Metabolites or derivatives of PROGESTERONE with hydroxyl group substitution at various sites.
Compounds that interact with PROGESTERONE RECEPTORS in target tissues to bring about the effects similar to those of PROGESTERONE. Primary actions of progestins, including natural and synthetic steroids, are on the UTERUS and the MAMMARY GLAND in preparation for and in maintenance of PREGNANCY.
The condition of carrying TWINS simultaneously.
A metabolite of PROGESTERONE with a hydroxyl group at the 17-alpha position. It serves as an intermediate in the biosynthesis of HYDROCORTISONE and GONADAL STEROID HORMONES.
Incompetent UTERINE CERVIX is usually diagnosed in the second trimester of PREGNANCY. It is characterized by passive painless cervical dilation in the absence of UTERINE CONTRACTION; BLEEDING; INFECTION; and sometimes with the amniotic sac (AMNIOTIC MEMBRANE) bulging through the partially dilated cervix. Left untreated, this condition may lead to premature pregnancy loss, such as HABITUAL ABORTION.
The neck portion of the UTERUS between the lower isthmus and the VAGINA forming the cervical canal.
The condition of carrying TRIPLETS simultaneously.
A parameter usually used in PRENATAL ULTRASONOGRAPHY to measure the length of the uterine neck (CERVIX UTERI). Cervical length or its shortening is used to identify and prevent early cervical opening and PRETERM BIRTH.
CHILDBIRTH before 37 weeks of PREGNANCY (259 days from the first day of the mother's last menstrual period, or 245 days after FERTILIZATION).
Two individuals derived from two FETUSES that were fertilized at or about the same time, developed in the UTERUS simultaneously, and born to the same mother. Twins are either monozygotic (TWINS, MONOZYGOTIC) or dizygotic (TWINS, DIZYGOTIC).
The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.
A group of inherited disorders of the ADRENAL GLANDS, caused by enzyme defects in the synthesis of cortisol (HYDROCORTISONE) and/or ALDOSTERONE leading to accumulation of precursors for ANDROGENS. Depending on the hormone imbalance, congenital adrenal hyperplasia can be classified as salt-wasting, hypertensive, virilizing, or feminizing. Defects in STEROID 21-HYDROXYLASE; STEROID 11-BETA-HYDROXYLASE; STEROID 17-ALPHA-HYDROXYLASE; 3-beta-hydroxysteroid dehydrogenase (3-HYDROXYSTEROID DEHYDROGENASES); TESTOSTERONE 5-ALPHA-REDUCTASE; or steroidogenic acute regulatory protein; among others, underlie these disorders.
A 21-carbon steroid that is converted from PREGNENOLONE by STEROID 17-ALPHA-HYDROXYLASE. It is an intermediate in the delta-5 pathway of biosynthesis of GONADAL STEROID HORMONES and the adrenal CORTICOSTEROIDS.
Disorders affecting TWINS, one or both, at any age.
The condition of carrying two or more FETUSES simultaneously.
An adrenal microsomal cytochrome P450 enzyme that catalyzes the 21-hydroxylation of steroids in the presence of molecular oxygen and NADPH-FERRIHEMOPROTEIN REDUCTASE. This enzyme, encoded by CYP21 gene, converts progesterones to precursors of adrenal steroid hormones (CORTICOSTERONE; HYDROCORTISONE). Defects in CYP21 cause congenital adrenal hyperplasia (ADRENAL HYPERPLASIA, CONGENITAL).
17,21-Dihydroxypregn-4-ene-3,20-dione. A 17-hydroxycorticosteroid with glucocorticoid and anti-inflammatory activities.
Onset of OBSTETRIC LABOR before term (TERM BIRTH) but usually after the FETUS has become viable. In humans, it occurs sometime during the 29th through 38th week of PREGNANCY. TOCOLYSIS inhibits premature labor and can prevent the BIRTH of premature infants (INFANT, PREMATURE).
A delta-4 C19 steroid that is produced not only in the TESTIS, but also in the OVARY and the ADRENAL CORTEX. Depending on the tissue type, androstenedione can serve as a precursor to TESTOSTERONE as well as ESTRONE and ESTRADIOL.
Two off-spring from the same PREGNANCY. They are from a single fertilized OVUM that split into two EMBRYOS. Such twins are usually genetically identical and of the same sex.
The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated as the time from the last day of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization.
Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; SPONTANEOUS ABORTION; INDUCED ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO.
A metabolite of 17-ALPHA-HYDROXYPROGESTERONE, normally produced in small quantities by the GONADS and the ADRENAL GLANDS, found in URINE. An elevated urinary pregnanetriol is associated with CONGENITAL ADRENAL HYPERPLASIA with a deficiency of STEROID 21-HYDROXYLASE.
Saturated derivatives of the steroid pregnane. The 5-beta series includes PROGESTERONE and related hormones; the 5-alpha series includes forms generally excreted in the urine.
The middle third of a human PREGNANCY, from the beginning of the 15th through the 28th completed week (99 to 196 days) of gestation.
The visualization of tissues during pregnancy through recording of the echoes of ultrasonic waves directed into the body. The procedure may be applied with reference to the mother or the fetus and with reference to organs or the detection of maternal or fetal disease.
A change in the CERVIX UTERI with respect to its readiness to relax. The cervix normally becomes softer, more flexible, more distensible, and shorter in the final weeks of PREGNANCY. These cervical changes can also be chemically induced (LABOR, INDUCED).
A long-acting potent progestogen structurally related to PROGESTERONE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1185)
A term used to describe pregnancies that exceed the upper limit of a normal gestational period. In humans, a prolonged pregnancy is defined as one that extends beyond 42 weeks (294 days) after the first day of the last menstrual period (MENSTRUATION), or birth with gestational age of 41 weeks or more.
Two offspring from the same PREGNANCY. They are from two OVA, fertilized at about the same time by two SPERMATOZOA. Such twins are genetically distinct and can be of different sexes.
A major C19 steroid produced by the ADRENAL CORTEX. It is also produced in small quantities in the TESTIS and the OVARY. Dehydroepiandrosterone (DHEA) can be converted to TESTOSTERONE; ANDROSTENEDIONE; ESTRADIOL; and ESTRONE. Most of DHEA is sulfated (DEHYDROEPIANDROSTERONE SULFATE) before secretion.
Derivatives of caproic acid. Included under this heading are a broad variety of acid forms, salts, esters, and amides that contain a carboxy terminated six carbon aliphatic structure.
A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes, and the genital tract in the male. Common urological problems include urinary obstruction, URINARY INCONTINENCE, infections, and UROGENITAL NEOPLASMS.
A subspecialty of internal medicine concerned with the anatomy, physiology, and pathology of the kidney.
A mutant strain of Rattus norvegicus used in research on renal function and hypertension and as a disease model for diabetes insipidus.
Hospital department responsible for the administration and provision of diagnostic and therapeutic services for the urologic patient.
Component of the NATIONAL INSTITUTES OF HEALTH. It was initially established to investigate the broad aspects of human development as a means of understanding developmental disabilities, including mental retardation, and the events that occur during pregnancy. It now conducts and supports research on all stages of human development. It was established in 1962.
An infant whose weight at birth is less than 1000 grams (2.2 lbs), regardless of GESTATIONAL AGE.
An infant during the first month after birth.
The surgical closure of the incompetent cervix uteri with suture material.
