For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
13
views
42
references
 Top references
cited by
3
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      426
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Comparative Evaluation of Arabin Pessary and Cervical Cerclage for the Prevention of Preterm Labor in Asymptomatic Women with High Risk Factors

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objective: Preterm labor is one of the most significant obstetric problems associated with high rate of actual and long-term perinatal complications. Despite the creation of scoring systems, uterine activity monitoring, cervical ultrasound and several biochemical markers, the prediction and prevention of preterm labor is still a matter of concern. The aim of this study was to examine cervical findings for the prediction and the comparative use of Arabin pessary or cerclage for the prevention of preterm birth in asymptomatic women with high risk factors for preterm labor. Material and methods: The study group was composed of singleton pregnancies (spontaneously conceived) with high risk factors for preterm labor. Cervical length, dilatation of the internal cervical os and funneling, were estimated with transvaginal ultrasound during the first and the second trimesters of pregnancy. Results: Cervical funneling, during the second trimester of pregnancy, was the most significant factor for the prediction of preterm labor. The use of Arabin cervical pessary was found to be more effective than cerclage in the prolongation of pregnancy. Conclusion: In women at risk for preterm labor, the detection of cervical funneling in the second trimester of pregnancy may help to predict preterm labor and to apply the appropriate treatment for its prevention. Although the use of cervical pessary was found to be more effective than cerclage, more studies are needed to classify the effectiveness of different methods for such prevention.

          Related collections

          Most cited references42

          • Record: found
          • Abstract: found
          • Article: not found

          Preterm delivery.

          Katie Slattery, Liam J. Morrison (2002)
          Preterm delivery and its short-term and long-term sequelae constitute a serious problem in terms of mortality, disability, and cost to society. The incidence of preterm delivery, which has increased in recent years, is associated with various epidemiological and clinical risk factors. Results of randomised controlled trials suggest that attempts to reduce these risk factors by use of drugs are limited by side-effects and poor efficacy. An improved understanding of the physiological pathways that regulate uterine contraction and relaxation in animals and people has, however, helped to define the complex processes that underlie parturition (term and preterm), and has led to new scientific approaches for myometrial modulation. The continuing elucidation of the mechanisms that regulate preterm labour, combined with rigorous clinical assessment, offer hope for future solutions.
          Article 0 comments Cited 151 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Mid-trimester endovaginal sonography in women at high risk for spontaneous preterm birth.

            O Langer, Deanna Swain, Gary Dildy … (2001)
            Although shortened cervical length has been consistently associated with spontaneous preterm birth, it is not known when in gestation this risk factor becomes apparent. To determine whether sonographic cervical findings between 16 weeks' and 18 weeks 6 days' gestation predict spontaneous preterm birth and whether serial evaluations up to 23 weeks 6 days' gestation improve prediction in high-risk women. Blinded observational study performed between March 1997 and November 1999 at 9 university-affiliated medical centers in the United States in 183 women with singleton gestations who previously had experienced a spontaneous birth before 32 weeks' gestation. Certified sonologists performed 590 endovaginal sonographic examinations at 2-week intervals. Cervical length was measured from the external os to the functional internal os along a closed endocervical canal. Funneling and dynamic cervical shortening were also recorded. Spontaneous preterm birth before 35 weeks' gestation, analyzed by selected cutoff values of cervical length. Forty-eight women (26%) experienced spontaneous preterm birth before 35 weeks' gestation. A cervical length of less than 25 mm at the initial sonographic examination was associated with a relative risk (RR) for spontaneous preterm birth of 3.3 (95% confidence interval [CI], 2.1-5.0; sensitivity = 19%; specificity = 98%; positive predictive value = 75%). After controlling for cervical length, neither funneling (P =.24) nor dynamic shortening (P =.054) were significant independent predictors of spontaneous preterm birth. However, using the shortest ever observed cervical length on serial evaluations, after any dynamic shortening, the RR of a cervical length of less than 25 mm for spontaneous preterm birth increased to 4.5 (95% CI, 2.7-7.6; sensitivity = 69%; specificity = 80%; positive predictive value = 55%). Compared with a single cervical measurement at 16 weeks' to 18 weeks 6 days' gestation, serial measurements at up to 23 weeks 6 days significantly improved the prediction of spontaneous preterm birth in a receiver operating characteristic curve analysis (P =.03). Cervical length assessed by endovaginal sonography between 16 weeks' and 18 weeks 6 days' gestation, augmented by serial evaluations, predicts spontaneous preterm birth before 35 weeks' gestation in high-risk women.
            Article 0 comments Cited 52 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Prediction and prevention of recurrent spontaneous preterm birth.

