Preterm labor is a common obstetric complication. Clinical evaluation of cervical ripening to predict preterm labor is very inaccurate. We used frequency-domain near-infrared spectroscopy (FD-NIRS) to non-invasively investigate the changes of the optical properties (i.e., absorption and scattering of light) in the uterine cervix during regular pregnancies. Optical properties of ...

OBJECTIVE: To estimate the relationship between cervical length and hemorrhage leading to preterm delivery in women with placenta previa. METHODS: Between October 2007 and May 2009, transvaginal cervical-length measurements were obtained in all singleton pregnancies with placenta previa identified at or beyond 24 weeks of gestation. Only women who delivered ...

Cervical pregnancy is a rare form of ectopic pregnancy. Its treatment has been described by different authors. We report our successful experience of a cervical twin pregnancy that was diagnosed by transabdominal and transvaginal ultrasound and confirmed by magnetic resonance imaging. To preserve fertility, our patient was treated by a ...

Abstract Objective: To evaluate differences in placental lesions in twin pregnancies with and without mid-trimester sonographic cervical shortening. Methods: Two groups of women were identified: those with twin gestations and a cervical length

Abstract Aims: To evaluate uterine cervical consistency using a vaginal ultrasound gray-level histogram. Methods: Vaginal ultrasound and digital examination were performed for 214 women with low-risk singleton pregnancy during 27-30(th) pregnancy week. The mean gray-level (MGL) of an ultrasound gray-level histogram, representing the echogenicity of a region of interest, was ...

INTRODUCTION: Cervical cancer is the most frequently encountered malignancy during pregnancy. Presence of nodal metastasis is the most important negative prognostic factor and its assessment represents a crucial parameter to decide if pregnancy can safely continue. We describe the results of 18 pregnant patients with cervical cancer who had their ...

OBJECTIVE: To evaluate the efficacy of isosorbide mononitrate (IMN) for cervical ripening prior to first trimester surgical termination of pregnancy. METHODS: A prospective, double-blind, randomized, placebo-controlled trial. Women scheduled for surgical termination of a nonviable fetus before 12 weeks of gestation from October 2008 to June 2009 were enrolled and ...

OBJECTIVE: This study was undertaken to identify the prognostic indicators associated with postpartum regression of cervical dysplasia diagnosed in pregnancy. STUDY DESIGN: A retrospective cohort study of pregnant women referred for colposcopy from 2004-2007 at four academic centers. RESULTS: One thousand seventy-nine patients were identified. Colposcopic impression by cervical cytology ...

OBJECTIVE: The purpose of this study was to determine the pregnancy outcome of asymptomatic patients in the second trimester with a nonmeasurable cervical length (0 mm). STUDY DESIGN: This retrospective cohort study included 78 patients with singleton pregnancies and a sonographic nonmeasurable cervix that was detected at 14-28 weeks of ...

OBJECTIVE: We hypothesized that, at the time of ultrasound indicated cerclage, the endocervical concentration of hyaluronan (HA), 27kDa heat shock protein (hsp27), and/or interleukin-8 (IL-8) would predict pregnancy outcome. METHODS: Endocervical samples, obtained from 40 women undergoing ultrasound indicated cerclage at 15.4-25.0 weeks gestation, were assayed by ELISA for HA, ...

OBJECTIVE: To document predictors of success of emergency cervical cerclage. METHODS: This is a retrospective cohort study of 8 years at a university hospital. Emergency cerclage was defined as when the membranes were at or beyond the external os and was only performed where evidence of infection or labour were ...

Uterine glial heterotopia is a rare, yet biologically intriguing lesion, mostly involving the cervix. Although an implantation of the fetal brain tissue is widely accepted as the etiology, there has been no confirming evidence to support this hypothesis. We investigated a case of polypoid glial heterotopia of the uterine cervix ...

The transneuronal tracer pseudorabies virus was used to test the hypothesis that connections from the cervix to the forebrain and hypothalamus are maintained with pregnancy. The virus was injected into the cervix of nonpregnant or pregnant mice, and, after 5 days, virus-labeled cells and fibers were found in specific forebrain ...

Cervicovaginal fistula is a recognized complication of induced mid-trimester termination of pregnancy, but more recently it has also been recognized as representing a complication of prior cervical cerclage. We report the ultrasound findings of prolapse of the amniotic sac through a cervicovaginal fistula in a woman with prior cervical cerclage. ...

