The purpose of this study was to evaluate the delivery of alendronate, calcitonin, and osteoprotegerin (OPG) through human dentin by both diffusion and iontophoresis for the potential treatment of invasive cervical resorption. Radiolabeled alendronate, calcitonin, and OPG were added to the top of a split chamber device that contained 1-mm ...

A cervical varix during pregnancy is a very rare complication. It can lead to hemorrhage and may result in significant morbidity. Furthermore, appropriate management has not yet been established. We present a case of a cervical varix with placenta previa totalis. A 30-year-old woman with placenta previa totalis also had ...

Cervical remodeling during pregnancy and parturition is a single progressive process that can be loosely divided into four overlapping phases termed softening, ripening, dilation/labor, and post partum repair. Elucidating the molecular mechanisms that facilitate all phases of cervical remodeling is critical for an understanding of parturition and for identifying processes ...

Blue rubber bleb nevus syndrome (BRBNS) is a rare disorder showing venous malformations in the skin and gastrointestinal tract, and other internal organs. We encountered a patient with BRBNS in whom hemangiomas of the uterine cervix appeared during pregnancy. This was apparently the first reported occurrence. To avoid unexpected bleeding ...

OBJECTIVE: To describe treatment of an intractable cervical pregnancy that failed intracervical Foley catheter tamponade and uterine artery embolization followed by curettage of gestational tissue. DESIGN: Case report. SETTING: Tertiary-care university hospital. PATIENT(S): A 37-year-old infertile woman who achieved an 8-week cervical pregnancy after IVF-ET. INTERVENTION(S): Temporary intraoperative balloon occlusion ...

BACKGROUND: The incidence of cervical cancer in pregnancy is estimated to be 1-10/10000 pregnancies. Approximately 3% of cervical cancers are diagnosed during pregnancy. The incidence of abnormal Pap smears has been reported to be 5%-8%. Data on the spontaneous evolution of an intraepithelial neoplasia during pregnancy are quite diverse. Of ...

STUDY OBJECTIVE: To report the evolution and outcome of 12 cases of cervical pregnancy. DESIGN: Retrospective study (Canadian Task Force classification II-3). SETTING: University teaching hospitals. PATIENTS: Twelve women with cervical pregnancy. INTERVENTIONS: Methotrexate, uterine artery embolization, curettage, ligation of the descending branch of uterine vessels, or hysterectomy. MEASUREMENTS AND ...

OBJECTIVES: To assess the efficacy of a Shirodkar cervical suture in arresting hemorrhage following surgical removal of a Cesarean scar ectopic pregnancy. METHODS: The study included women with an ultrasound diagnosis of Cesarean scar ectopic pregnancy who were scheduled for surgical evacuation. After administration of general anesthetic, a Shirodkar cervical ...

This study was conducted to explore the value of transvaginal ultrasonographic cervical length measurement, in addition to gestational age, maternal age, parity, Bishop score, and weight of the newborn, in predicting the mode of delivery in pregnancies in which labor is induced with oxytocin at or beyond the 40th gestational ...

The objective of this study is to describe magnetic resonance (MR) signal intensity (SI) changes in the cervix during pregnancy. This is an observational cohort study of women with a history of preterm delivery. MR imaging sequences were performed every 3 to 4 weeks. Using 8 regions of interest, the ...

Cervical insufficiency with dilation can be associated with amniotic fluid microbial invasion. Cerclage placement in the presence of infection is contraindicated because it is associated with poor fetal and maternal outcome. A 30-year-old gravida 4 para 0 with cervical insufficiency had emergent cervical suture placement at 19 weeks. The patient ...

OBJECTIVE: To present a case of a simultaneous nonviable cervical pregnancy and viable intrauterine pregnancy diagnosed in the 13th gestational week and to discuss the possible therapeutic options. DESIGN: Case report. SETTING: University hospital of Münster, Germany. PATIENT(S): A 40-year-old woman who had undergone IVF-embryo transfer because of previous surgical ...

