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Spontaneous Preterm Labour

M Sood, Z Mohd Zain, N A Abu, S C Chee, N S Mohd Nor
INTRODUCTION: Some anecdotal reports suggest that maternal colonisation with Acinetobacter baumannii during pregnancy is associated with adverse maternal and neonatal effects, including preterm premature rupture of membrane (PPROM). The objective of this study was to compare the maternal and neonatal effects of A. baumannii colonisation in cases with PPROM and those with spontaneous onset of labour at term. METHODS: The recruitment of participants' was carried out at Selayang Hospital, Selangor, Malaysia...
February 2019: Medical Journal of Malaysia
Carme Merced, Maria Goya, Laia Pratcorona, Carlota Rodó, Elisa Llurba, Teresa Higueras, Luis Cabero, Elena Carreras
BACKGROUND: No intervention has proved effective to date in reducing the spontaneous preterm birth rate in twin pregnancies following an episode of threatened preterm labour and with a short cervix remaining. This study was designed to ascertain whether cervical pessaries are useful in preventing spontaneous preterm birth in women with twin pregnancies and a short cervix remaining after a threatened preterm labour episode. METHODS: This open randomised controlled trial was conducted in 132 pregnant women who had not delivered 48h after a threatened preterm labour episode and had a short cervix remaining (≤20mm between 240 and 296 weeks and ≤10mm between 300 and 336 weeks)...
February 28, 2019: American Journal of Obstetrics and Gynecology
Lindsay L Richter, Joseph Ting, Giulia M Muraca, Anne Synnes, Kenneth I Lim, Sarka Lisonkova
OBJECTIVE: After a decade of increase, the preterm birth (PTB) rate has declined in the USA since 2006, with the largest decline at late preterm (34-36 weeks). We described concomitant changes in gestational age-specific rates of neonatal mortality and morbidity following spontaneous and clinician-initiated PTB among singleton infants. DESIGN, SETTING AND PARTICIPANTS: This retrospective population-based study included 754 763 singleton births in Washington State, USA, 2004-2013, using data from birth certificates and hospitalisation records...
February 1, 2019: BMJ Open
Anh Duy Nguyen, Cathy Zhenao Liu, Christoph Lehner, Akwasi Atakora Amoako, Renuka Sekar
BACKGROUND: Recent data suggest that quantitative measurements of fetal fibronectin can be used accurately to predict increased risk of preterm birth. AIM: The purpose of this study was to demonstrate that the quantification of fetal fibronectin improves diagnostic accuracy in women who present with symptoms suggestive of threatened preterm labour (TPL) using a quantitative fetal fibronectin (qfFN) bedside analyser. STUDY DESIGN: This was a retrospective cohort study of pregnant women who presented between 22+6 and 32+6  weeks gestation with symptoms of TPL who had qfFN measured using the Rapid fFN Q10 system...
February 6, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Daniela Urrego, Anthony C Liwa, William C Cole, Stephen L Wood, Donna Michelle Slater
Preterm birth (<37 weeks of gestation) significantly increases the risk of neonatal mortality and morbidity. As many as half of all preterm births occur following spontaneous preterm labour. Since in such cases there are no known reasons for the initiation of labour, treatment of preterm labour (tocolysis) has sought to stop labour contractions and delay delivery. Despite some success, the use of cyclooxygenase (COX) inhibitors is associated with maternal/fetal side effects, and possibly increased risk of preterm birth...
January 19, 2019: Canadian Journal of Physiology and Pharmacology
S D Mandondo, G J Hofmeyr, F Mbengo, N T Mshweshwe-Paleka, T R Mavundla
BACKGROUND: Little is known about the outcomes of self-induced pregnancy termination after 24 weeks' gestation, as previous studies have concentrated on outcomes before 24 weeks. OBJECTIVES: To investigate the gestational age, misoprostol dosage, source of information on misoprostol, reasons for termination and outcomes of self-induced pregnancy termination after 24 weeks' gestation. METHODS: A quantitative, retrospective case series observational research design was utilised...
October 26, 2018: South African Medical Journal
Jane E Norman, John Norrie, Graeme Maclennan, David Cooper, Sonia Whyte, Sarah Cunningham Burley, Joel B E Smith, Andrew Shennan, Stephen C Robson, Steven Thornton, Mark D Kilby, Neil Marlow, Sarah J Stock, Philip R Bennett, Jane Denton
INTRODUCTION: The STOPPIT-2 study aims to determine the clinical utility of the Arabin cervical pessary in preventing preterm birth in women with a twin pregnancy and a short cervix, about which there is current uncertainty. STOPPIT-2 will resolve uncertainty around effectiveness for women with a twin pregnancy and a cervical length of 35 mm or less, define adverse effects, ascertain acceptability and estimate National Health Service costs and savings. METHODS: STOPPIT-2 is a pragmatic multicentre open-label randomised controlled trial...