The excision of a cone of tissue, especially of the CERVIX UTERI.
The major progestational steroid that is secreted primarily by the CORPUS LUTEUM and the PLACENTA. Progesterone acts on the UTERUS, the MAMMARY GLANDS and the BRAIN. It is required in EMBRYO IMPLANTATION; PREGNANCY maintenance, and the development of mammary tissue for MILK production. Progesterone, converted from PREGNENOLONE, also serves as an intermediate in the biosynthesis of GONADAL STEROID HORMONES and adrenal CORTICOSTEROIDS.
A nursing specialty concerned with the care provided to cancer patients. It includes aspects of family functioning through education of both patient and family.
Forceful administration into a muscle of liquid medication, nutrient, or other fluid through a hollow needle piercing the muscle and any tissue covering it.
A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine.
A human infant born before 37 weeks of GESTATION.
The mass or quantity of heaviness of an individual at BIRTH. It is expressed by units of pounds or kilograms.
The repetitive uterine contraction during childbirth which is associated with the progressive dilation of the uterine cervix (CERVIX UTERI). Successful labor results in the expulsion of the FETUS and PLACENTA. Obstetric labor can be spontaneous or induced (LABOR, INDUCED).
Drugs that prevent preterm labor and immature birth by suppressing uterine contractions (TOCOLYSIS). Agents used to delay premature uterine activity include magnesium sulfate, beta-mimetics, oxytocin antagonists, calcium channel inhibitors, and adrenergic beta-receptor agonists. The use of intravenous alcohol as a tocolytic is now obsolete.
Premature separation of the normally implanted PLACENTA from the UTERUS. Signs of varying degree of severity include UTERINE BLEEDING, uterine MUSCLE HYPERTONIA, and FETAL DISTRESS or FETAL DEATH.
Artificially induced UTERINE CONTRACTION. Generally, LABOR, OBSTETRIC is induced with the intent to cause delivery of the fetus and termination of pregnancy.
INFLAMMATION of the placental membranes (CHORION; AMNION) and connected tissues such as fetal BLOOD VESSELS and UMBILICAL CORD. It is often associated with intrauterine ascending infections during PREGNANCY.
Comparison of a novel test for placental alpha microglobulin-1 with fetal fibronectin and cervical length measurement for the ... During pregnancy their mother had pre-eclampsia, requiring birth by caesarean section. The larger twin left the hospital at the ... Progestogens-often given in the form of vaginal progesterone or hydroxyprogesterone caproate-relax the uterine musculature, ... A cervical length of less than 25 mm at or before 24 weeks of gestational age is the most common definition of cervical ...
In these women, if the transvaginal ultrasound cervical length shortens to < 24 weeks, cervical cerclage may be offered. In the ... Johnson JW, Austin KL, Jones GS, Davis GH, King TM (October 1975). "Efficacy of 17alpha-hydroxyprogesterone caproate in the ... "Pharmacokinetics of Hydroxyprogesterone Caproate and its Primary Metabolites during Pregnancy". AJP Reports. 8 (2): e106-e112. ... However, in women pregnant with twins rather than a singlet, the elimination half-life of OHPC was found to be shorter than ...
Plasma progesterone, estradiol, and unconjugated estriol concentrations in twin pregnancies: Relation to cervical length and ... alpha-hydroxyprogesterone caproate (17P) in the treatment of preterm delivery. Treatment with progesterone is emergin... ... cervical length and preterm delivery in twin pregnancies, including the effect of progesterone treatment. ... 5-alpha-dihydroprogesterone. A biologically active 5-alpha-reduced metabolite of plasma PROGESTERONE. It is the immediate ...
These findings need to be confirmed in future prospective trials of women with a twin pregnancy and a short cervical length. ... All twin gestations with a cervical length ,20 mm prior to 28 weeks of gestation were included. All twins received vaginal ... Cervical length of 2287 women was measured of which 137 had a sonographic cervical length ,25 mm. These women were randomly ... either in unselected twin gestations, twins with a shortened cervical length, or symptoms of PTL. When confronted more acutely ...
These findings need to be confirmed in future prospective trials of women with a twin pregnancy and a short cervical length. ... All twin gestations with a cervical length Grantz, KL, Grewal, J, Albert, PS. "Dichorionic twin trajectories: the NICHD Fetal ... Cervical length of 2287 women was measured of which 137 had a sonographic cervical length Fox, NS, Gupta, S, Lam-Rachlin, J. " ... either in unselected twin gestations, twins with a shortened cervical length, or symptoms of PTL. When confronted more acutely ...
Pregnancy; Pregnancy, Twin; Premature Birth; Progesterone; Progestins; Treatment Outcome. ISSN:. 1097-6868. Full metadata ... We sought to evaluate in women with twin gestation the relationship between 17-hydroxyprogesterone caproate (17-OHPC) ... We sought to evaluate in women with twin gestation the relationship between 17-hydroxyprogesterone caproate (17-OHPC) ... Effect of 17-alpha hydroxyprogesterone caproate on cervical length in twin pregnancies.Authors: Lim AC, Schuit E, Papatsonis D ...
Twin Pregnancy * Pregnancy * Cervical Length Measurement * Multiple Pregnancy 11 Citations (Scopus) * 2013 ... Van Der Pol, M., Currie, G., Kromm, S. & Ryan, M., Mar 2014, In: Value in Health. 17, 2, p. 297-301 5 p.. Research output: ... Effect of 17-alpha hydroxyprogesterone caproate on cervical length in twin pregnancies. Lim, A. C., Schuit, E., Papatsonis, D ... 17, p. 6528 1 p.. Research output: Contribution to journal › Comment/debate › peer-review ...
... hydroxyprogesterone caproate for the prevention of preterm birth in women with prior preterm birth and a short cervical length ... The studies included data on a total of 775 women, 723 (93%) with singleton pregnancies and 52 (7%) with twin pregnancies. A ... Alpha Hydroxyprogesterone. Crinone®. Hydroxyprogesterone, 17a-. Hylutin®. Makena. Prochieve®. Prodrox. The use of specific ... cervical length ≤ 25 m) in the mid-trimester and are pregnant with twins (Romero, 2017). Two independent reviewers selected ...
Deruelle recommends that women who know they are pregnant with twins get an ultrasound to measure their cervical length, as ... Home Pregnancy Test. A home pregnancy test is a test done to find out if one is pregnant or not in the relative comforts of the ... "We found that 17P was not effective in women with twin pregnancies and a short cervix (defined as less than 25 mm between 24 ... Progesterone Shots Do Not Positively Impact Preterm Delivery in Twin Pregnancies. by Savitha C Muppala on February 14, 2013 at ...
Gestational age at delivery [ Time Frame: Length of pregnancy ]. *Placement of cervical cerclage [ Time Frame: During pregnancy ... Drug Information available for: Hydroxyprogesterone Hydroxyprogesterone caproate U.S. FDA Resources Arms and Interventions ... Twin-twin transfusion syndrome [ Time Frame: During pregnancy ]. *Birth weight and degree of birth weight discordance [ Time ... Twin or triplet pregnancy. Quadruplets reduced to triplets may be included, but no other prior reductions. ...
... of women with cervical length between 15 and 25 mm did not deliver before 35 weeks, as well as approximately 70 % with cervical ... whose pregnancies reached term as compared to fifty randomly sampled pregnancies (n = 50) complicated by spontaneous preterm ... Romero R. Progesterone to prevent preterm birth in twin gestations: what is the next step forward? BJOG. 2013;120:1-4.View ... Does midtrimester cervical length ≥25 mm predict preterm birth in high-risk women? Am J Obstet Gynecol. 2010;203(393):e1-5. ...
