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Cervical screening

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16 papers 100 to 500 followers
By Chad Klauser Maternal Fetal Medicine physician in NYC
https://www.readbyqxmd.com/read/26333191/the-effect-of-gestational-age-and-cervical-length-measurements-in-the-prediction-of-spontaneous-preterm-birth-in-twin-pregnancies-an-individual-patient-level-meta-analysis
#1
REVIEW
L M Kindinger, L C Poon, S Cacciatore, D A MacIntyre, N S Fox, E Schuit, B W Mol, S Liem, A C Lim, V Serra, A Perales, F Hermans, A Darzi, P Bennett, K H Nicolaides, T G Teoh
OBJECTIVE: To assess the effect of gestational age (GA) and cervical length (CL) measurements at transvaginal ultrasound (TVUS) in the prediction of preterm birth in twin pregnancy. DESIGN: Individual patient data (IPD) meta-analysis. SETTING: International multicentre study. POPULATION: Asymptomatic twin pregnancy. METHODS: MEDLINE and EMBASE searches were performed and IPD obtained from authors of relevant studies...
May 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/26250480/cervical-length-at-mid-gestation-in-screening-for-preterm-birth-in-twin-pregnancy
#2
G Pagani, V Stagnati, A Fichera, F Prefumo
OBJECTIVE: Short cervical length (CL) in mid-gestation is considered predictive of spontaneous preterm birth (PTB). The medical literature suggests 20 mm as the cut-off for high risk in twin pregnancies. Our objective was to assess the predictive value of CL for spontaneous PTB < 32 weeks' gestation in twin pregnancies and to calculate the cut-off point with the best sensitivity and specificity. METHODS: This was a single-center retrospective cohort study of women in whom CL had been measured by transvaginal ultrasound at 18-23 weeks' gestation...
July 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/26071914/cost-effectiveness-of-transvaginal-ultrasound-cervical-length-screening-in-singletons-without-a-prior-preterm-birth-an-update
#3
Erika F Werner, Maureen S Hamel, Kelly Orzechowski, Vincenzo Berghella, Stephen F Thung
OBJECTIVE: We sought to reevaluate the cost-effectiveness of universal transvaginal ultrasound (TVU) cervical length (CL) screening in singleton pregnancies without prior spontaneous preterm birth. STUDY DESIGN: We developed a decision model to assess costs and effects of universal TVU CL screening at 18-23 weeks' gestation compared to routine care for singleton pregnancies without prior preterm birth. Based on recent data, the model contains the following updates: (1) reduced incidence of CL ≤20 mm at initial screening ultrasound (0...
October 2015: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26115020/midpregnancy-cervical-length-in-nulliparous-women-and-its-association-with-postterm-delivery-and-intrapartum-cesarean-delivery
#4
MULTICENTER STUDY
A J van der Ven, M A van Os, C E Kleinrouweler, C J M Verhoeven, E de Miranda, P M Bossuyt, C J M de Groot, M C Haak, E Pajkrt, B W J Mol, B M Kazemier
OBJECTIVE: To evaluate the association between midpregnancy cervical length and postterm delivery and cesarean delivery during labor. STUDY DESIGN: In a multicenter cohort study, cervical length was measured in low-risk singleton pregnancies between 16 and 22 weeks of gestation. From this cohort, we identified nulliparous women who delivered beyond 34 weeks and calculated cervical length quartiles. We performed logistic regression to compare the risk of postterm delivery and intrapartum cesarean delivery to cervical length quartiles, using the lowest quartile as a reference...
January 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/25436510/first-trimester-cervical-length-is-associated-with-mid-trimester-loss
#5
Ioannis Papastefanou, Ioannis Kavalakis, Athanasios Pilalis, Makarios Eleftheriades, Athena P Souka
OBJECTIVE: To study the value of the cervical length (CL) measurement at 11-14 weeks in predicting second trimester miscarriage occurring at 16-24 weeks. METHODS: Prospective study in routine obstetric population using transvaginal ultrasound examination to measure the length of the endocervical canal at 11-14 weeks. RESULTS: The study group consisted of 2836 singleton pregnancies. Eleven (0.0038%) women miscarried between 16 and 24 weeks whereas 2825 delivered after 34 weeks...
