Routine cervical length in twins and perinatal outcomes

2005 ◽  
Vol 193 (6) ◽  
pp. S151
Author(s):  
Cynthia Gyamfi (F) ◽  
Veronica Lerner ◽  
Ian Holzman ◽  
Joanne L. Stone
Keyword(s):  
Perinatal Outcomes ◽  
Cervical Length

scholarly journals Perinatal outcomes of quadruplet pregnancy

2021 ◽  
Vol 15 (4) ◽  
pp. 371-378
Author(s):  
S. A. Kalashnikov ◽  
D. R. Kudratova
Keyword(s):  
Pregnant Women ◽  
Assisted Reproductive Technologies ◽  
Risk Group ◽  
Perinatal Outcomes ◽  
Reproductive Technologies ◽  
Cervical Length ◽  
Massive Bleeding ◽  
Extremely Low Birth Weight ◽  
Comprehensive Examination ◽  
Level 3

Introduction. A significantly increased frequency of multiple pregnancies including more than two fetuses is a consequence of using assisted reproductive technologies and ovulation stimulations. However, such pregnancies remain poorly investigated. Aim: to study the course and perinatal outcomes of quadruplet pregnancies.Materials and Methods. 7 pregnant women with quadruplets were examined. A comprehensive examination, including fetometry, monitoring of the cervical length, Doppler examination, and treatment of all complications were performed for all pregnant women. Results. Quadruplet pregnancy belongs to the peak risk group for the frequency of multiple gestational complications: cervical incompetence (85.7 %), anemia (71.4 %), preeclampsia (57.1 %), fetal growth retardation (71.4 %), premature birth (100.0 %), massive bleeding during delivery (33.3 %), extremely low birth weight newborns (30.8 %), respiratory disorders (100.0 %), intraventricular hemorrhages (38.5 %).Conclusion. Women with quadruplet pregnancies should be monitored and give a birth in level 3 perinatal centers. Delivery should be preferentially performed by caesarean section. The data obtained additionally underline that as few as a single embryo should solely transferred.

Routine Cervical Length in Twins and Perinatal Outcomes

2007 ◽  
Vol 62 (6) ◽  
pp. 366-368
Author(s):  
Cynthia Gyamfi ◽  
Veronica Lerner ◽  
Ian Holzman ◽  
Joanne L. Stone
Keyword(s):  
Perinatal Outcomes ◽  
Cervical Length

scholarly journals Vaginal progesterone in risk reduction of preterm birth in women with short cervix

2019 ◽  
Vol 8 (7) ◽  
pp. 2695
Author(s):  
Shubhi Srivastava ◽  
D. Borgohain
Keyword(s):  
Preterm Birth ◽  
Transvaginal Ultrasound ◽  
Perinatal Outcomes ◽  
Cervical Length ◽  
Singleton Pregnancy ◽  
Short Cervix ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Vaginal Progesterone ◽  
Adverse Neonatal Outcomes

Background: Preterm birth is a global health problem affecting the neonate, family and country in general. It is the leading cause of perinatal mortality and morbidity. Short cervical length detected on transvaginal ultrasound is the most practical risk factor for prediction of preterm birth. The aim of this study was to determine the efficacy and safety of vaginal progesterone in reducing the rate of preterm birth in women with a short cervix and to determine its effect on neonatal mortality and morbidity.Methods: The study was carried out in the Department of Obstetrics and Gynaecology at Assam Medical College, Dibrugarh for a period of one year. It included 128 asymptomatic women with a singleton pregnancy and a sonographic short cervix. Women were randomly divided into two groups, one of which was given placebo and the other was given vaginal progesterone and a comparative study was conducted.Results: It was observed that delivery before 37 weeks of gestation was less frequent in the progesterone group than in the placebo group (60.94% vs. 90.63%). Vaginal progesterone was also associated with a significant reduction in adverse neonatal outcomes like the rate of sepsis (6.25% vs. 18.75%), requirement of ventilator (12.5% vs. 26.56%), admission to NICU (10.94% vs. 26.56%) and birth weight ≤1.5kg (7.81% vs. 21.88%).Conclusions: Vaginal progesterone reduces the risk of preterm birth and adverse perinatal outcomes in pregnant women without any deleterious effects on the foetus or mother.

scholarly journals Effect of preoperative lower-normal cervical length on perinatal outcomes after laparotomy-assisted fetoscopic spina bifida repair

