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cervical length preterm delivery

Mohamed Kandil, Zakaria Sanad, Tarek Sayyed, Hamed Ellakwa
In this prospective cohort study, one hundred participants were allocated into four groups according to their body mass indices. Vaginal ultrasound was performed at enrolment to measure cervical length. The shortest cervical measurement was recorded. Overweight and obese groups had significantly longer mean cervical length than women in the normal weight group when measured at 20-22 weeks of gestation (p < .001). Underweight women had the shortest mean cervical length. The incidence of preterm delivery was the highest in underweight women (RR; 1...
October 20, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Merel M C Bruijn, Jolande Y Vis, Femke F Wilms, Martijn A Oudijk, Anneke Kwee, Martina M Porath, Guid Oei, Hubertina C J Scheepers, Marc E A Spaanderman, Kitty W M Bloemenkamp, Monique C Haak, Antoinette C Bolte, Frank P H A Vandenbussche, Mallory D Woiski, Caroline J Bax, Jérôme M J Cornette, Johannes J Duvekot, Bas W A Nij Bijvank, Jim van Eyck, Maureen T M Franssen, Krystyna M Sollie, Joris A M van der Post, Patrick M M Bossuyt, Brent C Opmeer, M Kok, Ben W J Mol, Gert-Jan van Baaren
OBJECTIVE: To compare the accuracy of the Actim Partus test and fetal fibronectin (fFN) test in the prediction of spontaneous preterm delivery within seven days in symptomatic women undergoing cervical length measurement. STUDY DESIGN: We performed a post-hoc analysis on frozen samples of a nationwide cohort study in all 10 perinatal centres in the Netherlands. We selected samples from women with signs of preterm labour between 24 and 34 weeks of gestational age and a cervical length below 30mm...
September 20, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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
Anna Palatnik, Emily S Miller, Moeun Son, Michelle A Kominiarek
Objective The objective of this study was to determine if mid-trimester cervical length is associated with the inverse relationship between maternal body mass index (BMI) at delivery and spontaneous preterm birth (SPTB). Materials and Methods This was a retrospective cohort of women with a singleton pregnancy without prior SPTB who underwent routine transvaginal cervical length assessment between 18 and 24 weeks. Women were categorized into four BMI groups: (1) 18.5 to 24.9, (2) 25 to 29.9, (3) 30 to 34...
September 23, 2016: American Journal of Perinatology
Sevan A Vahanian, Anthony M Vintzileos
PURPOSE OF REVIEW: Placental implantation abnormalities (PIAs) comprise a large group of disorders associated with significant maternal, fetal, and neonatal morbidity. RECENT FINDINGS: Risk factors include prior uterine surgery/myometrial scarring and the presence of placenta previa with or without prior cesarean delivery. Newly identified risk factors include previous prelabor cesarean delivery and previous postpartum hemorrhage. PIAs contribute substantially to preterm birth with prematurity rates ranging from 38 to 82%...
September 21, 2016: Current Opinion in Obstetrics & Gynecology
David A Crosby, Jan Miletin, Jana Semberova, Sean Daly
INTRODUCTION: A recent meta-analysis has suggested that routine measurement of the cervical length should be performed in conjunction with the anomaly scan to identify a group of women at increased risk of preterm delivery. We decided to investigate whether this recommendation is justifiable in a population where the risk of preterm birth is low. MATERIAL AND METHODS: We reviewed 12 years of obstetric data from the Coombe Women and Infants University Hospital. Relative risks of adverse outcomes from the randomized controlled trial were applied and we extrapolated the possible numbers of women requiring intervention...
September 13, 2016: Acta Obstetricia et Gynecologica Scandinavica
Malipati Maerdan, Chunyan Shi, Xiaoxiao Zhang, Lixin Fan
OBJECTIVE: The objective of this study is to understand the prevalence of short cervical length between 20 and 24 weeks gestation in China and to evaluate the efficacy of micronized progesterone for prolonging gestation in nulliparous patients with a short cervix. METHODS: From May 2010 to May 2015, a total of 25 328 asymptomatic women with singleton pregnancies at Peking University First Hospital had their cervical length routinely measured between 20 and 24 weeks of gestation...