OBJECTIVE: To study endogenous sialidase activity in genital tract secretions of pregnant and nonpregnant women. DESIGN: Laboratory study. SETTING: Department of Evolutionary Biology and Department of Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy. INTERVENTION(S): Vaginal and cervical mucus samples were obtained from pregnant and nonpregnant women in different ...

BACKGROUND: A 28-year-old Hispanic gravida 1 was found to have a 4-5 cm cervical mass when she presented at 23 weeks gestation. On pelvic examination, the tumor was shown to encompass the entire circumference of the cervix without parametrial or vaginal involvement. A biopsy of the mass revealed a poorly ...

Although it was devised over 50 years ago, only recently controlled randomized trials have evaluated the efficacy of cervical cerclage. Cerclage was originally devised for women with both prior preterm birth (PTB) and cervical changes in the current pregnancy. Evidence suggests that transvaginal cerclage probably prevents second trimester loss/PTB in ...

OBJECTIVE: The aim of this study was to assess the role of cervical length measurement in predicting successful treatment, by misoprostol administration, of early (first-trimester) pregnancy failure. METHOD: A prospective study was conducted of all patients who agreed to medical treatment of pregnancy failure. Cervical length and other sonographic variables ...

OBJECTIVE: The purpose of this study was to visualize and quantify dynamic changes in the cervix and to study factors influencing cervical length. METHODS: Eighteen women with a gestational age between 23 and 40 weeks were examined by transvaginal ultrasound during a continuous observation period of 30 minutes. RESULTS: All ...

The purpose of this study is to determine the effectiveness of fetal fibronectin (FFN) compared to assessment of cervical dilation (CD) in clinical management of women with symptomatic preterm labor (PTL). Pregnant women presenting to Thomas Jefferson University Hospital between May 1, 2001 and November 30, 2002 with symptomatic PTL ...

PROBLEM: Data regarding cervical interleukin 18 (IL-8) and IL-10 concentrations during pregnancy is limited. METHOD OF STUDY: This was a cross sectional study of healthy pregnant women. Specimens were collected from the cervical os secretions. IL-8 and IL-10 levels were measured by using enzyme-linked immunosorbent assay. Median (range) cytokine concentrations ...

The cervix maintains the fetus in situ during pregnancy and dilates during labour to allow delivery of the baby. Congenital or iatrogenically-induced structural abnormalities of the cervix are associated with an increased risk of preterm birth. The role of cervical infection is less clear. Cervical studies may be useful in ...

After randomization of subfertile couples with an isolated cervical factor to intrauterine insemination for 6 months or expectant management for 6 months, 26 women (51%) vs. 16 women (33%) conceived, respectively. Of these pregnancies, 22 (43%) vs. 13 (27%) were ongoing (relative risk, 1.6; 95% confidence interval, 0.91 to 2.8). ...

BACKGROUND: Cervical incompetence can lead to the inability to sustain an intrauterine pregnancy and may account for a substantial portion of second-trimester losses. Placement of a transvaginal cerclage has been shown to decrease morbidity in a substantial number of such cases. In patients lacking sufficient cervical tissue, a cerclage may ...

OBJECTIVE: The purpose of this study was to evaluate whether 17-alpha-hydroxyprogesterone caproate (17P) treatment affect changes in cervical length. STUDY DESIGN: Women with singleton pregnancy, between 25 and 33 + 6 weeks of gestation, who were hospitalized for preterm labor were included. Patients with rupture of membranes and/or signs of ...

Maternal group B streptococcal infection is an uncommon entity. Herein we describe a case of a 27-year-old-woman who presented life-threateniing group B streptococcus meningitis with an ectopic cervical pregnancy. No other infectious focus have been found. To our knowledge this is the first time that this association has been reported.

OBJECTIVE: To describe our experience with sonographically guided injection of methotrexate and potassium chloride (KCl) to treat early cervical pregnancy. METHODS: We prospectively reviewed all cases of cervical pregnancies treated conservatively through transvaginal ultrasound-guided therapy at our institutions. Thirty-eight cases were identified, from 1993 through 2004. All cases were managed ...

