OBJECTIVE: The purpose of this study was to determine whether there was a relationship between sonographic cervical length and the presence of culture-proven microbial invasion of the amniotic cavity in women with preterm labor and intact membranes. STUDY DESIGN: Ultrasonography and amniocentesis were performed in 401 patients admitted with preterm ...

BACKGROUND: Three cases of anaphylactoid syndrome of pregnancy developed in association with the use of intracervical dinoprostone for cervical ripening. CASES: All cases occurred at our institution between October 1996 and February 2001. The patients developed respiratory symptoms shortly after placement of 0.25 mg of intracervical dinoprostone gel. Hemodynamic changes, ...

OBJECTIVES: Review the uterine electromyography (EMG) and cervical light-induced fluorescence (LIF) devices and their role in the evaluation of uterine and cervical function in comparison with present methods. DESIGN: Review of recent studies. SETTING: University of Texas Medical Branch Labour and Delivery Clinics. POPULATION: Various groups of pregnant women. METHODS: ...

BACKGROUND: Cervical cerclage is a surgical procedure involving suturing the cervix with a purse type stitch to keep it closed during pregnancy. This procedure has been used widely in the management of pregnancies considered at high risk of preterm delivery. Several observational studies into the efficacy of cervical cerclage have ...

Our objective was to evaluate the effectiveness of a late or emergency (salvage) cerclage after tissue reinforcement with Pelvicol natural implant, in preventing premature rupture of the fetal membranes and advancing pregnancy prolongation. A flat sheet of Pelvicol, a sterile acellular natural (porcine) implant was used in an emergency cerclage ...

OBJECTIVE: Radical trachelectomy in combination with pelvic and parametric lymphadenectomy is indicated in young patients with early cervical cancer and planned pregnancy. If pregnancy occurs, premature delivery is a known problem in these patients. We evaluated if uterine blood supply is decreased after radical trachelectomy as one of various possible ...

Atypical glandular cells (AGC) in Papanicolaou (Pap) smears can be associated with premalignant and malignant cervical and endometrial lesions. AGC is difficult to diagnose in pregnancy due to confusion with normal cellular changes that accompany graviditas. While guidelines have been established for management of AGC cases in the non-pregnant patient, ...

BACKGROUND: The objective of this study was to evaluate the clinical outcomes and to discuss the management of women presenting with an invasive cervical cancer during pregnancy. PATIENTS AND METHODS: We retrospectively reviewed patients treated for an invasive cervical cancer diagnosed during pregnancy between 1985 and 2000 in our institution. ...

BACKGROUND: Cervical carcinoma diagnosed during pregnancy generates conflicting concerns between control of malignancy and continuation of pregnancy. CASE: An invasive cervical carcinoma FIGO Stage IB2 was diagnosed in a 33-year-old primigravida during the first trimester of pregnancy. Because the patient strongly desired to preserve her pregnancy, laparoscopic lymphadenectomy was performed ...

OBJECTIVE: The objective of this work was to assess proper management of squamous intraepithelial lesion (SIL) and microinvasive carcinoma during and after pregnancy, to assess risks of punch biopsy and conization in pregnancy and to assess regression, persistence and risk of progression with low-grade (L) and high-grade (H) SIL. METHODS: ...

Since cervical incompetence was introduced in the English literature in 1678, our understanding and obstetric management of this clinical entity, have changed tremendously over the years. This review shows the historical perspective of the development of cervical incompetence as a distinct clinical entity and an all or nothing phenomenon to ...

In the population of pregnant women in Serbia and Montenegro, hemorrhoids are present in 85% of the cases during the second and third pregnancy. Urged by the complications of non-treated hemorrhoids, we carried out a routine diagnostic procedure to examine hemorrhoids during pregnancy, i.e. a differential diagnosis with other possible ...