September 7, 2016: Journal of Maternal-fetal & Neonatal Medicine
P Wagner, J Sonek, M Heidemeyer, M Schmid, H Abele, M Hoopmann, K O Kagan
OBJECTIVE: To examine the value of a repeat measurement some days after the first cervical length measurement done at the time of preterm contractions. STUDY DESIGN: Retrospective study involving women with singleton pregnancies who presented with preterm contractions at 24 to 33 + 6 weeks of gestation. The cervical length was measured at the time of presentation and some days afterwards. RESULTS: The study population consisted of 17 cases with a preterm delivery within 14 days and 288 uneventful pregnancies...
July 2016: Geburtshilfe und Frauenheilkunde
Rafał Rzepka, Barbara Dołęgowska, Aleksandra Rajewska, Daria Sałata, Marta Budkowska, Sebastian Kwiatkowski, Andrzej Torbé
Preterm birth remains the most prevalent cause of neonatal morbidity. This study aimed to evaluate the diagnostic value of SDF-1α, resistin, secretory RAGE (sRAGE), and endogenous secretory RAGE (esRAGE) in preterm labor. A total of 211 pregnant women participated in the study. Group A contained 72 women between 22 and 36 weeks of gestation, with premature labor, who finally had preterm birth. Group B contained 66 women in labor between 37 and 41 weeks of gestation. Women in group A had lower SDF-1α and sRAGE levels than those in group B...
2016: BioMed Research International
Jessica N Buck, Kelly M Orzechowski, Vincenzo Berghella
PURPOSE: Racial minorities experience higher rates of spontaneous preterm birth (sPTB). Our objective was to evaluate whether there are racial discrepancies in the incidence of second trimester short cervical length (≤25mm). MATERIALS AND METHODS: Retrospective cohort of women with singleton gestations without prior sPTB undergoing universal second trimester transvaginal ultrasound cervical length (CL) screening between January 2012 and December 2013. Black women were compared to non-Hispanic white women...
August 23, 2016: Journal of Maternal-fetal & Neonatal Medicine
Kishwar Azad, Jiji Mathews
Preterm births (PTBs), defined as births before 37 weeks of gestation account for the majority of deaths in the newborn period. Prediction and prevention of PTB is challenging. A history of preterm labour or second trimester losses and accurate measurement of cervical length help to identify women who would benefit from progesterone and cerclage. Fibronectin estimation in the cervicovaginal secretions of a symptomatic woman with an undilated cervix can predict PTB within 10 days of testing. Antibiotics should be given to women with preterm prelabour rupture of membranes but tocolysis has a limited role in the management of preterm labour...
June 24, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
Alvaro Sepúlveda-Martínez, Francisco Díaz, Hernán Muñoz, Enrique Valdés, Mauro Parra-Cordero
OBJECTIVE: The aim of this article is to assess the use of the anterior cervical angle (ACA) as a predictor of spontaneous preterm delivery (sPTD) at 20+0-24+6 weeks of gestation in an unselected population. METHODS: We conducted a nested case-control study that included 93 women who later delivered spontaneously <34 weeks of gestation and 225 controls. The ACA was assessed retrospectively on all selected images using ImageJ® software. The concordance correlation coefficient was determined for the assessment of interobserver variability...
August 12, 2016: Fetal Diagnosis and Therapy
Maria Kyrgiou, Antonios Athanasiou, Maria Paraskevaidi, Anita Mitra, Ilkka Kalliala, Pierre Martin-Hirsch, Marc Arbyn, Phillip Bennett, Evangelos Paraskevaidis
OBJECTIVE:  To assess the effect of treatment for cervical intraepithelial neoplasia (CIN) on obstetric outcomes and to correlate this with cone depth and comparison group used. DESIGN:  Systematic review and meta-analysis. DATA SOURCES:  CENTRAL, Medline, Embase from 1948 to April 2016 were searched for studies assessing obstetric outcomes in women with or without previous local cervical treatment. DATA EXTRACTION AND SYNTHESIS:  Independent reviewers extracted the data and performed quality assessment using the Newcastle-Ottawa criteria...
2016: BMJ: British Medical Journal
Jessica Spiegelman, Whitney Booker, Simi Gupta, Jennifer Lam-Rochlin, Andrei Rebarber, Daniel H Saltzman, Ana Monteagudo, Nathan S Fox
Objective To estimate the independent association of a short cervical length (CL), positive fetal fibronectin (fFN), amniotic fluid (AF) sludge, and cervical funneling with spontaneous preterm birth in twin pregnancies. Methods Retrospective cohort study of twin pregnancies managed by a single maternal-fetal medicine practice from June 2005 to February 2014. All patients underwent transvaginal sonographic CL and fFN testing. We reviewed all images from the first CL at 22(0/7) to 25(6/7) weeks for the presence of (1) a short CL, which is defined as ≤25 mm, (2) AF sludge, and (3) cervical funneling, and also recorded (4) the fFN result from that time...
