AIMS: To examine the role of Chlamydia trachomatis in ectopic pregnancy by detection of DNA in archival salpingectomy specimens, and in their preceding cervical specimens and endometrial biopsies, by using the polymerase chain reaction (PCR). METHODS: Archival paraffin embedded salpingectomy tissues (n = 48) from 37 women with ectopic pregnancy ...

The reliability of cytology, colposcopy, and directed biopsy were assessed in pregnancy and compared with that observed in a matched non-pregnant control group in order to evaluate the influence of pregnancy. One hundred and seventeen gravidas in which the final pathology could be ascertained and 234 control patients were examined ...

PURPOSE: To assess the implications of spontaneous changes in the length and configuration of the gravid cervix during a single ultrasound (US) examination and to correlate specific cervical dimensions with pregnancy outcome. MATERIALS AND METHODS: Sonograms in 27 pregnant patients with a spontaneously changing cervix were studied prospectively. The length ...

OBJECTIVE: The aim of this study was to use the activity of a leukocyte-specific enzyme, myeloperoxidase, to quantify changes in leukocyte concentration in the ovine cervix during pregnancy. METHODS: Cervical tissue was collected under halothane general anesthesia from 26 sheep at different stages of gestation, in the nonpregnant state, and ...

OBJECTIVE: To study the effects of oral mifepristone and vaginal gemeprost on the mechanical properties of the cervix prior to first trimester termination of pregnancy by vacuum aspiration. DESIGN: A comparative study. Each patient served as her own control. SETTING: The Royal Infirmary of Edinburgh, Scotland, UK. SUBJECTS: Forty nulliparous ...

OBJECTIVE: To describe three cases of cervical pregnancy treated successfully with different conservative methods and review the literature on conservative treatment of cervical pregnancy over the last 30 years. METHODS: Three patients treated conservatively for cervical pregnancy are reported. The literature regarding the conservative management of cervical pregnancy since 1965 ...

Three cases of cervical pregnancy are described: the incidence, the diagnostic approach and different therapeutic managements used for this rare type of ectopic pregnancy are discussed. The last case shows that hysterectomy can be avoided by early diagnosis and by an adequate tamponing technique to control haemorrhage. For this purpose, ...

The uterine cervix is a unique organ composed predominately of the extracellular matrix proteins, collagen, elastin, and glycosaminoglycans. During pregnancy and labor, this organ is metabolically active, which is rare in adult tissue. The metabolism is under reproductive hormonal control and is more complex than previously appreciated. Smooth muscle cells, ...

The treatment of patients with cervical incompetence presenting with advanced cervical changes in the second trimester remains a challenge to every obstetrician. Cerclage operation may be the only hope for prolonging gestation until fetal viability is reached. A retrospective study on so-called emergency cervical cerclage in 20 patients with supposed ...

OBJECTIVE: Our purpose was to review the indications for transabdominal cervicoisthmic cerclage to determine whether it is a valid alternative to transvaginal cerclage. STUDY DESIGN: A retrospective review of transabdominal cerclage patients at one institution from 1978 to 1994, analysis of the indications for the transabdominal rather than the vaginal ...

OBJECTIVE: To determine if large loop excision of the transformation zone affects subsequent fertility and pregnancy outcome. DESIGN: A case-control study. SETTING: A teaching hospital serving a regional population. SUBJECTS: One thousand women who had undergone large loop excision of the transformation zone (LLETZ) for the treatment of cervical intraepithelial ...

The precerclage and postcerclage term delivery rate (TDR), premature delivery rate (PDR) and late abortion rate (LAR) were evaluated in 260 parturients undergoing elective cerclage at 12-16 weeks' gestation. The TDR increased from 0.49 to 0.78, the PDR dropped from 0.35 to 0.18, and the LAR dropped from 0.16 to ...

