Eradication of Cervical Canal Colonization In Treatment Associated With Prophylactic Cervical Cerclage: The LOOK FURTHER Study

2021 ◽  
Author(s):  
Natalia Sroka-Ostrow ◽  
Radosław Pietrzak ◽  
Dominika Pykało-Gawińska ◽  
Julia Zaręba-Szczudlik ◽  
Krzysztof Czajkowski ◽  
...  
Keyword(s):  
Preterm Labor ◽  
Reproductive Tract ◽  
Perioperative Management ◽  
Normal Development ◽  
Obstetric Outcomes ◽  
Cervical Canal ◽  
Cervical Cerclage ◽  
Negative Culture ◽  
The Look ◽  
Medical University

Abstract BACKGROUND: The perioperative management of the cervical cerclage procedure is not unified. Controlling microbiome cervical status does not affect obstetric outcomes in general population, but it can be beneficial in cervical insufficiency. Eliminating cervical pathogens in those patients may increase the effectiveness, resulting in prevention of miscarriage or preterm labor and delivery of a baby capable of normal development.METHODS: Thirty five patients undergoing cervical cerclage at the 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, were included in the study. The procedure was performed only after receiving a negative culture from the cervical canal.RESULTS: Thirty one (88.5%) patients delivered after the 34th and 28 (80%) after the 37th week of gestation. The colonization of genital tract was found in 31% of patients prior to the procedure, 42% in the subsequent course of pregnancy and 48% before delivery. Eighty five percent of patients who had miscarriage or delivered prematurely had abnormal cervical cultures. In patients with normal cervical cultures 91.67% women delivered at term. There were no abnormalities in children’s development.CONCLUSIONS: Controlling microbiological status of the cervical canal results in better or similar outcomes to those reported by other authors in terms of obstetric and neonatal outcomes. Active eradication of the reproductive tract colonization potentially increases the effectiveness of the cervical cerclage placement.

scholarly journals Testin interacts with vangl2 genetically to regulate inner ear sensory cell orientation and the normal development of the female reproductive tract in mice

2013 ◽  
Vol 242 (12) ◽  
pp. 1454-1465 ◽  
Author(s):  
Dong-Dong Ren ◽  
Michael Kelly ◽  
Sun Myoung Kim ◽  
Cynthia Mary Grimsley-Myers ◽  
Fang-Lu Chi ◽  
...  
Keyword(s):  
Inner Ear ◽  
Reproductive Tract ◽  
Normal Development ◽  
Sensory Cell ◽  
Female Reproductive Tract ◽  
Cell Orientation

scholarly journals Antimicrobial peptides and pregnancy

Reproduction ◽  
2011 ◽  
Vol 141 (6) ◽  
pp. 725-735 ◽  
Author(s):  
Lorraine Frew ◽  
Sarah J Stock
Keyword(s):  
Antimicrobial Peptides ◽  
Broad Spectrum ◽  
Preterm Labor ◽  
Reproductive Tract ◽  
Inflammatory Cells ◽  
Female Reproductive Tract ◽  
Pregnant Female ◽  
Inflammatory Conditions ◽  
Small Proteins ◽  
And Function

Antimicrobial peptides (AMPs) are small proteins produced by epithelial surfaces and inflammatory cells, which have broad-spectrum antimicrobial and immunomodulatory activities. They are known to be important in a number of infectious and inflammatory conditions and have been shown to be present in a number of sites throughout the female reproductive tract. Inflammation and infection are associated with a number of complications of pregnancy including preterm labor, and AMPs may play a key role in maintaining and protecting pregnancy. The aim of this review is to describe the expression and function of AMPs in the pregnant female reproductive tract and their relation to preterm labor.