October 2016: American Journal of Perinatology
L I Belmonte-Andújar, A M Fuentes-Rozalén, R M Soler-Garcia
BACKGROUND: Vasa praevia is a rare pregnancy complication with a high fetal mortality when not diagnosed in the prenatal period. CLINICAL CASES: two cases of vasa praevia diagnosed during the second trimester ultrasound cervical measurement. CONCLUSIONS: We propose carry out further investigation about cost effectiveness of double vaginal screening (cervical length measurement and vasa praevia) during the second trimester morphology ultrasound...
March 2016: Ginecología y Obstetricia de México
Frederik J R Hermans, Ewoud Schuit, Brent C Opmeer, Martijn A Oudijk, Mireille Bekker, Mallory Woiski, Caroline J Bax, Marieke Sueters, Hubertina C J Scheepers, Maureen T M Franssen, Eva Pajkrt, Ben Willem J Mol, Marjolein Kok
BACKGROUND: Preterm birth is a major cause of neonatal mortality and morbidity. As preventive strategies are largely ineffective, threatened preterm labor is a frequent problem that affects approximately 10 % of pregnancies. In recent years, risk assessment in these women has incorporated cervical length measurement and fetal fibronectin testing, and this has improved the capacity to identify women at increased risk for delivery within 14 days. Despite these improvements, risk for preterm birth continues to be increased in women who did not deliver after an episode of threatened preterm labor, as indicated by a preterm birth rate between 30 to 60 % in this group of women...
2016: BMC Pregnancy and Childbirth
Adele E Crowley, Rosalie M Grivell, Jodie M Dodd
BACKGROUND: Preterm prelabour rupture of the membranes (PPROM) complicates approximately 2% of pregnancies and can be either spontaneous or iatrogenic in nature. Complications of PPROM include prematurity, chorioamnionitis, neonatal sepsis, limb position defects, respiratory distress syndrome, pulmonary hypoplasia chronic lung disease, periventricular leukomalacia and intraventricular haemorrhage.A number of different sealing techniques have been employed which aim to restore a physical barrier against infection and encourage the re-accumulation of amniotic fluid...
2016: Cochrane Database of Systematic Reviews
Thorsten Braun, Alexander Weichert, Hannah C Gil, Deborah M Sloboda, Boris Tutschek, Thomas Harder, Joachim W Dudenhausen, Andreas Plagemann, Wolfgang Henrich
OBJECTIVE: To investigate effects of betamethasone on fetal growth and neonatal outcomes in twins. METHODS: A retrospective cohort study was conducted of twins delivered at one center in Berlin, Germany, between 1993 and 2011. The betamethasone group included twin pregnancies with preterm labor, cervical shortening, preterm premature rupture of membranes, or vaginal bleeding, and exposure to betamethasone between 23(+5) and 33(+6) weeks. The control group included twin pregnancies with no betamethasone exposure matched for length at delivery...
September 2016: International Journal of Gynaecology and Obstetrics
Jessica S Sheng, Frank P Schubert, Avinash S Patil
OBJECTIVE: To assess the utility of cervical funnel volume as a predictor of cerclage failure. METHODS: We performed a retrospective cohort study of pregnant women with a McDonald cerclage and sonographic evidence of cervical funneling between 1/2008 and 2/2014. Funnel volume (FV) was calculated and used as a correction factor for cervical length (CL) or cerclage height (CH). Receiver operating characteristic (ROC) curves were used to compare the predictive value of CL, CL:FV, CH and CH:FV for cerclage failure at <28 or <34 weeks...
July 6, 2016: Journal of Maternal-fetal & Neonatal Medicine
Scott A Shainker, Anna M Modest, Michele R Hacker, Steven J Ralston
Objective The objective of this study was to evaluate the effect of a universal cervical length screening program on the incidence of antepartum interventions. Study Design This retrospective cohort study included women delivering ≥ 20 weeks of gestation with singleton pregnancies before and after implementing universal cervical length screening. Antepartum interventions included admission for threatened preterm birth, ≥ 2 cervical length measurements, cervical cerclage, neonatology consultation, betamethasone, antibiotic administration for preterm premature rupture of membranes, and tocolysis...
April 2016: American Journal of Perinatology Reports
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