BACKGROUND: Computerized colposcopy is the noninvasive digital processing of colposcopic images acquired using a charge-coupled device camera. The purpose of this study was to evaluate the clinical applications of computerized colposcopy, and to record the colposcopic changes associated with progression or regression of cervical intraepithelial neoplasia in pregnancy. METHODS: Forty-one ...

BACKGROUND: Villoglandular adenocarcinoma of the cervix is a rare neoplasm associated with a favorable outcome and has not been described as a complication of pregnancy. CASE: A gravida at 20 weeks' gestation was found to have a bulky stage-IB adenocarcinoma of the cervix. She was delivered at 32 weeks' gestation ...

Ultrasonographic evaluation of the cervix in pregnancy has provided some insight into premature delivery and pregnancy wastage. Its use has led to the development of cervical length nomograms in uncomplicated singleton pregnancies and to the realization that varying degrees of cervical incompetence exist. In some instances the internal os has ...

BACKGROUND: Transperineal sonography has been used to detect incompetent cervices, placenta previa, cervical pregnancy, and vaginal and cervical atresia. CASE: Transperineal sonography was used to investigate primary amenorrhea in a 14-year-old girl. A mid-transverse septum was found and confirmed surgically. CONCLUSION: Transperineal or translabial sonography assisted in the differentiation of ...

OBJECTIVE: Our purpose was to investigate the hypothesis that cervical competence is a continuum that is related to cervical length and is reflected by pregnancy history. STUDY DESIGN: A cross-sectional study was performed of cervical length measured by transvaginal ultrasonography in women with prior preterm delivery at < or = ...

Detection of fetal Y-specific DNA by polymerase chain reaction was performed on cervical samplings obtained from 24 patients who underwent first trimester suction termination of pregnancy. The results were compared with the fetal gender determined by Y-sequence polymerase chain reaction on the fetal parts. Fourteen male pregnancies were identified. Correct ...

In specimens taken from the posterior lip of the cervix uteri we determined the collagenase activity and the glycosaminoglycan concentration. In biopsies obtained from the lower uterine segment during cesarian section we measured cytokines (IL-8, IL-2, TNF alpha) and matrix metalloproteinases (MMP-8, MMP-9). We found that the release of collagenases ...

Progressive peripheral neuropathy is an unusual condition in pregnancy requiring specialist opinion to identify the possible underlying pathology. The case presented is that of a patient with cervical intradural lipoma and worsening neurological symptoms, treated surgically at the time of caesarean section. This rare disease and its management are discussed.

In a cohort of 43 women with viable, singleton pregnancies, cervical dilatation greater than 4 cm, and absent labor between 20 and 27 weeks gestation, 22 women who underwent emergency cerclage within six hours of admission, were compared prospectively with 15 women who elected conservative bed rest treatment. The two ...

Because of the uncommon synchronous occurrence of pregnancy and invasive cervical carcinoma, this disease entity remains poorly understood. In addition inconsistent reporting has precluded meaningful meta-analysis. About 1 in 2000 pregnancies are associated with cervical cancer and pregnancy is a complication in approximately 3 percent of patients with cervical cancer. ...

Three cases of cervical pregnancy with different clinical parameters were successfully treated with methotrexate. Case 1 was a viable cervical pregnancy, case 2 was a cervical pregnancy after curettage that developed into a cervical hematoma, and case 3 was a cervical pregnancy at an early gestational age. The interval between ...

OBJECTIVE: The purpose was to determine the concentration of leukocyte elastase and SLPI in the cervical mucus plug, cervical tissue, fetal membranes, amniotic fluid and serum from pregnant women. STUDY DESIGN: Samples were analysed using radioimmunoassay, immunodiffusion, immunohistological and enzyme assay techniques. Statistical comparisons were performed by the Mann-Whitney two-sample ...

Incorporating effective screening into preventive health care for women would theoretically eliminate the diagnosis of cervical cancer in pregnancy. Until this goal is reached, our management decisions are limited by the relatively small and retrospective studies that form the basis for our pertinent knowledge and the ethical issues that would ...

