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Cerclage short cervix

A Care, R Jackson, E O'Brien, S Leigh, C Cornforth, A Haycox, M Whitworth, T Lavender, Z Alfirevic
OBJECTIVE: To assess feasibility for a definitive randomized controlled trial (RCT) comparing three treatments for short cervix in a population at high risk for spontaneous preterm birth (sPTB) over a 1-year period. DESIGN: Three arm, open label feasibility randomized clinical study. METHODS: Women with singleton pregnancy with risk factors for sPTB (history of sPTB or prelabor premature rupture of membranes (PPROM) <34 weeks or significant cervical surgery), and short cervix on transvaginal ultrasound scan detected between 16+0 and 24+6 weeks gestation were randomized to receive either cervical cerclage, vaginal pessary, or vaginal progesterone 200 mg nocte...
March 21, 2019: Journal of Maternal-fetal & Neonatal Medicine
Anca Matei, Gabriele Saccone, Joshua P Vogel, Anthony B Armson
BACKGROUND: Preterm birth (PTB) is a leading cause of perinatal morbidity and mortality. Interventions aimed at preventing PTB can be classified as primary, secondary, or tertiary prevention. OBJECTIVE: To conduct a review of systematic reviews on the effectiveness and safety of primary and secondary preterm birth prevention interventions. SEARCH STRATEGY: A systematic literature search of the Cochrane, PubMed/Medline, EMBASE and CINAHL databases was conducted on 2 September 2015, and updated on 21 November 2016...
January 25, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Frédéric Debiève, Aude Joskin, Patricia Steenhaut, Pierre Bernard, Corinne Hubinont
BACKGROUND: The diagnosis of cervical insufficiency is based on the previous history of recurrent second or early third trimester losses. Its incidence among pregnant women is 0.5-1% but can be as high as 75% among women with preterm birth. Transvaginal cerclage (TVC) is the common therapy of cervical insufficiency. However, this technique has several limits, especially in twin pregnancies. As some selected conditions, a transabdominal cerclage (TAC) is indicated, it has been offered to patients with multiple pregnancies...
February 22, 2019: Journal of Maternal-fetal & Neonatal Medicine
Malou Barbosa, Rikke Bek Helmig, Lone Hvidman
INTRODUCTION: Multiple gestations are high-risk pregnancies associated with an increased risk of neonatal morbidity and mortality, mainly due to preterm births. Numerous interventions have been attempted in order to delay the time of delivery and subsequently, prevent preterm births in twin gestations. To date, no really effective intervention has been found. Use of cerclage in twin pregnancies has been controversial. Recently, however, small retrospective cohort studies have shown a potentially positive effect with the use of cerclage in twin pregnancies...
January 27, 2019: Journal of Maternal-fetal & Neonatal Medicine
Marinela Grabovac, Anne Mary Lewis-Mikhael, Sarah D McDonald
OBJECTIVES: The most effective preterm birth (PTB) intervention is unknown for women who are at risk of PTB due to a history of conization. The objective of this systematic review was to determine whether PTB interventions, progesterone, cerclage, and pessary decrease the risk of PTB compared to no treatment in singleton-and separately in twin-pregnancies of women with history of conization. METHODS: We searched Cochrane Central, MEDLINE, EMBASE, CINAHL, and ClinicalTrials...
January 2019: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Anna Fichera, Federico Prefumo, Giorgia Mazzoni, Valentina Molinaris, Cristina Zanardini, Nicola Fratelli, Tiziana Frusca, Enrico Sartori
INTRODUCTION: Spontaneous preterm birth in women with a twin pregnancy is one of the main causes of perinatal mortality and morbidity. Our aim was to review the perinatal outcome of asymptomatic twin pregnancies with a sonographic short cervical length during the second trimester treated with an ultrasound-indicated cerclage or cervical pessary MATERIAL AND METHODS: Retrospective study on asymptomatic twin pregnancies with a short cervix (≤ 25 mm) at ultrasound transvaginal examination, during the second trimester, treated with a cervical cerclage or pessary (2001-2017)...