The effect of prenatal vaginal progesterone on cervical length in nonselected twin pregnancies. ... OBJECTIVES: To compare pregnancy outcomes of physical examination-indicated cerclage in twin pregnancies with acute cervical ... www.readbyqxmd.com/read/29117757/the-effect-of-prenatal-vaginal-progesterone-on-cervical-length-in-nonselected-twin-pregnancies ... short cervical length (CL), multiple pregnancies, ethnicity, smoking, uterine anomaly and history of curettage or cervical ...
Deruelle recommends that women who know they are pregnant with twins get an ultrasound to measure their cervical length, as ... Tags: 17p, multiple birth, Pregnancy, premature birth, prematurity, preterm delivery, progesterone, short cervix, twins. Posted ... "We found that 17P was not effective in women with twin pregnancies and a short cervix (defined as less than 25 mm between 24 ... We cant assume that what works for singleton pregnancies will work with multiples such as twins or triplets," says Edward R. B ...
"Effectiveness of cerclage according to severity of cervical length shortening: a meta-analysis". Ultrasound Obstet Gynecol. vol ... Unfortunately, prior to pregnancy, there are no good tests to assess the strength, competence or ability of the cervix to ... "Cervical length screening with ultrasound-indicated cerclage compared with history-indicated cerclage for prevention of preterm ... A better definition should be a short cervical length (CL) less than 25 mm measured by transvaginal ultrasound (TVU) before 24 ...
Women who have had a preterm birth in a previous pregnancy, have short cervical length, or are carrying twins or triplets are ... Progesterone is not the same as 17alpha-hydroxyprogesterone caproate: implications for obstetrical practice. Am J Obstet ... progestins/ or 20-alpha-dihydroprogesterone/ or algestone/ or algestone acetophenide/ or allylestrenol/ or desogestrel/ or ... a multiple gestation pregnancy, a short cervical length, or a positive fetal fibronectin test at randomization. Trials of ...
Serial cervical length determination in twin pregnancies reveals 4 distinct patterns with prognostic significance for preterm ... Cerclage, progesterone andα-hydroxyprogeterone caproate treatment in women at risk for preterm delivery ... Do serial measurements of cervical length improve the prediction of preterm birth in asymptomatic women with twin gestations? ... Keywords: Cervical cerclage; cost-effective analysis; infant mortality; pessary; pregnancy; prematurity; respiratory distress ...
If a pregnant woman has a history of premature birth, the physician should begin carefully monitoring her cervical length with ... Research: Vaginal Progesterone Can Reduce Preterm Birth Risk in Individuals with Twin Pregnancies ... birth of a single baby or twins) in the past, progesterone therapy is usually started around 16 - 20 weeks of pregnancy, ... In later pregnancy, progesterone helps the breasts get ready to create milk for the baby, and it helps the lungs work harder to ...
Johnson, J. W., Austin, K. L., Jones, G. S., Davis, G. H., and King, T. M. Efficacy of 17alpha-hydroxyprogesterone caproate in ... Facchinetti, F., Paganelli, S., Comitini, G., Dante, G., and Volpe, A. Cervical length changes during preterm cervical ripening ... El-refaie W, Abdelhafez MS, Badawy A. Vaginal progesterone for prevention of preterm labor in asymptomatic twin pregnancies ... Vanselow, W., Dennerstein, L., Greenwood, K. M., and de, Lignieres B. Effect of progesterone and its 5 alpha and 5 beta ...
... α-hydroxyprogesterone caproate on glucose intolerance in pregnancy," Obstetrics and Gynecology, vol. 114, no. 1, pp. 45-49, ... Other studies involving shortened cervical length in an index pregnancy also give consideration for prophylactic vaginal ... When compared with controls, neither singleton nor twin gestations revealed greater incidences of gestational diabetes, 5.8 ... alpha-Hydroxyprogesterone Caproate. Robert Egerman,1 Risa Ramsey,2 Niki Istwan,3 Debbie Rhea,3 and Gary Stanziano3 ...
Twin pregnancies discordant for single umbilical artery. Byers, B. D., Saade, G. R. & Harirah, H. M., Jun 1 2013, In: Journal ... Using cervical length measurement for lower spontaneous preterm birth rates among women with threatened preterm labor. Chiossi ... Weight gain in early, mid, and late pregnancy and hypertensive disorders of pregnancy. Dude, A. M., Kominiarek, M. A., Haas, D ... Tolosa, J. E. & Saade, G., Jan 1 2015, Protocols for High-Risk Pregnancies: An Evidence-Based Approach: Sixth Edition. Wiley ...
Twin pregnancies discordant for single umbilical artery. Byers, B. D., Saade, G. R. & Harirah, H. M., Jun 1 2013, In: Journal ... Using cervical length measurement for lower spontaneous preterm birth rates among women with threatened preterm labor. Chiossi ... Weight gain in early, mid, and late pregnancy and hypertensive disorders of pregnancy. Dude, A. M., Kominiarek, M. A., Haas, D ... Zika Virus and Pregnancy: A Review of the Literature and Clinical Considerations. Marrs, C., Olson, G., Saade, G., Hankins, G ...
It is known to have a higher incidence in twin pregnancies as well as being higher in I ... Twin pregnancies are increasing. Preterm birth is a major health problem with high incidence all over the world. ... even in the setting of a normal cervical length [35]. Serial cervical length measurements in twin pregnancies, is recommended ... Prediction of spontaneous preterm delivery in twin pregnancies by cervical length at mid-gestation. Twin Res Hum Genet. 2008;11 ...
... will prolong pregnancy and thereby reduce neonatal morbidity. Double-blind, placebo-controlled randomized clinical trial. Women ... The primary outcome was the rate of continuing the pregnancy until 34.0 weeks of gestation or until documentation of fetal lung ... We sought to test the hypothesis that a weekly dose of 17-hydroxyprogesterone caproate (17P) given to women with preterm ... Facchinetti F, Paganelli S, Comitini G, Dante G, Volpe A: Cervical length changes during preterm cervical ripening: effects of ...
Second trimester cervical length and risk of preterm birth in women with twin gestations treated with 17hydroxyprogesterone ... A normal cervix is about 25-60 mm long outside of pregnancy and up to 28 weeks of gestation. After 28 weeks, even women ... caproate". J Matern Fetal Neonat Med. 2010. pp. e1-5. SMFM, Berghella. "Progesterone and preterm birth prevention: translating ... "Universal cervical-length screening to prevent preterm birth: a cost-effectiveness analysis". Ultrasound Obstet Gynecol. vol. ...
Instead, monitoring of cervical length and therapeutic cerclage if needed is recommended. Interestingly, a study on women with ... Certain women are also predisposed to premature delivery: those with twin/triplet ie. multiple pregnancies, women with previous ... Click here for pregnancies in the presence of intrauterine adhesions (synechiae). Cervical incompetence/insufficiency. Cervical ... Cervical incompetence may be managed with bed rest and cervical cerclage (9). Cerclage is a cervical stitch sewn to prevent the ...