OBJECTIVE: To report a case of a very rare ectopic cervical intramural pregnancy. DESIGN: Case report. SETTING: Prefectural hospital. PATIENT(S): A 22-year-old woman, gravida 1, para 0, was referred to our hospital with the suspicion of a cervical ectopic pregnancy (EP). Pelvic examination revealed an enlarged uterine cervix with no ...

Appropriate and timely cervical remodeling is key for successful birth. Premature cervical opening can result in preterm birth which occurs in 12.5% of pregnancies. Research focused on the mechanisms of term and preterm cervical remodeling is essential to prevent prematurity. This review highlights recent findings that better define molecular processes ...

OBJECTIVE: To report our experience of conservative treatment in four patients with cervical ectopic pregnancy. DESIGN: Case series. SETTING: Academic medical center. PATIENTS: Four women diagnosed with cervical ectopic pregnancy managed conservatively. INTERVENTION(S): Systemic methotrexate alone or combined with subsequent uterine artery embolization (UAE). MAIN OUTCOME MEASURES: Conservative management with ...

A case of cervical pregnancy resistant to systemic methotrexate (MTX) administration is presented. A 41 year old patient with cervical pregnancy at 6 weeks 4 days' gestation was successfully treated by intraamniotic MTX injection through the cervical canal using Tuohy needle after failure of systemic MTX treatment.

PURPOSE: To evaluate maternal and neonatal outcomes after transabdominal cerclage. METHODS: Retrospective analysis of 15 patients receiving transabdominal cerclage. Using the patient's prior pregnancy as her own control, we assessed the effect of this procedure on gestational age and neonatal survival. RESULTS: All patients had experienced a prior pregnancy loss. ...

OBJECTIVE: The aim was to construct a chart for cervical length measured by transvaginal ultrasound. RESEARCH DESIGN AND METHODS: Singleton pregnant women underwent a transvaginal scan to measure the cervical length (CxL) from 20 to 34 weeks. Exclusion criteria were preterm delivery, preterm rupture of membranes, multiple pregnancies, cerclage, and ...

Cervical insufficiency is a known risk factor for preterm birth and miscarriage. The etiology of cervical insufficiency has not been fully recognized and the association between it and prior cesarean delivery is unknown. We experienced two similar characteristic cases of cervical insufficiency following term cesarean delivery. Interestingly, both cesarean sections ...

OBJECTIVE: To determine if a shortened screening cervical length measurement in twin gestations, measured between 16 and 24 weeks, is a predictor of preterm delivery. STUDY DESIGN: A retrospective chart review was conducted on patients who delivered twins at Bayfront Medical Center between January 1, 2006, and April 1, 2008. ...

PURPOSE: Cervical length during the first trimester of pregnancy has not been completely investigated yet. The objective of our study is to compare cervical size in the first ten gestational weeks with that of non-pregnant women, and to determine its correlation with maternal factors, including age, anthropometric features, and reproductive ...

OBJECTIVE: This study examines the necessity of a formal pelvic examination in patients with early pregnancy-related complaints and an intrauterine pregnancy on bedside ultrasound (US). METHODS: Data were prospectively collected on emergency department (ED) patients presenting with early pregnancy complaints and bedside US evidence of intrauterine pregnancy. All patients received ...

OBJECTIVE: Cesarean radical hysterectomy (CRH) for invasive cervical cancer during pregnancy is characterized by heavy blood loss. Any surgical modifications made in an attempt to reduce the blood loss are valuable. Our study was designed to evaluate the efficacy of amputating the uterine corpus during CRH. METHODS: All cases of ...

The management of women with abnormal cytology in pregnancy represents both a diagnostic and a therapeutic challenge for colposcopists. The emphasis should be on diagnosis and confirmation of cervical precancer (Cervical intraepithelial neoplasia (CIN) or Adenocarcinoma in situ (AIS), thus excluding invasive cancer). Following an initial assessment, careful follow-up is ...

Cervical cancer is the most frequently observed malignancy during pregnancy. The presence of nodal metastasis is the most important negative predictor factor, and its assessment is crucial in deciding whether the pregnancy can safely continue. To our knowledge, this is the first report of a twin pregnancy complicated by cancer ...