December 6, 2018: BMJ Open
Lucy C Chappell, Jenny Chambers, Peter H Dixon, Jon Dorling, Rachael Hunter, Jennifer L Bell, Ursula Bowler, Pollyanna Hardy, Edmund Juszczak, Louise Linsell, Catherine Rounding, Anne Smith, Catherine Williamson, Jim G Thornton
BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disorder specific to pregnancy and presents with maternal pruritus, raised concentrations of serum bile acids and abnormal liver function tests. ICP is associated with increased rates of spontaneous and iatrogenic preterm labour, fetal hypoxia, meconium-stained amniotic fluid and intrauterine death. Some clinicians treat ICP with ursodeoxycholic acid (UDCA) to improve maternal pruritus and biochemical abnormalities...
November 27, 2018: Trials
Karim Tararbit, Nathalie Lelong, François Goffinet, Babak Khoshnood
Objectives: To quantify the risk of preterm birth (PTB) for newborns with congenital heart defects (CHDs) conceived following infertility treatments, and to examine the role of multiple pregnancies in the association between infertility treatments and PTB for newborns with CHD. Methods: We used data from a population-based, prospective cohort study (EPICARD EPIdémiologie des CARDiopathies congénitales) including 2190 newborns with CHD and excluding cases with atrial septal defects born to women living in the Greater Paris area between May 2005 and April 2008...
2018: Open Heart
Jonas Bacelis, Julius Juodakis, Kristina M Adams Waldorf, Verena Sengpiel, Louis J Muglia, Ge Zhang, Bo Jacobsson
OBJECTIVES: To determine whether uterine distention is associated with human pregnancy duration in a non-invasive observational setting. DESIGN: Retrospective cohort study modelling uterine distention by interaction between maternal height and uterine load. SETTING: The study is based on the 1990-2013 population data from all delivery units in Sweden. PARTICIPANTS: Uncomplicated first pregnancies of healthy Nordic-born mothers with spontaneous onset of labour...
October 31, 2018: BMJ Open
Martha Lappas
Preterm birth remains the primary cause of early neonatal death and is a major determinant for long-term health consequences. Aberrant intrauterine inflammation and infection are known to augment the synthesis of proinflammatory cytokines and induce uterine contractions, which can subsequently lead to preterm birth. The transforming growth factor- β (TGF- β ) superfamily members regulate numerous cellular processes through the activation of intracellular mediators known as mothers against decapentaplegic homolog (SMADs)...
2018: Mediators of Inflammation
Mohammed Walid Zimmo, Katariina Laine, Sahar Hassan, Bettina Bottcher, Erik Fosse, Hadil Ali-Masri, Kaled Zimmo, Ragnhild Sørum Falk, Marit Lieng, Åse Vikanes
OBJECTIVE: To analyse the current situation of caesarean section in Palestine using the Robson Ten Group Classification System (TGCS). DESIGN: A population-based birth cohort study. SETTING: Obstetrical departments in three governmental hospitals in Gaza. PARTICIPANTS: All women (18 908) who gave birth between 1 January 2016 and 30 April 2017. METHODS: The contributions of each group to the study population and to the overall rate of caesarean section were calculated, as well as the rate of caesarean section in each TGCS group...
October 24, 2018: BMJ Open
Eline Houben, Elisabeth Smits, Jeanne M Pimenta, Libby K Black, Irene D Bezemer, Fernie Ja Penning-van Beest
AIM: Recent evidence is emerging indicating long-term effects in infants born after an episode of preterm labour (PTL), even if birth is at term. This population-based study compared long-term rates of outcomes and health-care utilisation (HCU) in children born following spontaneous preterm labour, irrespective of gestational age at delivery or of an uncomplicated pregnancy (SPTLu), with children born following full-term labour (FTL), overall stratified by comorbidity status and assessed using a composite morbidity measure (CM)...