The objective of this study was to examine the values of the cervical length measurement and detection of internal cervical os funneling by transvaginal ultrasonography in the prediction of spontaneous labor within a 7-day period at term. Ninety-three pregnant women were enrolled into this study. All patients were evaluated by ...

BACKGROUND: The postcoital test has poor diagnostic and prognostic characteristics. Nevertheless, some physicians believe it can identify scanty or abnormal mucus that might impair fertility. One way to avoid 'hostile' cervical mucus is intrauterine insemination. With this technique, the physician injects sperm directly into the uterine cavity through a small ...

BACKGROUND: The objective of the current study was to evaluate the adequacy and detection rates of SurePath after its implementation in Ontario. METHODS: The detection and adequacy rates of the SurePath liquid-based cytology system (SP-LBC) were calculated for manually reviewed slides of the year 2002. The adequacy and detection rates ...

Bilateral neurectomy of the pelvic nerve (BLPN) that carries uterine cervix-related sensory nerves induces dystocia, and administration of its vasoactive neuropeptides induces changes in the cervical microvasculature, resembling those that occur in the ripening cervix. This study was designed to test the hypothesis that (a) the cervix of pregnant rats ...

The effects of endogenous hyaluronan on cervical ripening during pregnancy were examined in rabbits. Hyaluronan of approximately 620 kilodalton (kDa) was detected in the uterine cervix on the 25th and 29th days of pregnancy, while it was not detected in cervix of non-pregnant animals. In addition, low-molecular-weight (less than 191 ...

BACKGROUND: Cervical pregnancy is potentially associated with life-threatening hemorrhage and often requires hysterectomy to stop the bleeding. Conservative management is becoming more common as treatment of cervical pregnancy. CASE: A case of cervical pregnancy presented with a severe vaginal hemorrhage at 6 weeks' gestation. The patient was conservatively managed with ...

This study attempts to point out the importance of the anatomo-clinical finding of an "hour-glass" shape to the uterus in the diagnosis and treatment of cervical pregnancy. From 1973 to 2001, four cases of cervical pregnancy were treated in the 2nd Obstetrical and Gynecological Clinic of the Aristotelion University of ...

BACKGROUND: The standard management of early-stage invasive cervical cancer in early pregnancy is radical hysterectomy with the fetus in situ. We describe a case of early invasive cervical cancer in pregnancy that was treated with a conservative surgical approach. CASE: A nulliparous pregnant women at 15 weeks of gestation was ...

OBJECTIVE: To measure the ultrasonographic cervical length in undelivered women after successful tocolysis for preterm labor, and to determine whether this could improve the predictive value of cervical length measured before initiation of tocolysis on the risk of preterm delivery. METHODS: This was a prospective study of patients admitted and ...

OBJECTIVE: In a previous study conducted in the UK we demonstrated that only 8% of women with threatened preterm labor deliver within 7 days. Furthermore, delivery within 7 days occurred in less than 1% of women presenting with a sonographically measured cervical length > or = 15 mm, compared to ...

There is evidence in humans that the C3/4 level of the spinal cord is a site for sensorimotor integration, analogous to the C3/4 propriospinal system (PS) in cat. Although the clinical relevance of the putative C3/4 PS in humans is not clear, there is some evidence indicating that drive to ...

OBJECTIVE: To determine whether sonographic measurement of cervical length in pregnancies complicated by preterm prelabor amniorrhexis helps distinguish between those women who deliver within 7 days and those who do not. METHODS: In 101 women with singleton pregnancies presenting with preterm prelabor amniorrhexis at 24-36 (median, 32) weeks of gestation ...

OBJECTIVES: To examine the value of pre-induction sonographic assessment of cervical length, posterior cervical angle and occipital position in the prediction of the induction-to-delivery interval within 24 h, the likelihood of vaginal delivery within 24 h, the likelihood of Cesarean section and to compare sonographic assessment with the Bishop score. ...