Over the past three years, loop excision has become a standard form of therapy for cervical intraepithelial neoplasia. Clinical trials have found loop excision to be faster and easier than laser ablation for treating cervical intraepithelial neoplasia and to have similar complication and success rates. In addition, loop excision produces ...

Cervical dilatation and softening after pretreatment with mifepristone are well documented. As this effect is similar to that observed after local application of prostaglandin E2 (PGE2) it is tempting to speculate that the effect of mifepristone is mediated via an increase of the endogenous secretion of prostaglandins from the cervical ...

To elucidate the clinical significance of cervical cytology during pregnancy, 7,725 pregnant women were examined. Abnormal cytologic findings were recorded in 65 cases (0.8%). Colposcopically directed punch biopsies revealed cervical dysplasia and carcinoma in 27 cases (0.35%). The incidences in a massive examination for 714,119 women in Osaka Prefecture were ...

OBJECTIVES: To determine the clinical significance of cervical colonization with (Ureaplasma urealyticum (Uu) and its possible relationship to pregnancy outcome. METHODS: Cervical cultures for Uu and serum antibodies to Uu were determined in four groups of pregnant women: (1) 117 women who underwent mid-trimester amniocentesis; (2) 47 women with preterm ...

Carbon dioxide laser conisation is a very reliable surgical technique for cervical intraepithelial dysplasia. As cervical morphology and function are better preserved than with other techniques, obstetrical morbidity should be lower in the often young and pauciparous women who undergo this procedure. In our study comparing the course of 71 ...

OBJECTIVE: To evaluate changes in cervical dimensions by transvaginal ultrasound in non-randomly selected pregnant women. METHODS: This longitudinal study included 154 pregnant women undergoing transvaginal ultrasound assessment of the cervix at a mean gestational age of 12, 16, 20, 25, and 31 weeks. On each occasion, the longitudinal and anteroposterior ...

A study was performed to evaluate the outcome of pregnancies in which the decision was not to repeat cerclage in women with a doubtful indication for the previous one. Thirty-five women with a history of at least one previous McDonald cerclage were followed prospectively. Pregnancy complications and outcome were compared ...

BACKGROUND: The role of cervical cerclage in the prevention of fetal wastage due to cervical incompetence is well established. The transvaginal approach and, failing that, the transabdominal approach, provide sufficient treatment in most cases. However, the traditional techniques require adequate cervical length for placement and maintenance of the suture. CASE: ...

BACKGROUND: Congenital cervical atresia and hypoplasia are rare abnormalities that generally require reconstructive or extirpative procedures to relieve outflow tract obstruction. Infertility is a common sequel, and only four previous pregnancies have been reported. In selected cases, zygote intrafallopian transfer (ZIFT) or other assisted reproductive techniques may offer alternatives for ...

OBJECTIVE: The purpose of this study was to compare the diagnostic performance of ultrasonographic and digital examination of the cervix in the prediction of preterm delivery in patients presenting with preterm labor and intact membranes. STUDY DESIGN: Endovaginal ultrasonography was performed in 59 patients admitted with preterm labor (20 to ...

Preterm delivery is strongly associated with neonatal mortality and morbidity. In some European countries, cervical examinations are used routinely during pregnancy to identify women at risk of preterm delivery. We sought to evaluate the efficacy and secondary effects of these routine cervical examinations. We did a randomised controlled trial in ...

Cervical pregnancy is a rare condition associated with a high maternal morbidity rate. Standard recommendations for the management of this ectopic pregnancy are not available. This paper presents a case report and reviews the respective literature. In many cases hysterectomy was the ultimate solution. In order to avoid hysterectomy chemotherapy ...

Our objective was to determine if any of the following parameters is a predictor of preterm delivery: gestational age, cervical dilatation, or biophysical profile score.Sixty-two women with certain dates, intact membranes, and preterm contractions more frequent than 300 min underwent a 30-min ultrasonographic assessment of fetal breathing movements, fetal tone, ...