OBJECTIVE: To evaluate the efficacy of cervical length measurement in combination with a bedside assessment of phosphorylated insulin-like growth factor-binding protein-1 (phIGFBP-1) as a predictor of preterm delivery in asymptomatic pregnant women with a history of preterm birth. METHODS: Cervical length was measured using transvaginal sonography at 22-24 weeks of ...

Cervical weakness and infection have long been regarded as major causes of preterm birth. Cervical cerclage has been used extensively to reduce the risk of preterm birth arising as a result of cervical weakness, but increasing evidence suggests that the cervix plays more than just a mechanical role. Immunological function ...

OBJECTIVE: To report a case of successful treatment of heterotopic cervical pregnancy resulting from IVF-embryo transfer. DESIGN: Case report. SETTING: Tertiary university clinical center. PATIENT(S): A 31-year-old patient, treated for heterotopic cervical pregnancy, diagnosed in the 6th gestational week. INTERVENTION(S): Transvaginal ultrasound-guided aspiration of cervical pregnancy and instillation of hypertonic ...

We report a case of cervical dystonia occurring in a 33-year-old without personal history of movement disorder but with family history of essential tremor, primigravid, primiparous woman at 1 weeks' amenorrhea, resolved completely after delivery in the course of 3 months. Dystonia never recurred in the following 5 years. Several ...

The uterine cervix has to provide mechanical resistance to ensure a normal development of the fetus. This is guaranteed by the composition of its extracellular matrix, which functions as a fiber-reinforced composite. At term a complex remodeling process allows the cervical canal to open for birth. This remodeling is achieved ...

OBJECTIVE: To determine the effectiveness of an electronic hormonal fertility monitor plus cervical mucus monitoring to avoid pregnancy. DESIGN: A 12-month prospective clinical efficacy trial. SETTING AND PARTICIPANTS: One hundred ninety five (195) women (mean age 29.8 years) seeking to avoid pregnancy with a natural method at 5 clinical sites ...

The aim of this audit was to evaluate the efficacy of cervical preparation with Dilapan dilators prior to late second-trimester surgical termination of pregnancy. The first audit cycle showed that after cervical preparation consisting of one or two Dilapan dilators, with or without misoprostol, on the day before or the ...

OBJECTIVE: To investigate cervical epithelial leukocyte sub-populations in pregnant women with a history of idiopathic preterm labour. METHODS: A prospective observational study was undertaken of 106 women with a past history of idiopathic preterm delivery following spontaneous labour. A cytobrush was used to sample the epithelium of the cervix at ...

BACKGROUND: Cervical pregnancy, an uncommon variety of ectopic gestation is associated with high morbidity and adverse consequences for future fertility. Currently there are no specific recommendations for the best treatment of this entity. CASE: A 35-year-old nullipara presented with 8 weeks of amenorrhea and painless brown discharge. The patient was ...

BACKGROUND: Women with a history of pregnancy loss in the second trimester are often diagnosed with cervical insufficiency and are treated with cervical cerclage. We present an unusual complication of this procedure that mimicked preterm rupture of membranes. CASE: A 38-year-old woman with a history of cervical conization, loss of ...

This study was done to evaluate transvaginal ultrasonographic measurement of cervical length at 20 to 24 weeks and 37 weeks as a predictor of prolonged pregnancy (defined as a pregnancy that extended beyond 41+2 weeks of gestation [289 days]) in nulliparous women. This prospective observational study enrolled 149 consecutive nulliparous ...

BACKGROUND: The aim of this study was to compare the performance of the Bishop score and transvaginal ultrasonography to predict successful labor induction, and to estimate the most useful cut-off points for the two methods. METHODS: The five components of the Bishop score were assessed by digital examination and cervical ...

OBJECTIVE: To examine the outcome of pregnancies in women with transabdominal cerclage (TAC) and to determine whether aspects of the obstetric history predict failure. METHODS: This was a cohort study of pregnant women referred for a transabdominal cerclage between 1978 and 2004. Records were reviewed for obstetric history and maternal ...