Transvaginal cervical cerclage: evidence for perioperative management strategies

2013 ◽  
Vol 209 (3) ◽  
pp. 181-192 ◽  
Author(s):  
Vincenzo Berghella ◽  
Jack Ludmir ◽  
Giuliana Simonazzi ◽  
John Owen
Keyword(s):  
Perioperative Management ◽  
Management Strategies ◽  
Cervical Cerclage

scholarly journals Double Cerclage In Cervical Insufficiency: A Single Tertiary Center Experience

2019 ◽  
pp. 1
Author(s):  
Ismet Hortu ◽  
Cagdas Sahin ◽  
Orkun Ilgen ◽  
Mert Kazandi ◽  
Ali Akdemir ◽  
...  
Keyword(s):  
Birth Weight ◽  
Cesarean Section ◽  
Perinatal Outcomes ◽  
Obstetric Outcomes ◽  
Cervical Insufficiency ◽  
Cervical Cerclage ◽  
History Of ◽  
Group 2 ◽  
Transvaginal Cerclage ◽  
Group 1

<p><strong>Objective:</strong> The aim of this study is to compare the perinatal outcomes of double cerclage via laparoscopic plus transvaginal technique in women with a history of transvaginal cerclage failure, between women with single transvaginal cerclage.</p><p><strong>Study Design:</strong> Five women who were diagnosed with cervical insufficiency with a history of at least one vaginal cerclage failure and 10 women who were diagnosed with cervical insufficiency were included in this study. Laparoscopic cerclage was performed to all women who have a medical history of vaginal cerclage failure, before pregnancy and additional transvaginal cervical cerclage was performed during their pregnancy (Group 1). Single transvaginal cervical cerclage was performed to the 10 women who had a short cervix and/or cervical insufficiency during their pregnancy (Group 2). The number of cerclage failure, perinatal outcomes, gestational week at the time of delivery, birth weight and Apgar scores were evaluated.</p><p><strong>Results:</strong> All five women in group 1 underwent a cesarean section. None of them had chorioamnionitis or poor obstetric outcomes and all gave birth after the 34th week of pregnancy. All ten women in group 2 were evaluated. Two women gave birth vaginally at the 33rd week of pregnancy. Remaining eight cases gave birth above 34th week of pregnancy. Six of the eight cases underwent cesarean section and two of the remaining were delivered vaginally. Mean birth weight of the fetuses were 2490±265 g and 2.710 ±361 g in group1 and group 2, respectively. Mean gestational age at the time of birth in group 1 and group 2 were found 36±1.83 weeks and 35.6±1.14 weeks, respectively.</p><p><strong>Conclusion:</strong> Laparoscopic cervical cerclage during pregnancy could be a safe and effective treatment. However, sometimes it might not be enough and transvaginal cervical cerclage may be needed to strengthen cervical tension.</p>

Systemic erythematosus lupus and pregnancy outcomes in a Colombian cohort

Lupus ◽  
2021 ◽  
pp. 096120332110614
Author(s):  
Valeria Erazo-Martínez ◽  
Ivana Nieto-Aristizábal ◽  
Isabella Ojeda ◽  
Michelle González ◽  
Cristian C Aragon ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Pregnant Women ◽  
Lupus Erythematosus ◽  
Preterm Labor ◽  
Activity Index ◽  
Perinatal Outcomes ◽  
Disease Activity Index ◽  
Obstetric Outcomes ◽  
Maternal Complications ◽  
Fetal Survival