The role of cervical length assessment to aid prediction of preterm labor in asymptomatic patients continues to be evaluated; ... As in twin pregnancies, chorionicity is assigned following visualization of the twin peak or lambda sign, the thickness of the ... If the pregnancy is further complicated by a monochorionic pair, weekly surveillance for twin to twin transfusion syndrome is ... While some argue that the morbidity gap is closing between twin and triplet pregnancies and that reduction of triplets to twins ...
The cumulative crude pregnancy rates, withdrawal rates, and adjusted pregnancy rates are similar to cohort studies of ART based ... The mean length of time that couples had attempted to conceive before NPT treatment was 5.6 years (range, 1 to 20 years). ... Among all live births observed, there were 13 twin births (4.6%) and no higher order births. At least 88% of all births were to ... Improvement of cervical factor with guaifenesin. Fertil Steril 1982; 37: 707-8. ...
The cumulative crude pregnancy rates, withdrawal rates, and adjusted pregnancy rates are similar to cohort studies of ART based ... The mean length of time that couples had attempted to conceive before NPT treatment was 5.6 years (range, 1 to 20 years). ... Among all live births observed, there were 13 twin births (4.6%) and no higher order births. At least 88% of all births were to ... Improvement of cervical factor with guaifenesin. Fertil Steril 1982; 37: 707-8. ...
... in singleton pregnancies are a history of preterm birth and a short cervical length noted in the midtrimester of pregnancy. The ... similar results have been noted in women with a twin gestation and a short cervix). Data supporting the efficacy of cerclage ... which noted benefits of cerclage in patients with singleton pregnancies, history of preterm birth, and a short cervical length. ... Cervical cerclage for singleton pregnant patients on vaginal progesterone with progressive cervical shortening. 08nov2018 ...
Cerclage in Twin Pregnancies Reduces Perinatal Mortality * Tissue-Engineered Uterus Supports Normal Pregnancy, Live Birth in ... Rates of recurrent preterm birth by obstetrical history and cervical length. Am J Obstet Gynecol. 2005 Sep. 193(3 Pt 2):1170-4 ... CL, cervical length; PTB, preterm birth; 17P, 17-alpha-hydroxy-progesterone caproate; TVT, transvaginal ultrasound. Reprinted ... Ross MG, Cousins L, Baxter-Jones R, Bemis-Heys R, Catanzarite V, Dowling D. Objective cervical portio length measurements: ...
SMFM, McIntosh J, Feltovich H, Berghella V, Manuck T. The role of routine cervical length screening in selected high and low- ... Twin pregnancy*BMI ,18.5 kg/m2 (underweight) - no recommendation due to insufficient data ... The quad screen involves measurement of four components of maternal serum: (1) hCG, (2) alpha fetoprotein (AFP), (3) dimeric ... Appropriate weight gain in pregnancy is based on pre-pregnancy BMI, which is calculated by taking weight (kg)/height (m2). The ...
It typically presents as acute, painless dilatation of the cervix, which can lead to a midtrimester pregnancy loss. ... as the inability of the uterine cervix to retain a pregnancy in the second trimester, in the absence of uterine contractions. ... Cervical insufficiency is defined by the American College of Obstetricians and Gynecologists (ACOG) ... Ultrasonographic transvaginal measurement of cervical length - Cervical length has a strong inverse correlation with the risk ...
  • Progesterone therapy as a technique to prevent preterm labor is considered not medically necessary in pregnant women who do not meet the above criteria, or those with other risk factors for preterm delivery in the current pregnancy, including, but not limited, to: multiple gestation pregnancy, cervical cerclage, a uterine anomaly, positive tests for cervicovaginal fetal fibronectin or preterm labor. (cchmedicalpolicies.com)
  • The role of cervical cerclage to prevent preterm birth (PTB) remains controversial. (readbyqxmd.com)
  • Some women may be able to receive progesterone treatment or cerclage in their next pregnancy to reduce their chances of giving birth early again. (marchofdimes.org)
  • These women may be better served by cervical cerclage, while progesterone does not seem to be very effective at prevention of PTB once the cervix is open all the way from internal to external os. (clinicaladvisor.com)
  • Prophylactic cerclage for prevention of preterm birth in twins resulted in an increase of the incidence of preterm birth. (springer.com)
  • Cervical incompetence may be managed with bed rest and cervical cerclage (9). (blogspot.com)
  • Cerclage is a cervical stitch sewn to prevent the cervix from opening and it may be placed vaginally or abdominally. (blogspot.com)
  • Therapeutic cerclage is used when the cervix is showing signs that it is dangerously shortened ( under 2cm) or funneling, however it is not always effective at this stage and pregnancy loss may still occur. (blogspot.com)
  • Instead, monitoring of cervical length and therapeutic cerclage if needed is recommended. (blogspot.com)
  • Randomized controlled trials (RCTs) and systematic reviews with meta-analyses have shown that either vaginal progesterone administration or the placement of a cervical cerclage reduce preterm births and improve perinatal outcomes. (fmfla.org)
  • Lack of evidence from direct comparisons between vaginal progesterone and cervical cerclage make it difficult for obstetricians to choose the most effective treatment for patients at risk of preterm birth. (fmfla.org)
  • A systematic review with meta-analysis indirectly comparing vaginal progesterone and cervical cerclage for the prevention of preterm birth and adverse perinatal outcomes was published in 2013 by Conde-Agudelo et al. (fmfla.org)
  • A randomized controlled trial of cervical scanning vs history to determine cerclage in women at high risk of preterm birth (CIRCLE trial). (medscape.com)
  • According to a 2014 practice bulletin from the ACOG concerning the management of cervical insufficiency, cervical cerclage, in which a stitch is placed at the cervicovaginal junction, may benefit women with a history of cervical insufficiency or painless cervical dilatation in the second trimester on physical examination. (medscape.com)
  • Moreover, cerclage is not recommended for twin pregnancies with a short cervix, as this has been associated with an increased risk for preterm birth. (medscape.com)
  • Although cervical cerclage has long been the focus of treatment, several studies support the use of progesterone supplementation in women at risk for preterm delivery. (medscape.com)
  • 2 To be succinct: progesterone is back, cervical length is hot, and cerclage is still unclear. (contemporaryobgyn.net)
  • Practice bulletin no. 142: cerclage for the management of cervical insufficiency. (medscape.com)
  • Outcomes With Cerclage Alone Compared With Cerclage Plus 17α-Hydroxyprogesterone Caproate. (uab.edu)
  • Can the optimal cervical length for placing ultrasound-indicated cerclage be identified? (uab.edu)
  • 24 weeks, cervical cerclage may be offered. (wikipedia.org)
  • Possibly a more specific diagnosis of cervical incompetence can be made by witnessing incompetence in evolution, an indication for emergent cerclage that will be covered in a later section. (glowm.com)
  • The available clinical trial data do not suggest a benefit from prophylactic cerclage, and so these women may be followed-up clinically for evidence of premature cervical changes. (glowm.com)
  • Women with a previous cervical surgery and spontaneous midtrimester loss, suggesting a clinical diagnosis of incompetence, should be considered for prophylactic cerclage in future pregnancies. (glowm.com)
  • We found that 17P was not effective in women with twin pregnancies and a short cervix (defined as less than 25 mm between 24 and 32 weeks)," says Philippe Deruelle, MD, with the Department of Obstetrics and Gynecology at H pital Jeanne de Flandre, Universit Lille 2, France, and one of the study's authors. (medindia.net)
