Gestational age at previous preterm birth does not affect cerclage efficacy. (25/47)

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Endocervical hyaluronan and ultrasound-indicated cerclage. (26/47)

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Does midtrimester cervical length >/=25 mm predict preterm birth in high-risk women? (27/47)

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Cervical funneling: effect on gestational length and ultrasound-indicated cerclage in high-risk women. (28/47)

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Association between second-trimester cervical length and spontaneous preterm birth in twin pregnancies. (29/47)

OBJECTIVE: The purpose of this study was to define normal second-trimester cervical length (CL) measurements and to estimate the association between second-trimester CL and spontaneous preterm birth (SPTB) in twin pregnancies. METHODS: A retrospective cohort of 309 asymptomatic patients with twin pregnancies who had routine outpatient CL assessment in the second trimester was studied. We looked at the gestational age periods of 16 to 17 6/7, 18 to 19 6/7, 20 to 21 6/7, and 22 to 23 6/7 weeks. We estimated the association between the CL measurement during each period and SPTB. A short CL was defined both as a CL at or below the 10th percentile for gestational age and 25 mm or less. We also performed regression analyses controlling for a number of clinically important factors: maternal age, chorionicity, in vitro fertilization, multifetal reduction, prior term births, prior preterm births, prepregnancy body mass index, and cerclage. RESULTS: The CL measurement at 16 to 17 6/7 weeks was not associated with gestational age at delivery or SPTB. At 18 to 19 6/7 and 20 to 21 6/7 weeks, the CL measurement was not significantly associated with gestational age at delivery or SPTB before 28 and 32 weeks. There was an association with SPTB before 35 weeks. At 22 to 23 6/7 weeks, the CL measurement had a significant association with gestational age at delivery and SPTB before 28, 32, and 35 weeks (P < .05). A short CL at 22 to 23 6/7 weeks was significantly associated with SPTB before 32 and 35 weeks (P < .05). CONCLUSIONS: In second-trimester twin pregnancies, the strongest association between CL and SPTB is at 22 to 23 6/7 weeks.  (+info)

Effects of uterine cervix constriction on Wistar rats. (30/47)

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Characteristics associated with severe perineal and cervical lacerations during vaginal delivery. (31/47)

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The clinical significance of digital examination-indicated cerclage in women with a dilated cervix at 14 0/7-29 6/7 weeks. (32/47)

OBJECTIVE: This study was to compare pregnancy outcomes between cerclage and expectant management in wemen with a dilated cervix. DESIGN: Retrospective multicenter cohort study. SETTING: Five hospitals of Catholic University Medical Center Network in Korea. POPULATION: A total of 173 women between 14 0/7 and 29 6/7 weeks' gestation with cervical dilation of 1 cm or greater by digital examination. METHODS: Pregnancy outcomes were compared according to cerclage or expectant management, with the use of propensity-score matching. MAIN OUTCOME MEASURES: Primary outcome was time from presentation until delivery (weeks). Secondary outcomes were gestational age at delivery, neonatal survival, morbidity, preterm birth, and so on. RESULTS: Of 173 women, 116 received a cerclage (cerclage group), and 57 were managed expectantly without cerclage (expectant group). Cervical dilation at presentation, and the use of amniocentesis performed to exclude subclinical chorioamnionitis differed between two groups. In the overall matched cohort, there was significant difference in the time from presentation until delivery (cerclage vs. expectant group, 10.6+/-6.2 vs. 2.9+/-3.2 weeks, p <0.0001). While there was no significant difference in the neonatal survival between two groups, there were lower neonatal morbidity as well as higher pregnancy maintenance rate at 28, 32, 34 and 37 weeks' gestation in the cerclage group, compared with the expectant group. CONCLUSION: This study suggests that digital examination-indicated cerclage appears to prolong gestation and decrease neonatal morbidity, compared with expectant management in women with cervical dilation between 14 0/7 and 29 6/7 weeks.  (+info)