2022 ◽  
Vol 226 (1) ◽  
pp. S622
Author(s):  
Magdalena Sanz Cortes ◽  
Jimmy Espinoza ◽  
Ahmed A. Nassr ◽  
Roopali V. Donepudi ◽  
Amy Mehollin-Ray ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Perinatal Outcomes ◽  
Cervical Length

The structure and incidence of preterm birth in nulliparous women

2015 ◽  
Vol 9 (2) ◽  
pp. 0-0
Author(s):  
Кузибаева ◽  
R. Kuzibaeva ◽  
Хадарцева ◽  
K. Khadartseva
Keyword(s):  
Preterm Birth ◽  
Early Diagnosis ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Cervical Length ◽  
Specific Method ◽  
Leading Role ◽  
Nulliparous Women ◽  
Ultrasound Assessment ◽  
Mechanisms Of Development

The article presents current views on the problem of preterm birth, various mechanisms of development and approaches to early diagnosis and prevention. Ultrasound plays a leading role in the examination of pregnant women, because of its relative simplicity, invasiveness, safety for mother and fetus. Ultrasound assessment of the cervix should be considered highly informative and prognostically valuable in the diagnosis of threatened abortion. Transvaginal measurement of cervical length is carried out for the prediction of parturition in pregnant women, who are not related to the risk of a premature birth. Ultrasound assessment of the cervix, as a screening technique is used in the Tula region for early diagnosis, accurate forecasting and perinatal outcomes, due to the large number of etiological factors and the lack of a specific method of timely diagnosis. Various risk factors are taken into account in nulliparous women who are associated with idiopathic preterm birth, prenatal rupture of membranes and termination of pregnancy for medical reasons. Preterm birth is a major cause of perinatal morbidity and mortality of newborns in nulliparous, despite the improvement in perinatal outcome in recent years.

scholarly journals Efficacy of an Emergency Cervical Cerclage Using Absorbable Monofilament Sutures

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Yuka Sato ◽  
Nobuhiro Hidaka ◽  
Takahiro Nakano ◽  
Saki Kido ◽  
Masahiro Hachisuga ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Spontaneous Abortion ◽  
Gestational Age ◽  
Perinatal Outcomes ◽  
Cervical Length ◽  
Cervical Cerclage ◽  
Extremely Preterm ◽  
Term Delivery ◽  
Gestational Age At Delivery ◽  
Full Term Delivery

Introduction. Although nonabsorbable woven tape has been widely used for cervical cerclage, technical difficulties that can occur with an effaced cervix because of the thickness of the tape, and the risks of local infection are two major concerns. This study investigated perinatal outcomes of pregnancies involving an emergency cervical cerclage using absorbable monofilament polydioxanone sutures, which is a narrow thread and protects against bacterial infection. Materials and Methods. We performed a chart review of patients who underwent emergency McDonald cerclage with polydioxanone sutures at our institution between 2007 and 2015. Gestational age at delivery, duration between cerclage and delivery, and neonatal prognosis were evaluated as primary outcomes. Results. Among the 23 patients (18 singleton and five twin pregnancies) evaluated, ultrasound-indicated (progressive cervical length shortening) were eight (35%) and physical examination-indicated (fetal membranes that prolapsed into the vagina or dilated cervix) were 15 patients (65%). The median gestational age at cerclage was 22+3 weeks (range, 17+5 to 25+3 weeks). Postoperative spontaneous abortion occurred in only one patient. The median gestational age at delivery was 32+5 weeks (range, 20+5 to 40+6 weeks). Extremely preterm delivery before 28 weeks of gestation occurred in four (17%) cases. Full-term delivery was achieved in 10 (42%) cases. The duration between cerclage and delivery ranged from 5 to 136 days (median, 77 days). Except for one case of spontaneous abortion, all newborns survived till hospital discharge. Conclusions. Although our series included some patients at high risk for spontaneous abortion and preterm delivery, satisfactory prolongation and favorable neonatal outcomes were achieved for most patients by using absorbable monofilament sutures, thus suggesting the efficacy of this type of suture for emergency cervical cerclage.