  • For the study reported in the abstract, entitled: Prevention of preterm delivery by 17 alpha-hydroxyprogesterone caproate in asymptomatic twin pregnancies with a short cervix: a randomized controlled trial, Deruelle and his colleagues conducted their trial on 165 women over the age of 18 at 10 university hospitals between June 2006 and January 2010. (medindia.net)
  • Cervical insufficiency (CI) refers to a condition in which the uterine cervix is weak, and because of this characteristic a woman can experience a pregnancy loss in the second or early third trimester. (oncologynurseadvisor.com)
  • Unfortunately, prior to pregnancy, there are no good tests to assess the strength, competence or ability of the cervix to retain the conceptus in uterus until term. (oncologynurseadvisor.com)
  • Most commonly, it is due to significant prior cervical surgery, which has damaged the features that give strength and consistency to the cervix. (oncologynurseadvisor.com)
  • There is no evidence that 17-α-hydroxyprogesterone caproate can reduce the rate of preterm delivery in women with a short cervix, and therefore, the compound of choice is natural progesterone (not the synthetic progestin). (degruyter.com)
  • Routine assessment of the risk of preterm birth with cervical ultrasound coupled with vaginal progesterone for women with a short cervix is cost-effective, and the implementation of such a policy is urgently needed. (degruyter.com)
  • An abnormally short cervix may open too early in pregnancy, and it is the biggest risk factor for premature birth. (abclawcenters.com)
  • A normal cervix is about 25-60 mm long outside of pregnancy and up to 28 weeks of gestation. (clinicaladvisor.com)
  • One of these is cervical insufficiency (CI), i.e. the presence of a weak cervix not strong enough to keep the conceptus in the uterus until the third trimester (see Cervical Insufficiency chapter). (clinicaladvisor.com)
  • This would include multiple D&Es, major excisional cervical procedures (e.g. cold knife cone, multiple LEEPs, etc.) or other procedures on the cervix that can cause major trauma to its connective tissue (see CI chapter). (clinicaladvisor.com)
  • In these women, the cervix may appear visually open, with the possibility of fetal membranes prolapsing to a level past the internal os, and even past the external cervical os. (clinicaladvisor.com)
  • Cervical incompetence or insufficiency is when the involuntary muscle of the cervix is structurally weak and unable to sustain the weight of the growing fetus. (blogspot.com)
  • Cervical incompetence is associated with AS although it is thought to result not from having had scarring but rather as a consequence of frequent dilations of the cervix during procedures such as D&C and hysteroscopy- which itself is used to correct AS. (blogspot.com)
  • The less widely and less often the cervix is dilated, the better, as frequent dilations of over 8mm put women at an increased risk of cervical incompetence in subsequent pregnancies. (blogspot.com)
  • Interestingly, a study on women with short cervix during pregnancy (under 1.5 cm measured around 22 weeks of gestation) found that progesterone supplementation reduced spontaneous delivery before 34 weeks compared to placebo (25). (blogspot.com)
  • The current practice in the United States is to offer 17-alpha hydroxyprogesterone caproate to patients with a history of preterm birth, and vaginal progesterone to patients with a short cervix. (fmfla.org)
  • The length of the cervix and the risk of spontaneous premature delivery. (medscape.com)
  • Ross MG, Cousins L, Baxter-Jones R, Bemis-Heys R, Catanzarite V, Dowling D. Objective cervical portio length measurements: consistency and efficacy of screening for a short cervix. (medscape.com)
  • Cervical insufficiency (cervical incompetence) is defined by the American College of Obstetricians and Gynecologists (ACOG) as the inability of the uterine cervix to retain a pregnancy in the second trimester, in the absence of uterine contractions. (medscape.com)
  • [ 1 ] It typically presents as acute, painless dilatation of the cervix, which can lead to a midtrimester pregnancy loss. (medscape.com)
  • Clinical predictors of PTB in 2012 are similar to those mentioned in the 2001 practice bulletin: prior PTB, smoking, vaginal bleeding during index pregnancy, and short cervix. (contemporaryobgyn.net)
  • There are at least 2 randomized trials of women with singleton pregnancies with a demonstrated short cervix in the second trimester who, when randomized to vaginal progesterone supplementation, had a significantly lower risk of PTB. (contemporaryobgyn.net)
  • Cervical damage from trauma may be visible or palpable on a careful examination of the cervix before or during the early part of pregnancy and, if detected, should be managed with surgical repair if associated with a previous poor obstetric history or if the defect is believed to involve the internal cervical os. (glowm.com)
  • This document addresses the use of intramuscular injections of 17-alpha hydroxyprogesterone caproate and vaginal progesterone for the prevention of preterm delivery in high-risk individuals. (cchmedicalpolicies.com)
  • This protocol outlines a randomized trial of 630 women evaluating the use of micronized vaginal progesterone or pessary versus control (placebo) to prevent early preterm birth in women carrying twins and with a cervical length of less than 30 millimeters. (stanford.edu)
  • A better definition should be a short cervical length (CL) less than 25 mm measured by transvaginal ultrasound (TVU) before 24 weeks in women with singletons gestations and with a prior preterm birth (PTB) before 37 weeks, or other significant cervical risk factors for CI such as significant cervical surgery (see below). (oncologynurseadvisor.com)
  • Women who have had a preterm birth in a previous pregnancy, have short cervical length, or are carrying twins or triplets are at greater risk of having a preterm birth. (biomedcentral.com)
  • Two important risk factors that significantly increase the risk of preterm birth in singleton pregnancies are a history of preterm birth and a short cervical length noted in the midtrimester of pregnancy. (fmfla.org)
  • A short cervical length, which is typically defined as less than 25 mm, has been consistently associated with an increased risk for preterm birth, regardless of other risk factors. (medscape.com)
  • [ 30 ] However, the presence of funneling does not add appreciably to prediction of the risk for preterm delivery with a short cervical length. (medscape.com)
  • For women without a history of preterm delivery, the American College of Obstetricians and Gynecologists (ACOG) recommends transabdominal cervical length assessment at the time of the fetal anatomical survey (between 18 and 22 weeks' gestation), followed by transvaginal measurement if a short cervical length is suspected. (medscape.com)
  • The management of these high risk pregnancies irrespective of the mode of conception is a common challenge in modern obstetrics. (clinicalpainadvisor.com)
  • The American Congress of Obstetricians and Gynecologists (ACOG) defines CI as painless cervical dilatation leading to recurrent second trimester losses (STLs). (oncologynurseadvisor.com)
  • In women with prolapsed membranes and/or cervical dilatation not only of the internal but also of the external os, the risk of PTB is much higher. (clinicaladvisor.com)
  • [ 37 ] Its use is limited to women with a gestational age between 22 and 34 weeks, as long as fetal membranes are intact and cervical dilatation is less than 3 cm. (medscape.com)
  • In contrast to false labour, true labor is accompanied by cervical dilatation and effacement. (wikipedia.org)
  • Certain lifestyle approaches, such as activity restriction, bed rest, and pelvic rest, have not been shown to be effective and thus, should not be used to treat cervical insufficiency. (medscape.com)
  • The diagnosis of cervical insufficiency is either based on a history of midtrimester pregnancy loss or a combination of clinical presentation, physical examination, and sonographic measurement of cervical length. (medscape.com)
  • The primary outcome was the rate of continuing the pregnancy until 34.0 weeks of gestation or until documentation of fetal lung maturity at 32.0 to 33.9 weeks of gestation. (beds.ac.uk)