October 4, 2018: Journal of Paediatrics and Child Health
Lynne Sykes, Phillip R Bennett
Preterm birth (PTB) occurs in 5-18% of pregnancies and is the leading cause of neonatal morbidity, mortality and infant death. Up to 30% of PTBs are due to iatrogenic reasons, but the remainder are due to the spontaneous onset of labour or pre-labour premature rupture of membranes (P-PROM). During pregnancy, the uterus remains quiescent and the cervix remains long and closed. Although the exact mechanisms that lead to spontaneous PTB (sPTB) are not fully understood, it is likely that the terminal pathways that are common to term labour are activated prematurely...
October 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Yasaswi Kaumadha Wijesuriya, Martha Lappas
BACKGROUND: Preterm birth is the most prominent complication attributing to poor pregnancy and neonatal outcome. Infection is most commonly implicated in preterm birth; it initiates a cascade of inflammatory events that leads to the rupture of fetal membranes and spontaneous uterine contractions. Anti-inflammatory agents may thus be a therapeutic approach to prevent the premature rupture of fetal membranes and block contractions. In non-gestational tissues, the polyphenol honokiol has been shown to possess potent anti-inflammatory properties...
October 1, 2018: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
Scott D Barnett, Iain L O Buxton
Preterm birth before 37 weeks of completed gestation results in numerous health consequences for the foetus. Preterm labour leads to preterm birth in over 50% of cases, and no FDA-approved treatment can prevent labour or help a foetus remain in the womb until term. Examination of nitric oxide mediated relaxation signaling in the uterine smooth muscle reveals a role for protein S-nitrosation. The recent discovery of upregulated S-nitrosoglutathione reductase (GSNOR) in spontaneously preterm labouring women has emphasized the need to explore the function of S-nitrosation regulation in the maintenance of uterine quiescence...
December 2018: Journal of Cellular and Molecular Medicine
Francesco D'Antonio, Anthony Odibo, Vincenzo Berghella, Asma Khalil, Karien Hack, Gabriele Saccone, Federico Prefumo, Danilo Buca, Marco Liberati, Giorgio Pagani, Ganesh Acharya
OBJECTIVE: To quantify the rate of perinatal mortality in monochorionic monoamniotic (MCMA) twin pregnancies according to gestational age and to ascertain the incidence of mortality in pregnancies managed as inpatient compared to outpatient. METHODS: Medline, Embase and Cinahl databases were searched. The primary outcomes explored were the incidence of intrauterine death (IUD), neonatal death (NND) and perinatal (PND) death in MCMA twin pregnancies at different gestational age windows (24-30, 31-32, 33-34, 35-36 and beyond 37 weeks of gestation)...
August 20, 2018: Ultrasound in Obstetrics & Gynecology
Jin-Wen Zhang, Ware Branch, Matthew Hoffman, Ank De Jonge, Sheng-Hui Li, James Troendle, Jun Zhang
OBJECTIVES: To identify obstetrical subgroups in which (1) the caesarean delivery (CD) rate may be reduced without compromising safety and (2) CD may be associated with better perinatal outcomes. DESIGN: A multicentre cross-sectional study. SETTING: 19 hospitals in the USA that participated in the Consortium on Safe Labor. PARTICIPANTS: 228 562 pregnant women in 2002-2008. MAIN OUTCOME MEASURES: Maternal and neonatal safety was measured using the individual Weighted Adverse Outcome Score...
August 5, 2018: BMJ Open
Ruth McCuaig, Diana Wong, Fergus W Gardiner, William Rawlinson, Jane E Dahlstrom, Stephen Robson
INTRODUCTION: Preterm birth is a common cause of adverse neonatal and childhood outcomes. It is commonly associated with infection of the maternal-fetal interface. The relationship between periodontitis and preterm labour is controversial. METHODS: Control placental tissues from uncomplicated term births were compared with those from spontaneous preterm births for incidence of common periodontal bacteria. A chi-square analysis was used to compare the populations, with significance determined at p=<0...
August 2018: Placenta
Sha Huang, Wei Xia, Xia Sheng, Lin Qiu, Bin Zhang, Tian Chen, Shunqing Xu, Yuanyuan Li
OBJECTIVES: Maternal exposure to lead (Pb) has been suggested to correlate with adverse birth outcomes, but evidence supporting an association between Pb exposure and premature rupture of membranes (PROM) is limited. The aim of our study was to investigate whether maternal Pb exposure was associated with PROM and preterm PROM. DESIGN: Cross-sectional cohort study. STUDY POPULATION: The present study involved 7290 pregnant women from the Healthy Baby Cohort in Wuhan, China, during 2012-2014...
July 23, 2018: BMJ Open
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