Recurrence of second trimester miscarriage and extreme preterm delivery at 16-27 weeks of gestation with a focus on cervical insufficiency and prophylactic cerclage

2016 ◽  
Vol 95 (12) ◽  
pp. 1383-1390 ◽  
Author(s):  
Kirstine Sneider ◽  
Ole B. Christiansen ◽  
Iben B. Sundtoft ◽  
Jens Langhoff-Roos
Keyword(s):  
Preterm Delivery ◽  
Cervical Insufficiency ◽  
Second Trimester ◽  
Prophylactic Cerclage

Adjuvant administration of 17-α-hydroxy-progesterone caproate in women with three or more second trimester pregnancy losses undergoing cervical cerclage is no more effective than cerclage alone

2018 ◽  
Vol 46 (2) ◽  
pp. 155-161 ◽  
Author(s):  
Fernand D. Samson ◽  
Amanda L. Merriman ◽  
Danielle L. Tate ◽  
Katherine Apostolakis-Kyrus ◽  
Luis M. Gomez
Keyword(s):  
Perinatal Outcomes ◽  
Cervical Insufficiency ◽  
Second Trimester ◽  
Trimester Pregnancy ◽  
Significant Difference ◽  
Gestational Age At Delivery ◽  
Adverse Neonatal Outcomes ◽  
Second Trimester Pregnancy ◽  
Prophylactic Cerclage ◽  
Hydroxy Progesterone

AbstractObjective:To investigate the role of adjuvant 17-α-hydroxy-progesterone caproate (17OHP-C) in reducing the risk of preterm delivery <34 weeks and adverse perinatal outcomes in women with ≥3 second trimester pregnancy losses attributed to cervical insufficiency undergoing prophylactic cerclage.Material and methods:Retrospective cohort study of women with prophylactic cerclage placed between 2006 and 2014 divided into a cohort of (i) those receiving adjuvant 17OHP-C (n=43), and (ii) controls with cerclage alone (n=59).Results:Demographic characteristics were comparable in both groups. There was no significant difference in gestational age at delivery between the cerclage-17OHP-C group (33.4±5.6 weeks) and the cerclage-alone group (34.4±4.6 weeks); P=0.33. We noted a non-significant increase for deliveries <34 weeks in the cerclage-17OHP-C group (44.2%) compared to controls (28.8%) which remained non-significant after adjusting for confounders; P=0.46. There was no statistically significant difference in the rate of delivery <37, 32, 28 and 24 weeks. Adverse neonatal outcomes were comparable in both groups (cerclage-17OHP-C 48.8% vs. cerclage-alone 39%); P=0.43.Conclusion:Intramuscular 17OHP-C in combination with prophylactic cerclage in women with cervical insufficiency and ≥3 second trimester pregnancy losses had no synergistic effect in reducing the rate of recurrent preterm birth or improving perinatal outcomes.

scholarly journals High Intake of Manganese During Second Trimester, Increases the Risk of Preterm Delivery: A Large Scale Cohort Study

2015 ◽  
Vol 7 (5) ◽  
Author(s):  
Sare Bakouei ◽  
Fatemeh Reisian ◽  
Minoor Lamyian ◽  
Ebrahim Haji Zadeh ◽  
Hadi Zamanian ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Delivery ◽  
Large Scale ◽  
Second Trimester ◽  
High Intake

scholarly journals The role of prophylactic cerclage in preventing preterm delivery after electrosurgical conization

2010 ◽  
Vol 21 (4) ◽  
pp. 230 ◽  
Author(s):  
Mi-Young Shin ◽  
Eun-Sung Seo ◽  
Suk-Joo Choi ◽  
Soo-Young Oh ◽  
Byoung-Gie Kim ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Prophylactic Cerclage

scholarly journals Prevention of preterm delivery in women with multiple pregnancy

2018 ◽  
Vol 22 (1) ◽  
pp. 126-132
Author(s):  
A.V. Tkachenko
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Rating Scale ◽  
Transvaginal Ultrasound ◽  
Multiple Pregnancy ◽  
Clinical Signs ◽  
Cervical Canal ◽  
Cervical Insufficiency ◽  
Cervical Incompetence ◽  
Vaginal Pessary