December 23, 2018: Acta Obstetricia et Gynecologica Scandinavica
Noelia Zork, Moti Gulersen, Anne Mardy, Caroline Pessel, Sara Brubaker, Joy Vink, Cynthia Gyamfi-Bannerman, Cande V Ananth
OBJECTIVE: To examine the utility of fetal fibronectin (fFN) for predicting spontaneous preterm birth (PTB) in asymptomatic women with a cervical length (CL) < 10 mm compared to those with a CL 11-25 mm. METHODS: Data was collected on all women with nonanomalous singleton and twin gestations who underwent transvaginal CL at a single institution between 2009 and 2012. Women with an incidental short cervix (CL ≤ 25 mm) between 22-32 weeks who had an fFN result within 7 days thereafter were included...
December 20, 2018: Journal of Maternal-fetal & Neonatal Medicine
Alexander Jarde, Olha Lutsiv, Joseph Beyene, Sarah D McDonald
BACKGROUND: Recent progesterone trials call for an update of previous syntheses of interventions to prevent preterm birth. OBJECTIVES: To compare the relative effects of different types and routes of administration of progesterone, cerclage and pessary at preventing preterm birth in at-risk women overall and in specific populations. SEARCH STRATEGY: We searched Medline, EMBASE, CINAHL, Cochrane CENTRAL, and Web of Science up to January 1st , 2018...
November 27, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
A Care, L Ingleby, Z Alfirevic, A Sharp
OBJECTIVE: To identify the current status of specialist preterm labour (PTL) clinics and identify changes in management trends over the last 5 years following release of the NICE preterm birth (PTB) guidance. DESIGN: Postal Survey of Clinical Practice. SETTING: UK. POPULATION: All consultant-led obstetric units. METHODS: A questionnaire was sent by post to all 187 NHS consultant-led obstetric units...
November 20, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
N Vasudeva, C Reddington, M Bogdanska, L De Luca
One of the biggest obstetric challenges is the diagnosis and management of a short cervix as cervical length has an inverse relationship with risk of preterm birth. A cervical cerclage is a surgical procedure to reduce the risk of preterm birth and can be placed in an elective or emergency setting. This is a retrospective review of cervical cerclages inserted at an outer metropolitan hospital from February 2014 to May 2017. Since the introduction of the service, a total of 43 patients were identified as requiring a cervical cerclage...
2018: BioMed Research International
Christos Iavazzo, Evelyn Eleni Minis, Ioannis D Gkegkes
INTRODUCTION: The gold standard in the management of cervical incompetence is cerclage via vaginal approach. Minimally invasive techniques, such as robotic, have been also described. MATERIALS AND METHODS: A systematic search was performed in PubMed and Scopus, searching evidence on robotic assisted laparoscopic cerclage in both pregnant and non pregnant women. RESULTS: Sixty-four patients were included in this study. Cervical insufficiency, failure of transvaginal cerclage, and short cervix were the most frequent indications for robotic assisted cerclage...
October 13, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Amber M Wood, Sarah K Dotters-Katz, Brenna L Hughes
OBJECTIVE:  To evaluate the risk of preterm birth in low-risk women with cervical length (CL) ≤25 mm on transvaginal ultrasound (TVUS) managed with vaginal progesterone (VagP) therapy versus cerclage. STUDY DESIGN:  This is a retrospective cohort of women with no prior history of preterm birth or cervical insufficiency and CL ≤ 25 mm on TVUS, managed with either VagP therapy alone or cerclage (with or without VagP). The primary outcome was rate of preterm delivery < 37 weeks gestational age (GA)...
January 2019: American Journal of Perinatology
Luis Sanchez-Ramos
No abstract text is available yet for this article.