2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/25251479/predictive-value-of-cervical-length-in-women-with-twin-pregnancy-presenting-with-threatened-preterm-labor
#6
N Melamed, L Hiersch, R Gabbay-Benziv, R Bardin, I Meizner, A Wiznitzer, Y Yogev
OBJECTIVE: To assess the accuracy and determine the optimal threshold of sonographic cervical length (CL) for the prediction of preterm delivery (PTD) in women with twin pregnancies presenting with threatened preterm labor (PTL). METHODS: This was a retrospective study of women with twin pregnancies who presented with threatened PTL and underwent sonographic measurement of CL in a tertiary center. The accuracy of CL in predicting PTD in women with twin pregnancies was compared with that in a control group of women with singleton pregnancies...
July 2015: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/24705970/implementation-of-a-universal-cervical-length-screening-program-for-the-prevention-of-preterm-birth
#7
Kelly M Orzechowski, Sara S Nicholas, Jason K Baxter, Stuart Weiner, Vincenzo Berghella
OBJECTIVE: The objective of this article is to evaluate the implementation and acceptability of a universal cervical length (CL) screening program for prediction and prevention of preterm birth (PTB). STUDY DESIGN: We performed a prospective observational study to evaluate the implementation and acceptability of a universal CL screening program. Between January 1, 2012, and December 31, 2012, women with singleton gestations, without a cerclage or prior spontaneous PTB, were offered transvaginal ultrasound (TVU) for CL between 18(0/7) and 23(6/7) weeks' gestation...
December 2014: American Journal of Perinatology
https://www.readbyqxmd.com/read/20079888/universal-cervical-length-screening-and-treatment-with-vaginal-progesterone-to-prevent-preterm-birth-a-decision-and-economic-analysis
#8
Alison G Cahill, Anthony O Odibo, Aaron B Caughey, David M Stamilio, Sonia S Hassan, George A Macones, Roberto Romero
OBJECTIVE: The purpose of this study was to estimate which strategy is the most cost-effective for the prevention of preterm birth and associated morbidity. STUDY DESIGN: We used decision-analytic and cost-effectiveness analyses to estimate which of 4 strategies was superior based on quality-adjusted life-years, cost in US dollars, and number of preterm births prevented. RESULTS: Universal sonographic screening for cervical length and treatment with vaginal progesterone was the most cost-effective strategy and was the dominant choice over the 3 alternatives: cervical length screening for women at increased risk for preterm birth and treatment with vaginal progesterone; risk-based treatment with 17 alpha-hydroxyprogesterone caproate (17-OHP-C) without screening; no screening or treatment...
June 2010: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25162252/a-universal-transvaginal-cervical-length-screening-program-for-preterm-birth-prevention
#9
Kelly M Orzechowski, Rupsa C Boelig, Jason K Baxter, Vincenzo Berghella
OBJECTIVE: To evaluate a universal transvaginal ultrasonogram cervical length screening program on the incidence of a cervical length 20 mm or less and adherence to the management protocol for a cervical length less than 25 mm. METHODS: We conducted a prospective cohort study of women with singleton gestations 18 0/7 to 23 6/7 weeks of gestation eligible for universal transvaginal ultrasonogram cervical length screening over an 18-month period. Only women receiving antenatal care at our institution were included...
September 2014: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/22633270/universal-maternal-cervical-length-screening-during-the-second-trimester-pros-and-cons-of-a-strategy-to-identify-women-at-risk-of-spontaneous-preterm-delivery
#10
Samuel Parry, Hyagriv Simhan, Michal Elovitz, Jay Iams
Three large randomized controlled trials investigating the efficacy of universal cervical length screening and treatment with vaginal progesterone or cervical cerclage to prevent preterm delivery have been published over the past several years. None of these trials demonstrate proven efficacy for universal cervical length screening and cerclage placement in women with short cervical length. However, universal cervical length screening and treatment with daily vaginal progesterone in women with short cervical length reduces the risk of preterm birth, but large numbers of women must be screened to prevent a relatively small number of preterm deliveries...
August 2012: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25174798/is-universal-cervical-length-screening-indicated-in-women-with-prior-term-birth
#11
Kelly Marie Orzechowski, Rupsa Boelig, Sara Shaw Nicholas, Jason Baxter, Vincenzo Berghella
OBJECTIVE: To determine whether universal transvaginal ultrasound (TVU) cervical length (CL) screening is indicated in women with prior term births. STUDY DESIGN: We conducted a prospective cohort study from Jan. 1, 2012, to June 30, 2013, of singleton gestations between 18 0/7-23 6/7 weeks undergoing TVU CL screening for prediction of spontaneous preterm birth (sPTB). Women with a prior sPTB, with cerclage, and without delivery data available were excluded. Primary outcomes were the incidence of a CL ≤20 mm, and rates of sPTB <37, <34, and <32 weeks gestation among women with prior term births vs nulliparous women...