The objective — to asses the effectiveness of obstetric pessary for cervical incompetence correction in women with multiple pregnancy and infertility in the anamnesis, treated by ART. 30 ART treated pregnant women with infertility in the anamnesis, with dichorionic diamniotic twins (DCDA) were divided into 3 groups, depending on the gestational age when cervical incompetence was diagnosed and vaginal pessary placed: the I group consisted of 5 pregnant women (17%), whom pessary was inserted at 19–22 gestational weeks, the II group included 18 (60.0%) women with correction of cervical insufficiency from 23 to 27 weeks of gestation, the III — 7 (23%) of the patients with pessary implementation in terms of 28–32 gestational weeks. Diagnosis of cervical incompetence was based on the FMF criterias, the Score Rating Scale (Shtember Scale in the modification of G.M. Savelieva) and cervical indices (CI). The sonographic evaluation of cervical insufficiency considered the cervical length (less than 25 mm), opening of the internal os and / or cervical canal (9 mm or more), ICSC>0.22, IPC>0.18 and the Rating Scale score > 5–6 points. With the aim to treat cervical incompetence during pregnancy, silicone vaginal pessary (ASQ, perforated) was used. The cervical assessment by transvaginal ultrasound probe was performed every 2 weeks and evaluated 1 month after correction. The data obtained were processed statistically, using the Microsoft Excel software. The average age of pregnant women was 27.7±2.8 years (28–38 years). Extragenital pathology was determined in 83.3% of women. All pregnant women had infertility in anamnesis, treated by ART, 18 (60%) by standard IVF procedure and 12 (40%) using ICSI method. The number of primiparous and multiparous women was the same. Within pregnancy duration, there were artificial abortions in 8 (53,3%), miscarriages in 7 (46,7%), prematurity in 3 (20,0%) and term delivery in 2 (13,3%) patients in the anamnesis. The current pregnancy was complicated by threatened abortions in all groups, which clinical signs most often occurred within 8–10 and 14–17 weeks of gestation. The average duration of pessary placement in groups was 15.0±1.8; 12.2±1.6 and 4.7±2.1 weeks, respectively. According to ultrasonography evaluation, the visual lengthening of the cervix from 21.6±3.4 mm to 30.2±3.6 mm (p<0,05) were observed in all groups, during the first week of treatment. Preterm delivery occurred in 6 (20%) women, among them before 32 weeks — 3.3%, 32–34 weeks — 10% and in 35–36 weeks — 6.5% of observations. 16.7% of pregnant women had vaginal delivery, 25 (83.3%) underwent Cesarean Section, 76.7% of them had a planned CS. No cases of antenatal or intranatal fetal death happened, as well as newborns with extremely low body weight were not observed in women of all three groups. Results were obtained testify the role of cervical incompetence in the pathogenesis of perinatal losses in women with multiple pregnancy. Evaluation and diagnosis of cervical insufficiency to predict and prevent premature labor in such group of patients should be based on criteria of Fetal Medicine Foundation (FMF), using the method of transvaginal ultrasound cervicometry. An additional calculation of cervical indices may improve the reliability of the prognostic technique. The safety, accessibility and efficacy of obstetric vaginal pessary usage for non-surgical correction of cervical incompetence, as well as absence of severe complications in women with twin pregnancies, have been demonstrated.

scholarly journals Data on clinical significance of second trimester inflammatory biomarkers in the amniotic fluid in predicting preterm delivery

Data in Brief ◽  
2016 ◽  
Vol 9 ◽  
pp. 47-50 ◽  
Author(s):  
Assaad Kesrouani ◽  
Elie Chalhoub ◽  
Elie El Rassy ◽  
Mirna Germanos ◽  
Aline Khazzaka ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Preterm Delivery ◽  
Clinical Significance ◽  
Inflammatory Biomarkers ◽  
Second Trimester

Ultrasonography of the uterine cervix and preterm delivery

1999 ◽  
Vol 11 (1) ◽  
pp. 7-16
Author(s):  
Vilho Hiilesmaa ◽  
Pekka Taipale
Keyword(s):  
Preterm Delivery ◽  
Premature Birth ◽  
Clinical History ◽  
Premature Delivery ◽  
Perinatal Morbidity ◽  
Second Trimester ◽  
Uterine Contractions ◽  
The Past ◽  
Increased Risk ◽  
Digital Evaluation

The incidence of premature delivery (at less than 37 completed weeks) has been stable at between 5–10% of deliveries over the past 20 years despite intensive research in this field. Preterm delivery is a major cause of perinatal morbidity and mortality. The identification of women at increased risk for this condition has traditionally been based on clinical history (e.g. previous premature birth or second-trimester miscarriage), digital evaluation of the cervix and the occurrence of uterine contractions.

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