BACKGROUND/AIMS: To determine predictive values of fetal fibronectin and phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) in cervicovaginal secretions and ultrasonographic measurement of cervical length for delivery <35 weeks in patients with uterine contractions. METHODS: Our study included 51 women between 24 and 35 weeks' gestation with uterine contractions and ...

We describe a rare case of an Arias-Stella reaction in an adenomyomatous polyp of the endometrium found in the first trimester of pregnancy. A 33-year-old Japanese woman, gravida 1, para 1, presented for an initial prenatal examination at 6-week gestation; ultrasound revealed a myoma-like solid mass in the cervical canal. ...

Treatment of cervical intraepithelial neoplasia (CIN) greatly reduces the risk of cervical cancer. Treatment involves ablation or excision of the transformation zone of the cervix, most commonly using an electrosurgical excision technique known as LLETZ. However, the peak incidence of CIN occurs in young women, so if excision of a ...

BACKGROUND: To evaluate cervical length changes as predictors of preterm delivery. METHODS: Two hundred and fifty-seven pregnant women underwent transvaginal ultrasound examination at 16 and 24 weeks of gestation. Cervical length was measured and the difference between the 2 measurements was calculated. The sensitivity, specificity, positive predictive value and negative ...

OBJECTIVE: The purpose of this study was to define the impact of asymptomatic trichomoniasis on lower genital tract neutrophil activation in pregnancy. STUDY DESIGN: In this nested cohort study, pelvic examination was performed on 65 asymptomatic pregnant women between 7 and 22 weeks' with vaginal pH > 4.4. Concentrations of ...

The cervix serves as a protective barrier from invading microorganisms and as a structural barrier to delivery of the fetus. Among all biological processes, the phenomenal connective tissue remodeling that occurs in the cervix during and after parturition is unparalleled in scope and magnitude. The process of connective tissue remodeling ...

Pentasomy 49,XXXXY occurs in 1/85,000 newborn males. The origin of this particular form of aneuploidy is believed to be a result of consecutive nondisjunction events during maternal meiosis. Typical presentation consists of hypotonia, developmental delay, various dysmorphic features, and severe hypogenitalism. A 13-year-old with pentasomy 49,XXXXY and a Chiari type ...

BACKGROUND: Cervical pregnancy is a rare form of ectopic pregnancy, and the most effective method of its treatment is still under investigation. We would like to call attention to selective uterine artery embolization as an effective modern treatment method. CASE: A patient with suspected cervical pregnancy and 7-week amenorrhea was ...

OBJECTIVE: The incidence of hematometra caused by cervical stenosis after conization is <1%. Nevertheless, if dilatation was unsuccessful, further therapy often remains unclear, and the clinical consequences can be severe, including hysterectomy. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 33-year old patient who developed recurrent cervical stenosis with consecutive ...

OBJECTIVE: To report two cases of advanced pelvic endometriosis, both with deep rectal involvement and one with extensive cervical involvement appearing like a carcinoma, where both patients achieved spontaneous pregnancy and delivered viable babies. DESIGN: Case report. SETTING: Institute of Reproductive Medicine. PATIENT(S): Two nulliparous patients, one with extensive cervical ...

OBJECTIVE: To report successful conservative management of advanced cervical ectopic pregnancy with placenta percreta. DESIGN: Case report. Setting: University tertiary care hospital. PATIENT(S): A 37-year-old woman with second-trimester cervical ectopic pregnancy and placenta percreta. INTERVENTION(S): Ultrasound-guided injection of potassium chloride into the fetal heart followed by multiple systemic methotrexate injections, ...

OBJECTIVE: To assess the value of measuring cervical resistance index (CRI) as an aid to selecting patients with a history of spontaneous mid-trimester miscarriage for cervical cerclage in subsequent pregnancies. STUDY DESIGN: An observational study of 175 patients with a history of one or more spontaneous mid-trimester losses and 123 ...