Misoprostol as an adjunct to overnight osmotic dilators prior to second trimester dilation and evacuation: A systematic review and meta-analysis,

Contraception ◽  
2020 ◽  
Vol 101 (2) ◽  
pp. 74-78 ◽  
Author(s):  
Erica P. Cahill ◽  
Andrea Henkel ◽  
Jonathan G. Shaw ◽  
Kate A. Shaw
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Second Trimester

scholarly journals Spiral artery blood flow during pregnancy: a systematic review and meta-analysis.

2019 ◽  
Author(s):  
Veronique Schiffer ◽  
Laura Evers ◽  
Sander de Haas ◽  
Chahinda Ghossein ◽  
Salwan Al-Nasiry ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Flow ◽  
Meta Analysis ◽  
Resistance Index ◽  
First Trimester ◽  
Trophoblast Invasion ◽  
Cochrane Library ◽  
Second Trimester ◽  
Spiral Artery ◽  
Third Trimester

Abstract Background: Downstream remodeling of the spiral arteries (SpA) decreases utero-placental resistance drastically, allowing sustained and increased blood flow to the placenta at all circumstances. We systematically evaluated available reports to visualize adaptation of spiral arteries throughout pregnancy by ultra-sonographic measurements and evaluated when this process is completed.Methods: A systematic review and meta-analysis of spiral artery flow (pulsatility index (PI), resistance index (RI) and peak systolic velocity (PSV)) was performed. English articles were obtained from Pubmed, EMBASE and Cochrane Library and included articles were assessed on quality and risk of bias. Weighted means of Doppler indices were calculated using a random-effects model. Results: In healthy pregnancies, PI and RI decreased from 0.75 (95% CI: 0.67-0.83) and 0.49 (95% CI: 0.46-0.53) in the first trimester to 0.52 (95% CI: 0.48-0.56, p=0.003) and 0.40 (95% CI: 0.38-0.42, p=0.080) in the second trimester and to 0.49 (95% CI: 0.44-0.53, p=0.510) and 0.36 (95% CI: 0.35-0.37, p=0.307) in the third trimester, respectively. In parallel, PSV altered from 0.24 m/s (95% CI: 0.17-0.31 m/s) to 0.28 m/s (95% CI: 0.22-0.34 m/s, p=0.377) and to 0.25 m/s (95% CI: 0.21-0.28 m/s, p=0.919) in the three trimesters. In absence of second and third trimester Doppler data in complicated gestation, only a difference in PI was observed between complicated and healthy pregnancies during the first trimester (1.49 vs 0.76, p<0.001). Although individual studies have identified differences in PI between SpA located in the central part of the placental bed versus those located at its periphery, this meta-analysis could not confirm this (p=0.349).Conclusions: This review and meta-analysis concludes that an observed decrease of SpA PI and RI from the first towards the second trimester parallels the physiological trophoblast invasion converting SpA during early gestation, a process completed in the midst of the second trimester. Higher PI and RI were found in SpA of complicated pregnancies compared to healthy pregnancies, possibly reflecting suboptimal utero-placental circulation. Longitudinal studies examining comprehensively the predictive value of spiral artery Doppler for complicated pregnancies are yet to be carried out.

scholarly journals Does Vitamin D Deficiency in Different Periods of Gestation Have the Same Effect on Preterm Birth? A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
bin Yi ◽  
Rui-han Lian ◽  
Ping-an Qi ◽  
Tao Yuan ◽  
Pei-jing Yan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Preterm Birth ◽  
Vitamin D Deficiency ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Second Trimester ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Vitamin D Levels

Abstract Background: Current studies suggest that vitamin D deficiency during pregnancy can produce a certain effect for preterm birth, but there is no research showing whether vitamin D deficiency has a consistent effect in different pregnancies; thus, we conducted a systematic review and meta-analysis of 24 observational studies, grouping them according to the gestational age at the time of serum sampling, to investigate whether vitamin D deficiency in different periods of gestation has different effects on preterm birth and to provide an evidence-based basis for pregnant women to measure and supplement vitamin D. Methods: The databases PubMed-Medline, EMBASE, the Cochrane Library, Web of Science, EBSCO, CBM, and CNKI were searched until July 2019. Two researchers independently assessed the eligibility and quality of studies, and STATA 12.0 software was used for meta-analysis. Result: Seven cohort studies, 13 case-control studies, and four cross-sectional studies were included from 2500 articles by inclusion and exclusion criteria. After adjusting for age, race, and other confounding factors, meta-analysis results showed that vitamin D deficiency in the first trimester, the second trimester and the third trimester did not increase the risk of preterm birth (odds ratio (OR) = 1.01, 95% confidence interval (CI) (0.88, 1.16), P = 0.867; OR = 1.12, 95%CI (0.92, 1.37), P = 0.249; OR = 1.05, 95%CI (0.87, 1.27), P = 0.602). However, there was moderate heterogeneity in the study of vitamin D deficiency in the second trimester, and subgroup analysis suggested that vitamin D deficiency in the second trimester may increase the risk of preterm birth (OR = 1.33, 95%CI (1.15, 1.54), P = 0.000). A sensitivity analysis of the second trimester showed that excluding any one study did not significantly change the results. Conclusions: Vitamin D deficiency in early and late pregnancy may not be associated with preterm birth, while vitamin D deficiency in middle pregnancy is likely to have an important effect on preterm birth. Vitamin D levels should be measured in the second trimester of pregnancy, and vitamin D supplements should be provided if necessary.

scholarly journals Spiral artery blood flow during pregnancy: a systematic review and meta-analysis.