February 2015: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/23954533/cost-effectiveness-of-transabdominal-ultrasound-for-cervical-length-screening-for-preterm-birth-prevention
#12
COMPARATIVE STUDY
Emily S Miller, William A Grobman
OBJECTIVE: Transabdominal ultrasound (TAUS) cervical length (CL) screening has been proposed as an alternative to universal transvaginal screening to identify women at an increased risk of preterm birth. We sought to identify whether and under what circumstances TAUS would be cost-effective. STUDY DESIGN: This is a decision analytic model designed to compare an initial TAUS CL screening approach with universal transvaginal screening in a hypothetical cohort of women with a singleton pregnancy...
December 2013: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/24817155/cervical-length-in-late-second-and-third-trimesters-a-mixture-model-for-predicting-delivery
#13
A P Souka, I Papastefanou, G Papadopoulos, C Chrelias, D Kassanos
OBJECTIVES: To examine the distribution of cervical length (CL) in the late second and third trimesters of pregnancy and construct survival models for spontaneous delivery. METHODS: This cross-sectional study included 647 women with a singleton pregnancy who had routine CL measurements taken by transvaginal ultrasonography between 24 and 40 weeks' gestation. Only one measurement per patient was included in the analysis. Exploratory data analysis revealed that the distribution of CL measurements was a mixture of two Gaussian distributions, and subsequently a mixture model was applied to describe the distribution of CL...
March 2015: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/24979358/pros-and-cons-of-maternal-cervical-length-screening-to-identify-women-at-risk-of-spontaneous-preterm-delivery
#14
REVIEW
Samuel Parry, Michal A Elovitz
Large randomized controlled trials have demonstrated that universal maternal cervical length screening and treatment with daily vaginal progesterone in women with short cervical length reduces the risk of preterm birth, but large numbers of women must be screened to prevent a relatively small number of preterm deliveries. Issues that should be considered while implementing universal cervical length screening include: (1) the standards of quality and reproducibility for transvaginal ultrasound cervical length ascertainment; and (2) the implications of screening on the application of therapeutic strategies to populations not known to benefit (so-called "indication creep")...
September 2014: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/24907701/the-role-of-cervical-length-in-women-with-threatened-preterm-labor-is-it-a-valid-predictor-at-any-gestational-age
#15
Liran Hiersch, Yariv Yogev, Noam Domniz, Israel Meizner, Ron Bardin, Nir Melamed
OBJECTIVE: To determine whether the predictive accuracy of sonographic cervical length (CL) for preterm delivery (PTD) in women with threatened preterm labor (PTL) is related to gestational age (GA) at presentation. STUDY DESIGN: A retrospective cohort study of all women with singleton pregnancies who presented with PTL at less than 34 + 0 weeks and underwent sonographic measurement of CL in a tertiary medical center between 2007 and 2012. The predictive accuracy of CL for PTD was stratified by GA at presentation...
November 2014: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/24798668/prediction-of-preterm-birth-in-multiple-pregnancies-development-of-a-multivariable-model-including-cervical-length-measurement-at-16-to-21-weeks-gestation
#16
RANDOMIZED CONTROLLED TRIAL
Lidewij van de Mheen, Ewoud Schuit, Arianne C Lim, Martina M Porath, Dimitri Papatsonis, Jan J Erwich, Jim van Eyck, Charlotte M van Oirschot, Piet Hummel, Johannes J Duvekot, Tom H M Hasaart, Rolf H H Groenwold, Karl G M Moons, Christianne J M de Groot, Hein W Bruinse, Maria G van Pampus, Ben W J Mol
OBJECTIVE: To develop a multivariable prognostic model for the risk of preterm delivery in women with multiple pregnancy that includes cervical length measurement at 16 to 21 weeks' gestation and other variables. METHODS: We used data from a previous randomized trial. We assessed the association between maternal and pregnancy characteristics including cervical length measurement at 16 to 21 weeks' gestation and time to delivery using multivariable Cox regression modelling...
April 2014: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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