Objective Pregnant women with SLE have higher probabilities of maternal complications. SLE during pregnancy has alternating patterns of remission and flare-ups; however, most pregnant SLE patients tend to worsen with associated poor obstetric and perinatal outcomes. This study aimed to describe obstetric outcomes in pregnant women with SLE. Methods This retrospective study was performed between 2011 and 2020 at a highly complex referral health center in Cali, Colombia. Pregnant women with a diagnosis of SLE were included. Demographic, clinical, and laboratory features and obstetric and fetal outcomes, including intensive care unit (ICU) characteristics, were evaluated. Results Forty-eight pregnant women with SLE were included. The median age was 29 (25–33.7) years. The SLE diagnosis was made before pregnancy in 38 (79.1%) patients, with a median disease duration of 46 (12–84) months. Thirteen (27.1%) patients had lupus nephritis. Preterm labor (34, 70.8%), preeclampsia (25, 52%), and preterm rupture of membranes (10, 20.8%) were the most common obstetric complications. A relationship between a greater systemic lupus erythematosus pregnancy disease activity index (SLEPDAI) and the development of hypertensive disorders during pregnancy was established (preeclampsia = p < 0.0366; eclampsia = p < 0.0153). A relationship was identified between lupus nephritis (LN) and eclampsia ( p < 0.01), preterm labor ( p < 0.045), and placental abruption ( p < 0.01). Seventeen (35.4%) patients required ICU admission; 52.9% of them were due to AID activity, 17.6% for cardiovascular damage, 11.7% for septic shock, and 5.8% for acute kidney failure. Fetal survival was 89.5% ( N = 43/48). Among the live births, two (4.2%) newborns were diagnosed with neonatal lupus, and two (4.2%) were diagnosed with congenital heart block. One maternal death was registered due to preeclampsia and intraventricular hemorrhage. Conclusions This study is the first to describe SLE during pregnancy in Colombia. SLE was the most prevalent AID in this cohort, and complications included preterm labor, preeclampsia, and postpartum hemorrhage. A higher SLEPDAI and lupus nephritis predicted adverse maternal outcomes.

scholarly journals Deficiency of Reproductive Tract α(1,2)Fucosylated Glycans and Normal Fertility in Mice with Targeted Deletions of the FUT1 or FUT2 α(1,2)Fucosyltransferase Locus

2001 ◽  
Vol 21 (24) ◽  
pp. 8336-8345 ◽  
Author(s):  
Steven E. Domino ◽  
Liang Zhang ◽  
Patrick J. Gillespie ◽  
Thomas L. Saunders ◽  
John B. Lowe
Keyword(s):  
Epithelial Cell ◽  
Epithelial Cells ◽  
Reproductive Tract ◽  
Normal Development ◽  
Sperm Maturation ◽  
Male Reproductive Tract ◽  
Uterine Epithelial Cells ◽  
Uterine Epithelial Cell ◽  
Normal Fertility ◽  
Genes Encoding

ABSTRACT The fucose α(1→2) galactose β structure is expressed by uterine epithelial cells in the mouse and has been implicated in blastocyst adhesion events thought to be required for murine implantation. Fucα(1→2)Galβ moieties and cognate fucosyltransferases are also expressed by epithelial cells of the male reproductive tract and have been implicated in sperm maturation events that may contribute to fertilization. To determine directly if Fucα(1→2)Galβ moieties are required for fertility, we have generated strains of mice that are deficient in genes encoding FUT1 and FUT2, a pair of GDP-l-fucose:β(1→4)-d-galactosyl-R2-α-l-fucosyltransferase enzymes (EC 2.4.1.69 ) responsible for Fucα(1→2)Galβ synthesis and expression. FUT1 null mice and FUT2 null mice develop normally and exhibit no gross phenotypic abnormalities. The Fucα(1→2)Galβ epitope is absent from the uterine epithelia of FUT2 null mice and from the epithelia of the epididymis of FUT1 null mice. Fully normal fertility is observed in FUT1 null intercrosses and in FUT2 null intercrosses. These observations indicate that Fucα(1→2)Galβ moieties are not essential to blastocyst-uterine epithelial cell interactions required for implantation and are not required for sperm maturation events that permit fertilization and that neither the FUT loci nor their cognate fucosylated glycans are essential to normal development.

scholarly journals A Retrospective Database Analysis of Neonatal Morbidities to Evaluate a Composite Endpoint for Use in Preterm Labor Clinical Trials

2018 ◽  
Vol 08 (01) ◽  
pp. e25-e32 ◽  
Author(s):  
Jeanne Pimenta ◽  
Myla Ebeling ◽  
Timothy Montague ◽  
Kathleen Beach ◽  
Jill Abell ◽  
...  
Keyword(s):  
Clinical Trials ◽  
South Carolina ◽  
Neonatal Mortality ◽  
Preterm Labor ◽  
Length Of Hospital Stay ◽  
Composite Endpoint ◽  
University Of South Carolina ◽  
Neurodevelopmental Impairment ◽  
Clinically Meaningful Outcomes ◽  
Medical University