  • With PROM before 32 weeks of gestation, the morbidity of PTB is high, so attempts to prolong the pregnancy are generally advocated [ 1 , 2 ], a strategy called "expectant management. (beds.ac.uk)
  • The majority of ultrasound-diagnosed placenta previa cases in twin pregnancies resolve by 32 weeks of gestation. (lww.com)
  • The goal of early prenatal care has moved past reliably identifying a twin gestation. (renalandurologynews.com)
  • Early diagnosis of the correct type of twin gestation is necessary in order to counsel the patient effectively regarding her specific risks. (renalandurologynews.com)
  • in that group of women, more than one third of twins were not diagnosed until after 26 weeks' gestation and almost 10% were not diagnosed until labor. (renalandurologynews.com)
  • Although the RADIUS trial was not powered to identify significant differences in the multiple gestation subgroup, it revealed an almost 50% reduction in composite adverse perinatal outcomes among the twins routinely screened. (renalandurologynews.com)
  • To distinguish a single monochorionic placenta from a fused dichorionic placenta, the presence of a "twin peak" or lambda sign will identify the dichorionic gestation virtually 100% of the time. (renalandurologynews.com)
  • Relationship between 17-hydroxyprogesterone caproate concentrations and gestational age at delivery in twin gestation. (lenus.ie)
  • We sought to evaluate in women with twin gestation the relationship between 17-hydroxyprogesterone caproate (17-OHPC) concentration and gestational age at delivery and select biomarkers of potential pathways of drug action. (lenus.ie)
  • Pharmacokinetics of 17-hydroxyprogesterone caproate in multifetal gestation. (lenus.ie)
  • Given this dramatic benefit and the extremely high risk of preterm birth in women with multifetal gestation, a trial to evaluate the benefit of progesterone in women with multifetal pregnancy is appropriate and timely. (clinicaltrials.gov)
  • This protocol outlines a randomized, double-masked clinical trial comparing weekly treatment by injection of 17 alpha-hydroxyprogesterone caproate (17P) with placebo in women with twin or triplet gestation. (clinicaltrials.gov)
  • This trial aims to enroll six hundred women with twin gestation and one hundred twenty women with triplet gestation between 16 weeks 0 days to 20 weeks 6 days. (clinicaltrials.gov)
  • The American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal Fetal Medicine Publications Committee suggest offering 17- alpha -hydroxyprogesterone caproate (17OHPC) administration to women with a singleton gestation having a history of a preterm birth [ 1 ]. (hindawi.com)
  • If a patient's prior delivery was a spontaneous PTB (delivery initiated by spontaneous rupture of membranes or preterm labor) and her current pregnancy is singleton, then she should be offered progesterone supplementation from 16 to 24 weeks until 34 to 37 weeks' gestation. (contemporaryobgyn.net)
  • In asymptomatic women with a prior preterm birth, serial transvaginal cervical length screening is typically performed starting at 16 weeks' gestation and is repeated every 2 weeks until 26-28 weeks' gestation. (medscape.com)
  • Major morbidity in these pregnancies is attributable the high rate of preterm births and extreme low birth weight (ELBW). (clinicalpainadvisor.com)
  • It was formerly called cervical incompetence, a term which should no longer be used. (oncologynurseadvisor.com)
  • Because cervical incompetence is a clinical diagnosis, the diagnosis is usually retrospective and made only after poor obstetric outcomes have occurred (or rarely, are in evolution). (glowm.com)
  • The physician managing a patient who experiences a spontaneous midtrimester birth is in the optimal position to assess whether the typical clinical criteria for cervical incompetence were present. (glowm.com)
  • Because cervical incompetence is a retrospective diagnosis and depends on a history of untoward outcomes, clinicians have sought criteria that might lead to a prospective and more objective diagnosis. (glowm.com)
  • In women considered to be at risk for cervical incompetence, based on an atypical history or because of other identified risk factors, serial examinations may be performed to detect progressive shortening and dilation, leading to a presumptive diagnosis of incompetence that may be amenable to therapeutic intervention. (glowm.com)
  • While the historic concept of the diagnosis and treatment of cervical incompetence often includes women with past cervical trauma from birth-associated lacerations, forced dilation, operative injury, or cervical amputation, the prevalence of these antecedent events appears to be decreasing in contemporary practice. (glowm.com)
  • A similar controversy arises over the management of women with in utero diethylstilbestrol (DES) exposure: should the finding of abnormal cervical or should uterine anatomy confirm a diagnosis of cervical incompetence in the absence of a typical history? (glowm.com)
  • Both an analysis of the clinical history and consideration of various coexistent risk factors for cervical incompetence require considerable judgment on the part of the managing physician, because highly specific and practical objective tests to confirm the diagnosis have not been developed. (glowm.com)
  • Unfortunately, clinical assessments are often subject to highly individualized interpretation and, not surprisingly, different clinicians might reasonably disagree over the diagnosis and management in all but the most classic presentations of cervical incompetence. (glowm.com)
  • Because the diagnosis of cervical incompetence has been determined primarily from past reproductive performance and physical examination findings, the obvious limitations associated with the clinical diagnosis have prompted the search for sensitive and specific tests that could be applied in a prospective manner to women deemed at risk for cervical incompetence, thus obviating the need for recurrent pregnancy loss. (glowm.com)
  • According to the FDA label, Makena (hydroxyprogesterone caproate injection) is "A progestin indicated to reduce the risk of preterm birth in women with a singleton pregnancy who have a history of singleton spontaneous preterm birth" defined as delivery before 37 weeks of pregnancy. (cchmedicalpolicies.com)
  • Hydroxyprogesterone caproate (OHPC), sold under the brand names Proluton and Makena among others, is a progestin medication which is used to prevent preterm birth in pregnant women with a history of the condition and to treat gynecological disorders. (wikipedia.org)
  • Prediction of preterm birth in twins through transvaginal cervical length measurement and vaginal fetal fibronectin measurement are good and well-documented methods. (springer.com)
  • Crane JM, Hutchens D. Transvaginal sonographic measurement of cervical length to predict preterm birth in asymptomatic women at increased risk: a systematic review. (medscape.com)
  • Precocious cervical ripening as a screening target to predict spontaneous preterm delivery among asymptomatic singleton pregnancies: a systematic review. (uab.edu)
  • Management of PROM involves a weighing of risks of prematurity complications versus risks of prolonging the pregnancy, such as chorioamnionitis, placental abruption, or cord prolapse. (beds.ac.uk)
  • Triplet pregnancies have significantly higher risks than twins or singletons for most maternal and neonatal complications. (clinicalpainadvisor.com)
  • 6 - 9 The most prominent concerns relate to the incidence of multiple pregnancies with ART treatment and the subsequent perinatal complications, including low birth weight and prematurity. (jabfm.org)
  • Lykke JA, Paidas MJ, Langhoff-Roos J. Recurring complications in second pregnancy. (medscape.com)
  • It is an opportunity to perform risk stratification in the hope of avoiding pregnancy complications for a variety of medical and obstetric conditions, including fetal growth restriction, red cell alloimmunization, depression, and HIV infection. (glowm.com)
  • His interests include maternal medical and surgical complications of pregnancy and prenatal diagnosis. (stanford.edu)