OBJECTIVES: To estimate the prevalence of Ureaplasma urealyticum (Uu) and Mycoplasma hominis (Mh) in the lower genital tract of pregnant women, their evolution during pregnancy, and the effect of these pathogens on the outcome of pregnancy in Equatorial Africa. STUDY DESIGN: 218 pregnant women were followed from before 20 weeks ...

PROBLEM: To determine the impact of the presence of antisperm antibodies (ASAs) in the cervical mucus of female partners in couples with unexplained poor postcoital tests (PCT). Furthermore, the efficacy of intrauterine insemination (IUI) in these same patients was determined by pregnancy rates (PRs). METHOD: Pregnancy rates following IUI in ...

A case is described in which a cervical pregnancy followed in vitro fertilization. Treatment was delayed at the request of the patient until the second trimester, and was successfully managed by preoperative bilateral angiographic uterine artery occlusion, surgical evacuation, and postoperative balloon tamponade. Subsequent embryo transfer of previously cryopreserved embryos ...

Eighty-one patients underwent directed biopsy with a large Lin's biopsy forceps during flexible hysteroscopy performed without cervical dilatation or anesthesia. Ninety-seven specimens were obtained, with an average size of 74.5 3(. For control study, 18 women underwent directed biopsy with a small conventional biopsy forceps. Nineteen specimens were obtained, with ...

Cervical pregnancy is rare but one of the most dangerous of all pregnancy complications. The aetiology of cervical implantation is unclear and because of the fear of profuse haemorrhage abdominal hysterectomy has been historically considered the standard therapy. We report here an unusual case of an infertile woman with cervical ...

Megaesophagus was diagnosed in 9 adult ferrets. Clinical history of the ferrets included regurgitation, difficulty in swallowing, partial anorexia, and lethargy. Cachexia, dehydration, weakness, and ptyalism were observed on physical examination. Radiography revealed the esophagus of each ferret to be dilated in the thoracic and cervical regions. Of 4 ferrets ...

Cervical pregnancy is a rare form of EP often resulting in an obstetric catastrophe. We report a case of a combined viable IUP and cervical pregnancy resulting from IVF-ET treatment and which was diagnosed during the 7th week of gestation. Nonsurgical treatment consisting of selective intra-arterial catheterization and administration of ...

PURPOSE: To review experience with early sonographic diagnosis and fertility-preserving treatment of cervical ectopic pregnancy. MATERIALS AND METHODS: The authors evaluated 12 consecutive cases of cervical ectopic pregnancy diagnosed with ultrasound (US) and treated with methods that successfully preserved the uterus. Gestational age, sonographic findings, means of conception, and method ...

This is a report of three cervical pregnancies, one of which was a heterotopic twin cervical pregnancy that occurred in combination with a single intrauterine pregnancy. Transvaginal ultrasound examination was sufficient to establish the diagnosis in two of three patients, and MRI scanning was conclusive in the third. Early diagnosis ...

Two cases of uterine leiomyosarcoma associated with pregnancy are reported. The outcome of the pregnancies were either second-trimester abortion or premature labor. Although the placentas were considered to be complete, both patients had foul-smelling vaginal discharge and tissue mass found at cervical os at the time of presentation. Both were ...

A 28 year old male sustained a cervical spinal cord injury (C5, complete) from a traffic accident and was impotent. He started intracavernous injection therapy, by his partner, of papaverine hydrochloride for impotence, restoring ejaculation. His partner had a successful pregnancy after normal sexual intercourse, and delivered a mature female ...

A 30 year old woman (gravida 4, para 2) presented with 2 1/2 mth amenorrhoea and vaginal spotting. On bimanual pelvic examination, an old tear was felt on posterior cervical lip with enlarged cervix and normal sized uterus. Ultrasonography revealed ectopic pregnancy with placenta implanted on isthmus and upper cervix. ...