potentially beneficial procedure. OBJECTIVE: To evaluate the association between obstetric outcomes and perioperative complications after placement of an ultrasound-indicated cerclage at periviability compared to placement in the previable period...
November 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29103351/cervical-pessary-for-preventing-preterm-birth-a-meta-analysis
#10
Zhen Jin, Liqin Chen, Dongyan Qiao, Astha Tiwari, Chhavi Devi Jaunky, Baiyun Sun, Lina Wang, Hong Yu
OBJECTIVE: To evaluate the efficacy of cervical pessary in the prevention of preterm birth and its influence on pregnancy and maternal outcomes, so as to provide a clinical basis for cervical pessary to prevent premature delivery. METHODS: The databases of PubMed, Web of Science, CNKI, WanFang Data, etc, were used to search for the eligible articles. The relevant data were abstracted by two independent reviewers and performed with Stata 12.0. RESULTS: Pregnancy Result: the PTB rates of pessary and control group before 28, 32, 34, and 37 weeks were analyzed and the combined RR (95%CI) values were 0...
November 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29095502/obstetric-outcomes-after-conservative-treatment-for-cervical-intraepithelial-lesions-and-early-invasive-disease
#11
REVIEW
Maria Kyrgiou, Antonios Athanasiou, Ilkka E J Kalliala, Maria Paraskevaidi, Anita Mitra, Pierre Pl Martin-Hirsch, Marc Arbyn, Phillip Bennett, Evangelos Paraskevaidis
BACKGROUND: The mean age of women undergoing local treatment for pre-invasive cervical disease (cervical intra-epithelial neoplasia; CIN) or early cervical cancer (stage IA1) is around their 30s and similar to the age of women having their first child. Local cervical treatment has been correlated to adverse reproductive morbidity in a subsequent pregnancy, however, published studies and meta-analyses have reached contradictory conclusions. OBJECTIVES: To assess the effect of local cervical treatment for CIN and early cervical cancer on obstetric outcomes (after 24 weeks of gestation) and to correlate these to the cone depth and comparison group used...
November 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29079144/society-for-maternal-fetal-medicine-smfm-consult-series-44-management-of-bleeding-in%C3%A2-the-late-preterm-period
#12
Cynthia Gyamfi-Bannerman
Third-trimester bleeding is a common complication arising from a variety of etiologies, some of which may initially present in the late preterm period. Previous management recommendations have not been specific to this gestational age window, which carries a potentially lower threshold for delivery. The purpose of this document is to provide guidance on management of late preterm (34 0/7-36 6/7 weeks of gestation) vaginal bleeding. The following are Society for Maternal-Fetal Medicine recommendations: (1) we recommend delivery at 36-37 6/7 weeks of gestation for stable women with placenta previa without bleeding or other obstetric complications, such as preeclampsia or fetal growth restriction (Grade 1B); (2) we do not recommend routine cervical length screening for women with placenta previa in the late preterm period because of a lack of data on an appropriate management strategy (Grade 2C); (3) we recommend a planned delivery between 34 and 37 weeks of gestation for stable women with placenta accreta (Grade 1C); (4) we recommend delivery between 34 and 37 weeks of gestation for stable women with vasa previa (Grade 1C); (5) we recommend that in women with active hemorrhage in the late preterm period, delivery should not be delayed for the purpose of administering antenatal corticosteroids (Grade 1B); (6) we recommend that fetal lung maturity testing should not be used to guide management in the late preterm period when an indication for delivery is present (Grade 1B); and (7) we recommend that antenatal corticosteroids should be administered to women who are eligible and are managed expectantly if delivery is likely within 7 days, the gestational age is between 34 0/7 and 36 6/7 weeks of gestation, and antenatal corticosteroids has not previously been administered (Grade 1A)...
October 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29055173/safety-and-efficacy-of-the-cervical-pessary-combined-with-vaginal-progesterone-for-the-prevention-of-spontaneous-preterm-birth
#13
Georgios Daskalakis, Dimitrios Zacharakis, Marianna Theodora, Panagiotis Antsaklis, Nikolaos Papantoniou, Dimitris Loutradis, Aris Antsaklis
INTRODUCTION: The aim of this study was to evaluate the safety and efficacy of the combined treatment of cervical pessary and endovaginal progesterone for the prevention of spontaneous preterm birth (SPB) in women with a short cervical length (CL) between 20 and 24 weeks of gestation. MATERIALS AND METHODS: This is a prospective study of women with a singleton pregnancy and a sonographically detected mid-trimester CL ≤25 mm. The primary outcome measure was spontaneous delivery before 34 weeks (238 days) of gestation...
October 21, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28940481/prevention-of-preterm-birth-with-pessary-in-singletons-popps-a-randomized-controlled-trial
#14
Lorraine Dugoff, Vincenzo Berghella, Harish Sehdev, A Dhanya Mackeen, Laura Goetzl, Jack Ludmir
OBJECTIVE: To determine if pessary use prevents preterm birth in singleton gestations with a short transvaginal ultrasound cervical length and without a prior spontaneous preterm birth. METHODS: In this open-label multicenter randomized trial we enrolled asymptomatic women with singleton gestations with a transvaginal ultrasound cervical length ≤ 25 mm at 18(0) -23(6) weeks and no prior spontaneous preterm birth. Subjects were randomized to receive the Bioteque cup pessary or no pessary...