  • This was a case-control study of women with singleton pregnancy, who presented between 24+0 and 26+6 weeks with threatened preterm labor and intact membranes. (readbyqxmd.com)
  • We sought to test the hypothesis that a weekly dose of 17-hydroxyprogesterone caproate (17P) given to women with preterm rupture of the membranes (PROM) will prolong pregnancy and thereby reduce neonatal morbidity. (beds.ac.uk)
  • Effacement (shortening and thinning of the cervical walls) occurs prematurely and in the absence of contractions, resulting in bulging of the amniotic membranes, leading to rupture and premature birth. (blogspot.com)
  • Gomez R, Romero R, Medina L, Nien JK, Chaiworapongsa T, Carstens M. Cervicovaginal fibronectin improves the prediction of preterm delivery based on sonographic cervical length in patients with preterm uterine contractions and intact membranes. (medscape.com)
  • In the evaluation of preterm premature rupture of membranes, placental alpha-microglobulin-1 is the most cost-effective test strategy in resource-limited settings. (lww.com)
  • [ 36 ] When considering women with an intermediate cervical length (between 15 and 30 mm), combining cervical length assessment with fetal fibronectin testing may be particularly useful. (medscape.com)
  • Prevention of preterm birth by administration of vaginal natural progesterone or IM synthetic progesterone injections is not effective in twins. (springer.com)
  • However, reliable early detection of twins requires a policy of routine first trimester ultrasound to confirm plurality, viability, and gestational age. (renalandurologynews.com)
  • Prior to the widespread use of diagnostic ultrasound, more than 50% of twins were not diagnosed until the onset of labor, and in 30% the second twin was not discovered until after the delivery of the first twin. (renalandurologynews.com)
  • However, despite these increased difficulties, the "twin-peak" sign remains highly reliable, and using a composite of available ultrasound findings, it is still possible to differentiate Di/Di from Mono/Di twin sets in over 90% of cases. (renalandurologynews.com)
  • Dr. Deruelle recommends that women who know they are pregnant with twins get an ultrasound to measure their cervical length, as this factor has shown to predict which women with twins are at higher risk for premature pregnancy. (medindia.net)
  • Transvaginal ultrasound (TVU) cervical length (CL) is a screening test for prediction of preterm birth (PTB). (clinicaladvisor.com)
  • Transvaginal ultrasound (TVU) cervical length (CL) is one of the best screening tests for prediction of preterm birth (PTB). (clinicaladvisor.com)
  • Triplet pregnancies are diagnosed prenatally with ultrasound. (clinicalpainadvisor.com)
  • Women known to be carrying triplets should be offered first trimester ultrasound when the crown-rump length measures from 45mm to 84mm (at approximately 11 weeks 0 days to 13 weeks 6 days) to estimate gestational age, determine chorionicity and screen for aneuploidy. (clinicalpainadvisor.com)
  • A pregnancy without an ultrasound examination that confirms or revives the EDD before 22 + 0/7 weeks of gestational age should be considered suboptimally dated. (glowm.com)
  • Cervical length measurements were all performed with transvaginal ultrasound in the second trimester. (contemporaryobgyn.net)
  • Twinning can be suspected in a variety of clinical situations, such as a uterine size greater than dates, maternal hyperemesis, positive personal or family history, significantly elevated beta human chorionic gonadotropin (hCG), or pregnancy as a result of assisted reproduction. (renalandurologynews.com)
  • PST, at the Society for Maternal-Fetal Medicine's 33rd annual meeting, The Pregnancy Meeting , researchers will report findings that suggest that 17P, a form of progesterone, is not effective in preventing preterm birth among women with twin pregnancies and may possibly be harmful. (medindia.net)
  • Cervical length, full blood count, C-reactive protein and maternal demographics were recorded at presentation. (readbyqxmd.com)
  • We examined maternal factors influencing the development of gestational diabetes (GDM) in obese women receiving 17- alpha -hydroxyprogesterone caproate (17OHPC) for preterm delivery prevention. (hindawi.com)
  • Retrospectively identified were 899 singleton pregnancies with maternal prepregnancy body mass indices of ≥30 kg/m 2 enrolled for either 17OHPC weekly administration (study group) or daily uterine monitoring and nursing assessment (control group). (hindawi.com)
  • Concurrently, there has been significant increase in pregnancies in women of advanced maternal age. (clinicalpainadvisor.com)
  • Multiple maternal serum analyte screening for neural tube defects or trisomy 21 is not available for triplet pregnancies. (clinicalpainadvisor.com)
  • The use of OHPC in pregnancy to prevent preterm birth in women with a history of preterm delivery between 20 weeks and 36 weeks and 6 days is supported by the Society of Maternal Fetal Medicine Clinic Guidelines put out in May 2012 as Level I and III evidence, Level A recommendation. (wikipedia.org)
  • Purpose: The Heart and Pregnancy Program (HPP) was created to evaluate and manage pregnant women with cardiac conditions simultaneously by cardiology and maternal-fetal medicine (MFM). (bvsalud.org)
  • 2 However, they did not mandate universal cervical length screening but said it can be considered and gave that statement a level B recommendation. (contemporaryobgyn.net)
  • Revisiting the cost-effectiveness of universal cervical length screening: importance of progesterone efficacy. (uab.edu)
  • To evaluate the effectiveness and safety of cervical pessaries for the prevention of preterm birth. (readbyqxmd.com)
  • however, this technique can provide early diagnosis to high risk patients who are planning multifetal pregnancy reduction based on karyotype results. (clinicalpainadvisor.com)
  • The canine species is naturally multiparous, but the diagnosis of monochorionic twin pregnancy is not common. (bvsalud.org)
  • Therefore, ultrasonographic exam during pregnancy allows an early monochorionic diagnosis and monitoring the fetal viability could bring health benefits to both the female and the littermates. (bvsalud.org)
  • Because there are few proven objective criteria, other than a rare, gross cervical malformation, a careful history and review of the past obstetric records are crucial to making an accurate diagnosis. (glowm.com)
  • Anembryonic sacs are frequently misdiagnosed as "vanishing twins" when they actually represent such things as subchorionic hemorrhage, cystic fibroids, endometrial polyps, or excessive transducer pressure on the uterus. (renalandurologynews.com)
  • When the fertilization of the ovum occurs in a place other than the uterus, the condition is called ectopic pregnancy. (medindia.net)
  • Progesterone is also necessary for implantation of the fertilized egg in the uterus and for maintaining pregnancy. (webmd.com)
  • Some reports have linked significant trauma during delivery (e.g., cervical lacerations) to subsequent development of CI. (oncologynurseadvisor.com)
  • Two decision and economic analyses have concluded that cervical length screening and subsequent treatment with progesterone in appropriate women are cost-effective. (contemporaryobgyn.net)
  • Predictive Value of Initial Cervical Length for Subsequent Cervical Length Shortening in Women with a Prior Preterm Birth. (uab.edu)
  • 37 weeks) and at least one subsequent pregnancy resulting in a singleton live birth. (bmj.com)
  • The loop electrosurgical excision procedure is not associated with an increased risk of cesarean delivery in a subsequent pregnancy. (lww.com)
  • A prolonged second stage of labor may increase the risk of cervical injury that, in turn, may be associated with increased risk of spontaneous preterm delivery in the subsequent pregnancy. (bvsalud.org)
  • Progesterone might be beneficial after PROM both because it tends to promote uterine quiescence by suppressing the formation of myometrial gap junctions and because it has anti-inflammatory properties, suppressing the production of inflammatory cytokines and thereby inhibiting cervical ripening. (bioportfolio.com)