July 2018: American Journal of Obstetrics and Gynecology
Ariel Zimerman, Ron Maymon, Yfat Viner, Noa Glick, Arie Herman, Ortal Neeman
BACKGROUND: Twin pregnancies with short mid-trimester cervical length have a high rate of preterm births. OBJECTIVES: To compare combined treatment of Arabin cerclage pessary, and intravaginal micronized progesterone to conservative treatment for the prevention of preterm births in twins pregnancies with short cervical length in second trimester of pregnancy. METHODS: A retrospective study that compared twin pregnancies with short ≤25mm cervix in second trimester 16-28 gestational weeks treated with combined treatment of Arabin cervical pessary and intravaginal micronized progesterone 200mg TID to a control group with conservative treatment for the prevention of preterm...
May 2018: Harefuah
Yiming Zhang, Manisha Gandhi, Courtney Birchall, Xiaoming Guan
No abstract text is available yet for this article.
August 2018: International Journal of Gynaecology and Obstetrics
Myrna S Aboudiab, Andrew H Chon, Lisa M Korst, Arlyn Llanes, Joseph G Ouzounian, Ramen H Chmait
The objective of this study was to describe the management and perinatal outcomes of patients with twin-twin transfusion syndrome (TTTS) and an extremely short cervical length (CL). This retrospective study examined 17 patients with TTTS and a preoperative CL ≤1.0 cm who had undergone laser surgery and perioperative cervical cerclage placement successfully. In this subset of patients, the median interval between surgery and delivery was 9.6 (range 2.1-13.9) weeks and only one patient had PPROM within 3 weeks of surgery...
April 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
H L Wang, Z Yang, Y Shen, Q L Wang
Objective: To investigate the clinical effect of therapeutic cervical cerclage on short cervix syndrome for anti-premature birth in the second trimester. Methods: Totally 44 singleton pregnant patients were diagnosed as short cervix syndrome, which was cervical length ≤2.5 cm without cervical dilatation, and received treatment from January 2008 and July 2015 in Peking University Third Hospital were collected. Among them, 30 patients who received therapeutic cervical cerclage were defined as cerclage group and another 14 cases who received conservative treatment were defined as un-cerclage group...
January 25, 2018: Zhonghua Fu Chan Ke za Zhi
Michelle N Han, Betsy E O'Donnell, Melanie M Maykin, Juan M Gonzalez, Khalil Tabsh, Stephanie L Gaw
PURPOSE: To evaluate whether cerclage in twins reduces the rate of spontaneous preterm birth <32 weeks when compared to expectant management. METHODS: This is a retrospective cohort study of twin pregnancies with the following indications for cerclage from two institutions: history of prior preterm birth, ultrasound-identified short cervix ≤2.5 cm, and cervical dilation ≥1.0 cm. The "cerclage" cohort received a cerclage from a single provider at a single institution from 2003-2016...
January 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
Alex Ades, Sneha Parghi, Mehrnoosh Aref-Adib
BACKGROUND: Cervical insufficiency is a significant cause of morbidity and mortality. Cervical cerclage is one option in the management of cervical insufficiency. AIM: To evaluate obstetric outcomes following insertion of a pre-pregnancy laparoscopic transabdominal cerclage in women at high risk for pre-term labour and/or mid-trimester pregnancy loss. METHODS: A prospective observational study of consecutive women who underwent laparoscopic transabdominal cerclage from 2007 to 2017...
January 23, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Shinichi Ishioka, Miseon Kim, Yuko Mizugaki, Saori Kon, Kyoko Isoyama, Masahito Mizuuchi, Miyuki Morishita, Tsuyoshi Baba, Takao Sekiya, Tsuyoshi Saito
AIM: Patients with an ultra-short uterine cervix as a result of large conization, repeated conization or radical trachelectomy (RT), are at high risk of preterm premature rupture of the membrane, which leads to preterm birth. We have commenced performing transabdominal cerclage (TAC) of the uterine cervix for these patients. In this study, we examined the safety of TAC and its impact on pregnancy. METHODS: We have performed TAC in 11 patients before pregnancy: in six after large cervical operations, such as repeated conization; and in five for difficulties with cervical cerclage after RT...
January 2018: Journal of Obstetrics and Gynaecology Research
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