September 20, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28935263/predicting-preterm-birth-cervical-length-and-fetal-fibronectin
#15
REVIEW
Moeun Son, Emily S Miller
Spontaneous preterm birth remains the leading cause of neonatal morbidity and mortality worldwide, and accounts for a significant global health burden. Several obstetric strategies to screen for spontaneous preterm delivery, such as cervical length and fetal fibronectin measurement, have emerged. However, the effectiveness of these strategies relies on their ability to accurately predict those pregnancies at increased risk for spontaneous preterm birth (SPTB). Transvaginal cervical shortening is predictive of preterm birth and when coupled with appropriate preterm birth prevention strategies, has been associated with reductions in SPTB in asymptomatic women with a singleton gestation...
December 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28889776/risk-of-spontaneous-preterm-birth-in-ivf-conceived-twin-pregnancies
#16
Gabriele Saccone, Fabrizio Zullo, Amanda Roman, Andrew Ward, Giuseppe Maruotti, Pasquale Martinelli, Vincenzo Berghella
OBJECTIVE: To compare the mean transvaginal ultrasound (TVU) cervical length (CL) at midtrimester in screening for preterm birth in in vitro (IVF)-conceived twin pregnancies versus spontaneously-conceived twin pregnancies. METHODS: This was a retrospective cohort study. Potential study subjects were identified at the time of a routine second trimester fetal ultrasound exam at 18 0/7 to 23 6/7-week gestation. All women with twin diamniotic pregnancies screened with a single TVU CL for this trial were included...
September 21, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28884811/repeated-cervical-length-measurements-for-the-verification-of-short-cervical-length
#17
Frederik J R Hermans, Bouchra Koullali, Melanie A van Os, Jeanine E M van der Ven, Brenda M Kazemier, Mallory D Woiski, Christine Willekes, Petra N Kuiper, Frans J M E Roumen, Christianne M de Groot, Esteriek de Miranda, Corine Verhoeven, Monique C Haak, Eva Pajkrt, Ewoud Schuit, Ben Willem J Mol
OBJECTIVE: To determine if the verification of short cervical length with a repeated measurement improved the identification of patients with short cervical length at increased risk of preterm delivery. METHODS: The present secondary analysis analyzed prospective cohort study data from patients with singleton pregnancies without a history of preterm delivery who presented for obstetric care in the Netherlands and delivered between November 18, 2009, and January 1, 2013...
September 8, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28883617/performance-of-cervical-phigfbp-1-test-alone-or-combined-with-short-cervical-length-to-predict-spontaneous-preterm-birth-in-symptomatic-women
#18
Florent Fuchs, Marie Houllier, Soizic Leparco, Anne Guyot, Marie-Victoire Senat, Hervé Fernandez
We aimed to assess the accuracy of cervical phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) test alone or in combination with cervical length (CL), to predict preterm birth (PTB) in symptomatic women. We performed a prospective cohort study from 2012 to 2015 including singleton pregnancies with symptoms of preterm labor, intact membranes and CL < 25 mm at 24-34 weeks of gestation. Studied outcome were spontaneous delivery within 7 and 14 days of testing and spontaneous PTB at <34 and <37 weeks of gestation...
September 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28882058/role-of-acoustic-radiation-force-impulse-and-shear-wave-velocity-in-prediction-of-preterm-birth-a-prospective-study
#19
Arjit Agarwal, Shubhra Agarwal, Shruti Chandak
Background Preterm birth is one of the important causes of neonatal morbidity where we rely on subjective criteria such as modified Bishop's scoring and contemporary sonographic measurement of cervical length. Acoustic radiation force impulse (ARFI) is a technological advancement in elastography that can be employed in prediction of cervical softening and preterm labor. Purpose To evaluate the role of ARFI technique and shear wave velocity (SWV) estimates as a predictor of preterm birth and its comparison with other clinical and sono-elastographic measures...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28870155/pessary-or-progesterone-to-prevent-preterm-delivery-in-women-with-short-cervical-length-the-quadruple-p-randomised-controlled-trial
#20
Maud D van Zijl, Bouchra Koullali, Christiana A Naaktgeboren, Ewoud Schuit, Dick J Bekedam, Etelka Moll, Martijn A Oudijk, Wilhelmina M van Baal, Marjon A de Boer, Henricus Visser, Joris van Drongelen, Flip W van de Made, Karlijn C Vollebregt, Moira A Muller, Mireille N Bekker, Jozien T J Brons, Marieke Sueters, Josje Langenveld, Maureen T Franssen, Nico W Schuitemaker, Erik van Beek, Hubertina C J Scheepers, Karin de Boer, Eveline M Tepe, Anjoke J M Huisjes, Angelo B Hooker, Evelyn C J Verheijen, Dimitri N Papatsonis, Ben Willem J Mol, Brenda M Kazemier, Eva Pajkrt
BACKGROUND: Preterm birth is in quantity and in severity the most important topic in obstetric care in the developed world. Progestogens and cervical pessaries have been studied as potential preventive treatments with conflicting results. So far, no study has compared both treatments. METHODS/DESIGN: The Quadruple P study aims to compare the efficacy of vaginal progesterone and cervical pessary in the prevention of adverse perinatal outcome associated with preterm birth in asymptomatic women with a short cervix, in singleton and multiple pregnancies separately...
September 4, 2017: BMC Pregnancy and Childbirth
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