OBJECTIVE: Less than 10% of women presenting with preterm contractions progress to active labor and delivery. This study investigates whether cervical length measurements by ultrasound can discriminate between true and false labor in women presenting with threatened preterm labor. METHODS: Cervical length was measured by transvaginal ultrasound in 253 women ...

The greatest risk element in any form of assisted conception, is the risk to a fetus within a multiple pregnancy, even with twin implantation. Recent research has examined the contribution of single embryo transfer in reducing the incidence of multiple gestation within IVF. Two recent studies from our assisted conception ...

OBJECTIVE: Our aim was to determine whether the Ki-67 immunostaining pattern, present on diagnosis of cervical intraepithelial neoplasia (CIN), predicts the change from low-grade to high-grade CIN over a 2-year period after diagnosis. MATERIALS AND METHODS: Of 59 cervical biopsy samples from 59 patients diagnosed as having cervical CIN, 35 ...

OBJECTIVE: To present a case of maternal morbidity encountered in a cervical heterotopic pregnancy after successful potassium chloride (KCl) injection for transvaginal multifetal pregnancy reduction. DESIGN: Case report. SETTING: Tertiary referral care center. PATIENT(S): A woman with heterotopic twin gestation after IVF. INTERVENTION(S): Diagnosis of a viable cervical heterotopic pregnancy ...

OBJECTIVE: We investigated the potential roles of relaxin and subclinical intra-amniotic inflammation by quantitating amniotic fluid relaxin and interleukin-6 concentrations for the prediction of outcome of rescue cerclage in women with cervical incompetence. STUDY DESIGN: Cervical incompetence was diagnosed when cervical dilatation exceeded 2 cm with intact but bulging membranes ...

OBJECTIVE: Preterm triplet delivery is common and has a tremendous impact on neonatal mortality and morbidity. We aimed at assessing early second-trimester cervical length as a means of detecting triplet pregnancies at risk for preterm birth. METHODS: Cervical length was measured in triplet pregnancies during weeks 14 to 20. Cervical ...

BACKGROUND: Trachelectomy is a conservative but locally radical procedure associated with a high risk of preterm delivery. CASE: A 28-year-old patient with cervical cancer FIGO stage IB1 was treated with laparoscopic pelvic lymphadenectomy followed by trachelectomy. Three years later, she conceived spontaneously. In consideration of the high risk of preterm ...

PROBLEM: High interleukin (IL)-8 concentration in cervical mucus in the second trimester is a risk factor for premature birth. We investigated the relationship between vaginal pathogens and IL-8 in cervical mucus. METHOD OF STUDY: In 501 women with single pregnancy, vaginal secretions were cultured for bacteria and cervical mucus IL-8 ...

BACKGROUND: Uterine cervical varix is a rare complication in pregnant women and can be the cause of obstetric hemorrhage in the vagina resulting in adverse events for both the mother and fetus. CASE: A 34-year-old Japanese woman was hospitalized at 18 weeks gestation because of cervical varix and placenta previa. ...

OBJECTIVE: To investigate the effectiveness of emergency cervical cerclage in prolongation of pregnancy and its effect on pregnancy outcome in patients with cervical incompetence. METHODS: A retrospective review of patients who had an emergency cervical cerclage performed for cervical incompetence during the period from July 1995 to June 2002 was ...

OBJECTIVE: The purpose of this study was to report pregnancy outcome and complication rates for women with recurrent late pregnancy loss who were treated with preconception transabdominal cervicoisthmic cerclage. STUDY DESIGN: This was a case note review of 19 women at high risk for second trimester loss and early preterm ...

This article reviews safety, efficacy, and complications of intracervical osmotic devices and discusses diagnostic, therapeutic, and preventative measures for managing them. Osmotic dilators have been used to ripen the cervix in gynecologic and obstetric procedures for centuries. Their gradual effect in softening and dilating the cervix reduces the chance of ...