Objective To propose and assess a composite endpoint (CE) of neonatal benefit based on neonatal mortality and morbidities by gestational age (GA) for use in preterm labor clinical trials. Study Design A descriptive, retrospective analysis of the Medical University of South Carolina Perinatal Information System database was conducted. Neonatal morbidities were assessed for inclusion in the CE based on clinical significance/risk of childhood neurodevelopmental impairment, frequency, and association with GA in a mother–neonate linked cohort, comprising women with uncomplicated singleton pregnancies delivered at ≥24 weeks' GA. Results Among 17,912 mother–neonate pairs, neonates were at a risk of numerous severe but infrequent morbidities. Clinically important, predominantly rare events were combined into a CE comprising neonatal mortality and morbidities, which decreased in frequency with increasing GA. The highest CE frequency occurred at <31 weeks. High frequency of respiratory distress syndrome, bronchopulmonary dysplasia, and sepsis drove the CE. Median length of hospital stay was longer at all GAs in those with the CE compared with those without. Conclusions Descriptive epidemiological assessment and clinical input were used to develop a CE to measure neonatal benefit, comprising clinically meaningful outcomes. These empirical data and CE allowed trials investigating tocolytics to be sized appropriately.

Fetal fibronectin for evaluation of preterm labor in the setting of cervical cerclage

2012 ◽  
Vol 25 (11) ◽  
pp. 2330-2332 ◽  
Author(s):  
James E. Benson ◽  
Helain J. Landy ◽  
Alessandro Ghidini ◽  
Daphnie Drassinower ◽  
Sarah H. Poggi
Keyword(s):  
Preterm Labor ◽  
Cervical Cerclage ◽  
Fetal Fibronectin

scholarly journals Obstetric, maternal, and neonatal outcomes in COVID-19 compared to healthy pregnant women in Iran: a retrospective, case-control study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Seyed-Abdolvahab Taghavi ◽  
Solmaz Heidari ◽  
Shayesteh Jahanfar ◽  
Shakiba Amirjani ◽  
Amireh Aji-ramkani ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Incidence Rate ◽  
Preterm Labor ◽  
Case Control Study ◽  
Case Control ◽  
Neonatal Outcomes ◽  
Obstetric Outcomes ◽  
Premature Delivery ◽  
Maternal And Neonatal Outcomes ◽  
Control Study

Abstract Background The purpose of the present study was to evaluate obstetric, maternal, and neonatal outcomes in COVID-19 compared to healthy pregnant women in Iran. Results A case-control study was conducted on 55 COVID-19 as the case and 55 matched control pregnant women in Hormozgan, Iran. Patients were considered to be cases if they had a positive COVID-19 test plus a positive chest X-ray result. Our measures were COVID-19 symptoms, including laboratory evaluations, clinical symptoms, and maternal and neonatal outcomes. The most prevalent symptoms related to COVID-19 were fever (69.09%) and cough (58.18%). Less common symptoms included fatigue, diarrhea, shortness of breath, sore throat, and myalgia. Hydroxychloroquine/chloroquine (58.18%) and antibiotic therapy (45.45%) were the most prevalent management in COVID-19 patients. Based on our findings, maternal and obstetric outcomes—neonatal in case groups—such as mode of delivery, premature rupture of membrane, postpartum hemorrhage, perineal resection rate, neonates’ birth weight, Apgar score, and neonatal asphyxia rate were similar to pregnant women without COVID-19. We observed a higher incidence rate of premature delivery in COVID-19 cases (25 vs. 10%) (p < 0.05). In the present study, we found that women with COVID-19 had a more than twofold increased odds of preterm labor. History of preterm delivery was also associated with high twofold odds of preterm labor. Conclusion We observed a higher incidence rate of premature delivery in COVID-19 cases. Women with COVID-19 had a more than twofold increased odds of preterm labor. Considering prematurity has high morbidity and is regarded as the primary cause of mortality in children under 5 years old, more case-control studies are needed to ascertain the results.

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