Predictors of Early Preterm Birth Despite Vaginal Progesterone Therapy in Singletons with Short Cervix

2020 ◽  
Vol 37 (13) ◽  
pp. 1289-1295
Author(s):  
Rupsa C. Boelig ◽  
Mackenzie N. Naert ◽  
Nathan S. Fox ◽  
Sean Hennessy ◽  
Inna Chervoneva ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Score ◽  
Gestational Age ◽  
Multiple Logistic Regression Analysis ◽  
Perinatal Outcomes ◽  
Cervical Length ◽  
Multiple Logistic Regression ◽  
Short Cervix ◽  
Vaginal Progesterone ◽  
Early Preterm Birth

Abstract Objective This study aimed to identify the incidence of and risk factors for early preterm birth (PTB) (delivery <34 weeks) in women without prior PTB and current short cervix (≤20 mm) prescribed vaginal progesterone. Study Design Retrospective cohort study of singletons without prior PTB diagnosed with short cervix (≤20 mm) between 180/7 and 236/7 weeks. Women who accepted vaginal progesterone and had delivery outcomes available were included. Demographic/obstetric history, cervical length, and pregnancy characteristics compared between women with early PTB versus delivery ≥34 weeks. Multiple logistic regression analysis used to identify predictors; odds ratio for significant factors used to generate a risk score. Risk score and risk of early PTB assessed with receiver operating characteristic curve (ROCC). Perinatal outcomes compared by risk score. Results Among 109 patients included, 29 (27%) had a spontaneous PTB <34 weeks. In univariate analysis, only gestational age at ultrasound, presence funneling, and mean cervical length were significantly different between those with and without early sPTB. With multiple logistic regression analysis, only gestational age at diagnosis (odds ratio [OR]: 0.66; 95% confidence interval [CI]: 0.46–0.96; p = 0.028) and index cervical length (OR: 0.84; 95% CI: 0.76–0.93; p = 0.001) remained significantly associated with early PTB. ROCC for the risk score incorporating cervical length and gestational age was predictive of early PTB with an AUC of 0.76 (95% CI: 0.67–0.86; p < 0.001). A high-risk score was predictive of early PTB with a sensitivity of 79%, specificity of 75%, positive predictive value of 54%, and negative predictive value of 91%. Women with a high-risk score had worse perinatal outcomes compared with those with low-risk score. Conclusion A total of 27% of patients with short cervix prescribed vaginal progesterone will have a sPTB < 34 weeks. Patients at high risk for early PTB despite vaginal progesterone therapy may be identified using gestational age and cervical length at diagnosis of short cervix. Given the narrow window for intervention after diagnosis of short cervix, this has important implications for clinical care.

scholarly journals Gestational and Neonatal Outcomes of a New Three-Step Procedure for Emergency Cerclage

2021 ◽  
Author(s):  
Manuel Gómez Castellano ◽  
Lorena Sabonet Morente ◽  
Ernesto González Mesa ◽  
Jesús S Jiménez Lopez
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Cervical Length ◽  
University Hospital ◽  
Cervical Dilatation ◽  
Step Procedure ◽  
The Mean ◽  
Infant Birth

Abstract Background: The objective of our study was to evaluate a new technique for emergency cerclage performed in a cohort of patients with cervical incompetence in the second trimester of pregnancy. Design: Prospective observational study in Regional university hospital. Population: Twenty-four pregnant women at 15 to 24 weeks gestation with cervical dilatation and bursa prolapseMethods: Depending on the clinical condition of the patient, a new emergency cerclage was performed with a technical consisting of a first cerclage in a purse-string and a second occlusive cerclage located inferiorly to the first one. The technique ended with the performance of a cervical cleisis, depending on the presence or absence of prolapse of the vaginal bag. This procedure is called the Three-Step Procedure for Emergency Cerclage (TSEC). Outcome measure: The latency period to deliveryResults: Latency from procedure to delivery, pregnancy duration, infant birth weight, rate of premature amniorrhexis. The mean latency from procedure to delivery was 14 weeks + 6 days, the mean weight of the newborns was 2550 g, and the mean age at delivery was 35 weeks. The neonatal survival rate was 95.8%. The rate of premature amniorrhexis <34 weeks was 8.3% (two cases) with successful perinatal outcomes. There were significant differences (p < 0.05) between groups when we sub-divided the cohort in terms of history of conization, preterm delivery, and bursal prolapse. The multivariate regression model showed that best predictor variables for latency to delivery were cervical dilatation at diagnosis, the use of the three step cerclage, cervical length after the procedure, and gestational age at diagnosis.Conclusion: The excellent results obtained with the TSEC procedure in terms of the latency from procedure to delivery, gestational age at delivery, birth weight, and few reported complications, highlight the importance of collecting new data on this promising novel procedure.

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