BACKGROUND: Different types of fibroids may affect reproductive outcome to a different extent, causing infertility and pregnancy wastage. Rectosigmoid compression, prolapse of a pedunculated submucous tumor through the cervix, venous stasis, polycythemia and ascites are infrequently associated with leiomyomas. Uterine leiomyomas arefound in approximately 2% of pregnant women; 1 in ...

OBJECTIVE: The aim of the present study was to compare the outcome of pregnancies among patients with suspected cervical incompetence treated either by elective cervical cerclage or an alternative management program involving cervical surveillance. DESIGN, SETTING AND METHODS: A prospective cohort study was performed in two groups of patients at ...

OBJECTIVE: To determine the accuracy of differential diagnosis by team consultation of abortion in progression, low-lying implantation/cervicoisthmic pregnancy, and cervical pregnancy (CP) in patients referred for suspicion of abnormal implantation on the lower segment and cervix of the uterus and to determine the efficacy of endoscopic surgery with uterine artery ...

OBJECTIVES: (1) To elucidate the views of obstetricians with respect to the use of transvaginal ultrasound in general, and, specifically, for determining cervical length, and the conditions under which obstetricians would employ cervical cerclage based on a sonographically revealed shortened cervix; and (2) to determine the possibility of a randomized ...

OBJECTIVE: To compare cervical clinical data, ultrasound parameters and fetal fibronectin assessment in the prediction of the duration of induced labor when the cervix is unfavorable. METHODS: This was a prospective study of 90 pregnant women with a Bishop score </= 5 undergoing labor induction. The Bishop score and its ...

Two otherwise healthy pregnant women presented with intrauterine fetal demise and underwent unremarkable induction of labor. Histopathologic examination of both placentas revealed polarizable foreign material with minimal associated tissue reaction in the membranes and adjacent maternal decidua. No overt foreign body giant cell reaction or inflammation was seen, suggesting recent ...

A case of a 38year old grandmultipara (Gravida9, Para7+1, all alive) woman with squamous cell carcinoma of the cervix co-existing with multiple pregnancy is presented. She had therapeutic termination of pregnancy with oxytocin at a gestation age of 18 weeks. This was followed by intracavitary and then extracavitary radiotherapy. The ...

Diethylstilbestrol is a synthetic nonsteroidal estrogen that was used to prevent miscarriage and other pregnancy complications between 1938 and 1971 in the United States. In 1971, the U.S. Food and Drug Administration issued a warning about the use of diethylstilbestrol during pregnancy after a relationship between exposure to this synthetic ...

Cervical pregnancy is an uncommon ectopic pregnancy that accounts for approximately <1% of extrauterine gestations. This condition is associated with an extremely high risk of massive hemorrhage and previously often required hysterectomy. Current early ultrasonographic diagnosis and medical management in conjunction with other conservative measures, which include uterine artery embolization ...

OBJECTIVE: The objective of this study is to compare the relative safety of 2 techniques for surgical abortion late in the second trimester.Study design Retrospective review of patients who underwent surgical abortion at >or=20 weeks' gestation at our hospital from June 1996 through June 2003. Records were reviewed to determine ...

Spontaneous cervical epidural haematoma is very rare during pregnancy. We describe a woman who presented with tetraplegia at 41 weeks of pregnancy. She had no previous history of any relevant medical disorder. Her upper level of anaesthesia was at the second thoracic segment. The condition was diagnosed by magnetic resonance ...

Our objective was to evaluate the role of the nitric oxide (NO)-cyclic guanosine monophosphate (cGMP) pathway in rat uterine and cervical contractility at mid- and late gestation. Rings of uterus and cervix from Sprague Dawley rats on day 14 of pregnancy (mid-) and day 21 of pregnancy (late) were equilibrated ...

In a previous study we observed that it is possible to reach the cervix in all queens with a 1 mm diameter probe only. So, we developed both a new technique and a catheter (1 mm diameter) to allow transcervical insemination [Zambelli and Castagnetti 2001]. The aims of this study ...