2020 ◽  
Author(s):  
Veronique Schiffer ◽  
Laura Evers ◽  
Sander de Haas ◽  
Chahinda Ghossein ◽  
Salwan Al-Nasiry ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Flow ◽  
Meta Analysis ◽  
Resistance Index ◽  
First Trimester ◽  
Trophoblast Invasion ◽  
Cochrane Library ◽  
Second Trimester ◽  
Spiral Artery ◽  
Third Trimester

Abstract Background: Downstream remodeling of the spiral arteries (SpA) decreases utero-placental resistance drastically, allowing sustained and increased blood flow to the placenta at all circumstances. We systematically evaluated available reports to visualize adaptation of spiral arteries throughout pregnancy by ultra-sonographic measurements and evaluated when this process is completed. Methods: A systematic review and meta-analysis of spiral artery flow (pulsatility index (PI), resistance index (RI) and peak systolic velocity (PSV)) was performed. English articles were obtained from Pubmed, EMBASE and Cochrane Library and included articles were assessed on quality and risk of bias. Weighted means of Doppler indices were calculated using a random-effects model. Results: In healthy pregnancies, PI and RI decreased from 0.80 (95% CI: 0.70-0.89) and 0.50 (95% CI: 0.47-0.54) in the first trimester to 0.50 (95% CI: 0.45-0.55, p<0.001) and 0.39 (95% CI: 0.37-0.42, p<0.001) in the second trimester and to 0.49 (95% CI: 0.44-0.53, p=0.752) and 0.36 (95% CI: 0.35-0.38, p=0.037) in the third trimester, respectively. In parallel, PSV altered from 0.22 m/s (95% CI: 0.13-0.30 m/s) to 0.28 m/s (95% CI: 0.17-0.40 m/s, p=0.377) and to 0.25 m/s (95% CI: 0.20-0.30 m/s, p=0.560) in the three trimesters. In absence of second and third trimester Doppler data in complicated gestation, only a difference in PI was observed between complicated and healthy pregnancies during the first trimester (1.49 vs 0.80, p<0.001). Although individual studies have identified differences in PI between SpA located in the central part of the placental bed versus those located at its periphery, this meta-analysis could not confirm this (p=0.349). Conclusions: This review and meta-analysis concludes that an observed decrease of SpA PI and RI from the first towards the second trimester parallels the physiological trophoblast invasion converting SpA during early gestation, a process completed in the midst of the second trimester. Higher PI was found in SpA of complicated pregnancies compared to healthy pregnancies, possibly reflecting suboptimal utero-placental circulation. Longitudinal studies examining comprehensively the predictive value of spiral artery Doppler for complicated pregnancies are yet to be carried out.

The Novel Ultrasonographic Marker of Uterocervical Angle for Prediction of Spontaneous Preterm Birth in Singleton and Twin Pregnancies: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-7
Author(s):  
Kamran Hessami ◽  
Maryam Kasraeian ◽  
Álvaro Sepúlveda-Martínez ◽  
Mauro Cristian Parra-Cordero ◽  
Homeira Vafaei ◽  
...  
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Meta Analysis ◽  
Predictive Marker ◽  
Second Trimester ◽  
Spontaneous Preterm Birth ◽  
Increased Risk ◽  
Study Heterogeneity ◽  
Mean Differences ◽  
Twin Pregnancies

The alteration of the uterocervical angle (UCA) has been proposed to play an important role in spontaneous preterm birth (sPTB). The aim of this systematic review and meta-analysis was to evaluate the evidence on the UCA predictive role in sPTB. In this study, PubMed, Web of Science, Scopus, and Google scholar were systematically searched from inception up to June 2020. Inter-study heterogeneity was also assessed using Cochrane’s <i>Q</i> test and the <i>I</i><sup>2</sup> statistic. Afterward, the random-effects model was used to pool the weighted mean differences (WMDs) and the corresponding 95% confidence intervals (CIs). Eleven articles that reported second-trimester UCA of 5,061 pregnancies were included in this study. Our meta-analysis results indicate that a wider UCA significantly increases the risk of sPTB in following cases: all pregnancies (WMD = 15.25, 95% CI: 11.78–18.72, <i>p</i> &#x3c; 0.001; <i>I</i><sup>2</sup> = 75.9%, <i>p</i> &#x3c; 0.001), singleton (WMD = 14.43, 95% CI: 8.79–20.06, <i>p</i> &#x3c; 0.001; <i>I</i><sup>2</sup> = 82.4%, <i>p</i> &#x3c; 0.001), and twin pregnancies (WMD = 15.14, 95% CI: 13.42–16.87, <i>p</i> &#x3c; 0.001; <i>I</i><sup>2</sup> = 0.0%, <i>p</i> = 0.464). A wider ultrasound-measured UCA in the second trimester seems to be associated with the increased risk of sPTB in both singleton and twin pregnancies, which reinforces the clinical evidence that UCA has the potential to be used as a predictive marker of sPTB.

Systematic review and meta-analysis of performance of second-trimester nasal bone assessment in detection of fetuses with Down syndrome

2014 ◽  
Vol 43 (3) ◽  
pp. 247-253 ◽  
Author(s):  
M. Moreno-Cid ◽  
A. Rubio-Lorente ◽  
M. J. Rodríguez ◽  
G. Bueno-Pacheco ◽  
J. M. Tenías ◽  
...  
Keyword(s):  
Systematic Review ◽  
Down Syndrome ◽  
Meta Analysis ◽  
Nasal Bone ◽  
Second Trimester ◽  
Analysis Of Performance ◽  
Bone Assessment
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