  • It is produced in the ovaries, and thickens the uterine lining after each ovulation in preparation for a potential pregnancy. (abclawcenters.com)
  • Even in the presence of uterine contractions, preterm birth is unlikely to occur with a cervical length of greater than 30 mm. (medscape.com)
  • All twin gestations should now be further defined as being either dichorionic or monochorionic due to the different risks experienced by the separate twin types. (renalandurologynews.com)
  • CI refers in general to pregnancies carrying singleton gestations. (oncologynurseadvisor.com)
  • Although most triplet pregnancies arise from three different oocytes, monozygotic gestations can also occur. (clinicalpainadvisor.com)
  • There is an increased risk of aneuploidy in triplet pregnancy especially in the setting of multizygotic gestations. (clinicalpainadvisor.com)
  • Preterm birth was reduced by 35% among progesterone-treated women with a singleton pregnancy when compared with women receiving placebo. (clinicaltrials.gov)
  • The current trial compares weekly treatment by injection of progesterone with placebo in women pregnant with twins or triplets. (clinicaltrials.gov)
  • Three clinical studies in singleton pregnancies of 250 mg/week of intramuscular OHPC have all shown a trend for an increase in pregnancy loss due to miscarriage compared to placebo. (wikipedia.org)
  • It is thought that the increased rate of second trimester pregnancy loss in women with past AS is due to CI. (blogspot.com)
  • According to the division of Vital Statistics of the National Centers for Health Statistics, the United States national twin birth rate reached an all time high of 33.9 per 1000 live births (3.4%) in 2014. (renalandurologynews.com)
  • Among non-Hispanic black mothers the twin birth rate is 40 per 1000 live births.The risk attributable to this rising twin birth rate cannot be overstated. (renalandurologynews.com)
  • This research finding is valuable because it will guide the care of women with a multi-fetal pregnancy, and highlights the need to better understand how to prevent preterm births for multiples. (medindia.net)
  • Twins constitute 2-4 % of all births, and the rate of twining has increased by 76 % between 1980 and 2009. (springer.com)
  • Reference 1) ,The natural incidence of spontaneous triplet pregnancy conception is estimated to be approximately 1 per 6,000-8,000 births and the remainder are attributable to childbearing at older ages and availability of fertility therapies and assisted reproductive techniques (ART). (clinicalpainadvisor.com)
  • Among live births, there were 4.6% twin births. (jabfm.org)
  • For this type of progesterone treatment, progesterone 17-alpha-hydroxyprogesterone caproate (progesterone 17 P) is given to the mother every week by injecting it into a muscle. (abclawcenters.com)
  • The Women's and Children's Health Division of Alere provides comprehensive home-based services to pregnant women throughout the United States who have medical or pregnancy-related problems that could harm their pregnancies including preterm labor, gestational diabetes, hypertensive conditions, coagulation disorders, and nausea and vomiting in pregnancy. (hindawi.com)
  • [ 38 ] Several studies have demonstrated the utility of fFN testing, in addition to cervical length assessment, with a significant improvement in the prediction of preterm delivery in women with a positive fFN and a cervical length less than 30 mm. (medscape.com)
  • Inflammation is a major pathway leading to preterm labor, cervical dilation & preterm delivery. (bioportfolio.com)
  • Possibilities for prevention of CI include the reduction/replacement of D&C with drugs or expectant management, the use of smaller instruments necessitating less dilation during hysteroscopic surgery (11), and the use of misoprostol for cervical priming (instead of mechanical force for dilation). (blogspot.com)
  • Obstetric care and surgical technique have improved, clinicians recognize the importance of gradual cervical dilation before curettage, and cervical amputation is rarely performed. (glowm.com)
  • We don't always know what causes premature birth, but we do know that if you've had a premature baby in the past, you're at increased risk of having a premature birth in another pregnancy. (marchofdimes.org)
  • If not treated, it can cause serious problems during pregnancy, including premature birth. (marchofdimes.org)
  • Some experts recommend using this therapy if the mother is pregnant with twins and had a premature birth in the past. (abclawcenters.com)
  • Gestational age at initiation of 17-alpha hydroxyprogesterone caproate and recurrent preterm birth. (lenus.ie)
  • 17-alpha Hydroxyprogesterone caproate did not reduce the rate of recurrent preterm birth in a prospective cohort study. (lenus.ie)
  • Rates of recurrent preterm birth by obstetrical history and cervical length. (medscape.com)
  • This analysis referred to pregnant women with singleton/multiple viable fetus/fetuses, with or without cervical pessary placement. (readbyqxmd.com)
  • While 17P (17 alpha-hydroxyprogesterone caproate) has been shown to prevent premature delivery among about one-third of women with a singleton pregnancy who have experienced a prior preterm delivery, this latest research shows that 17P prescriptions can't do the same for moms having twins, the authors say. (medindia.net)
  • NT measurements are distributed in the same manner as a singleton pregnancy. (clinicalpainadvisor.com)
  • [ 2 , 3 ] Cervical effacement appears to begin at the internal os and proceed caudally, with the appearance of a funnel-shaped opening at the internal os ("funneling"), which results in progressive shortening of the cervical canal. (medscape.com)
  • 17α-hydroxyprogesterone caproate for the prevention of adverse neonatal outcome in multiple pregnancies: a randomized controlled trial. (medscape.com)
  • [ 32 ] Although a 2013 Cochrane review did not find sufficient evidence to recommend routine cervical length screening for all pregnant women, the ACOG acknowledges that this screening strategy may be considered. (medscape.com)
  • 140/90 mmHg) compared ACOG- recommended standard during pregnancy (no treatment unless BP is severe) is effective and safe. (stanford.edu)
  • Women pregnant with twins or triplets are at high risk of preterm birth, yet no intervention or approach has served to reduce this risk. (clinicaltrials.gov)
  • one in every 7 couples hoping to have a baby experiences difficulties achieving or maintaining pregnancy serious enough to seek medical intervention. (jabfm.org)
  • The only screening tools that identify women who are at risk of spontaneous PTB and for whom we have an intervention that reduces that risk are obtaining a history of previous spontaneous PTB and second-trimester cervical length screening. (contemporaryobgyn.net)
  • In total, around 45 clinical trials have studied the use of progestogen in these types of pregnancies. (biomedcentral.com)
  • Preterm labor prevention and management, preeclampsia prevention and treatment, short and long-term impact of surgical techniques at cesarean, depression during pregnancy, fetal heart rate monitoring and long-term neurologic outcome, randomized clinical trials. (stanford.edu)
  • Injections of 17 alpha-hydroxyprogesterone caproate in a home setting by or through a licensed home health agency are considered not medically necessary, except when criteria for home health services are met (see CG-MED-23 Home Health). (cchmedicalpolicies.com)
  • In the past, intramuscular injections (IM) of 17 alpha-hydroxyprogesterone, (that is, Delalutin) were used to prevent the onset of premature labor. (cchmedicalpolicies.com)
  • The strategy of continuing the pregnancy is commonly called "expectant management. (bioportfolio.com)
  • Attempts to prolong the pregnancy with expectant management of PROM are often unsuccessful. (beds.ac.uk)
  • Early assignment of nomenclature to each fetus (for example, upper and lower, or left and right) should be documented clearly to ensure consistency throughout the pregnancy. (clinicalpainadvisor.com)