              Catherine Y. Spong (2007)
              Rates of preterm birth have continued to rise despite intensive research efforts over the last several decades. A woman who has a spontaneous preterm birth is at high risk for a subsequent preterm birth. Studies have identified clinical, sonographic, and biochemical markers that help to identify the women at highest risk. Determining cervical length and measuring cervicovaginal fibronectin have been proposed as useful tools for evaluating women at risk of preterm birth and may identify those who might benefit from a timely course of antenatal corticosteroids, but effective interventions to prevent preterm birth remain elusive. In the prevention of recurrent spontaneous preterm birth, recent trials have confirmed the use of progesterone beginning in the second trimester as an effective intervention. Optimal management of women with a history of spontaneous preterm birth includes a thorough review of the obstetric, medical, and social history, with attention to potentially reversible causes of preterm birth (eg, smoking cessation, acute infections, strenuous activities), accurate ultrasound dating, consideration of progesterone therapy beginning at 16-20 weeks of gestation, and close surveillance during the pregnancy for evolving findings. Results from the ongoing trials of cerclage as an interventional therapy and omega-3 fatty acid supplementation as a preventive therapy will provide additional knowledge for the optimal management of these high-risk women.
              Article 0 comments Cited 40 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Environ Res Public Health
                Journal ID (iso-abbrev): Int J Environ Res Public Health
                Journal ID (publisher-id): ijerph
                Title: International Journal of Environmental Research and Public Health
                Publisher: MDPI
                ISSN (Print): 1661-7827
                ISSN (Electronic): 1660-4601
                Publication date (Electronic): 18 April 2018
                Publication date (Print): April 2018
                Volume: 15
                Issue: 4
                Electronic Location Identifier: 791
                Affiliations
                [1 ]Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; gbmaroul@ 123456yahoo.com (V.M.); annachalkidou@ 123456yahoo.gr (A.C.); Dr.dorelia@ 123456hotmail.com (D.D.); xanthi_vatsidou@ 123456hotmail.com (X.A); arzouhalil@ 123456hotmail.com (A.H.B.); ggalaz@ 123456med.duth.gr (G.G.); lola-katerina@ 123456hotmail.gr (L.-K.I.)
                [2 ]Medical Informatics Laboratory, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece; anast@ 123456med.duth.gr (G.A.); tsatsarisg3@ 123456gmail.com (G.T.)
                [3 ]Department of Obstetrics and Gynecology, Rea Hospital, 17564 Athens, Greece; natashabothou@ 123456windowslive.com (A.B.); szervoud@ 123456otenet.gr (S.Z.)
                [4 ]Department of Obstetrics and Gynecology, Technological Educational Institute, 17564 Athens, Greece; giatrakis@ 123456teiath.gr
                [5 ]Department of Obstetrics and Gynecology, Clinicum Aschaffenburg, Teaching Hospital of University, 97070 Würzburg, Germany; drcsorbaroland@ 123456gmail.com (R.C.); buero.teichmann@ 123456gmx.de (A.-T.T.)
                Author notes
                [* ]Correspondence: ptsikour@ 123456med.duth.gr ; Tel.: +30-6974-728-272
                Author information
                https://orcid.org/0000-0001-8026-9795
                Article
                Publisher ID: ijerph-15-00791
                DOI: 10.3390/ijerph15040791
                PMC ID: 5923833
                PubMed ID: 29670041
                SO-VID: c7cd6666-5431-4ddb-99aa-a49ba2f8dc80
                Copyright © © 2018 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 17 March 2018
                Date accepted : 12 April 2018
                Categories
                Subject: Article

                ScienceOpen disciplines: Public health
                Keywords: cervical arabin pessary,cerclage,second trimester of pregnancy
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: cervical arabin pessary, cerclage, second trimester of pregnancy

                Comments

                Comment on this article

                scite_

                Similar content426

                See all similar

                Cited by3

                See all cited by

                Most referenced authors749

                See all reference authors