OBJECTIVE: The management of stage IB1 cervical cancer at 15 weeks pregnancy remains a significant challenge from both the oncologic and obstetrical standpoints. Abdominal trachelectomy has been recently described as a potential option in patients who have a very strong desire to attempt preservation of pregnancy and treat the cancer ...

ABSTRACT: INTRODUCTION: Conservative treatment of a heterotopic cervical pregnancy was performed with a modification of the fixation of a Foley catheter at the level of the external cervical os, followed by the ligature of the descending cervical branches of the uterine arteries and systemic methotrexate application. CASE PRESENTATION: A 34-year-old ...

BACKGROUND: Cervical cancer is one of the most frequently diagnosed cancers during pregnancy, but the management of such cases remains unclear. A Working Group was set up in 2007 in France to propose national recommendations for the management of pregnant patients with invasive cervical carcinoma. METHODS: The recommendations are based ...

Cervical incompetence is characterized by painless cervical dilation in the second or early in the third trimester with prolapsed membranes and expulsion of an immature fetus. Cervical cerclage performed during pregnancy is a typical and effective treatment of cervical incompetence. In case of previously failed cervical cerclages or other cervix ...

It is difficult to treat cervical pregnancy without harming the intrauterine pregnancy. We report the case of a patient who was 37 years old and had an abdominal myomectomy. She had become pregnant by in vitro fertilization and egg transfer, and was transferred because of massive bleeding at 6 weeks ...

Second trimester pregnancy loss and preterm delivery may be considered an obstetrical syndrome. A multifactorial approach to the diagnosis of true cervical insufficiency is paramount. Surgical modification of the cervix benefits those with at least 3 second trimester losses or preterm deliveries, those with 2 early second trimester losses when ...

SUMMARY: Ex utero intrapartum treatment (EXIT) is a procedure performed during caesarean section with preservation of fetal-placental circulation, which allows the safe handling of fetal airways with risk of airways obstruction. This report aimed at describing a case of anaesthesia for EXIT in a fetus with cervical teratoma. A 30-year-old ...

BACKGROUND: Cervical ripening during pregnancy resembles an inflammatory process. Matrix metalloproteinases (MMPs), particularly MMP-8, have been linked to inflammatory processes. We studied the concentrations of, and factors associated with, MMP-8 in the lower genital tract fluids in the first and second trimesters. METHODS: In a prospective population-based cohort study, vaginal ...

Cervical cancer is the most common gynecologic malignancy associated with pregnancy. However, there are no consensus guidelines that define the indications for or the optimal length of expectant management. The subjects were women who had a preexisting invasive cervical cancer or whose cancers were diagnosed during pregnancy or within 12 ...

CONTEXT AND OBJECTIVE: One third of all cervical carcinomas occur during the reproductive period. Cervical carcinoma is the second greatest cause of death due to cancer during this phase. The estimated frequency of cervical cancer during pregnancy is one case for every 1,000 to 5,000 pregnancies. The aim here was ...

The final stages of cervical ripening and parturition resemble an inflammatory process. Although the role of cytokines in both spontaneous and experimentally induced parturitions has been described in several small laboratory animals and humans, the involvement of pro-inflammatory and regulatory cytokines in physiologic parturition in cows has not been determined. ...

OBJECTIVE: The purpose of the study is to review the surgical technique, complication rate and obstetric outcome associated with the laparoscopic approach to the placement of the cervico-isthmic cerclage. STUDY DESIGN: A prospective cohort study was conducted from 2003-2008 and compared with previously reported cases of cervico-isthmic cerclage by laparotomy ...

In normal pregnancy, the cervix maintains its shape during a period of substantial fetal and uterine growth. Hence, maintenance of biomechanical integrity is an important aspect of cervical function. It is known that cervical mechanical properties arise from extracellular matrix (ECM). The most important constituent of the cervical ECM is ...

Standard management of stage IB1 cervical cancer in pregnancy is radical hysterectomy with fetus in situ if diagnosis precedes viability, or cesarean radical hysterectomy. Postpartum abdominal radical trachelectomy was performed as an alternative, fertility-preserving surgery in a 30-year-old nulliparous woman diagnosed with stage IB1 cervical at 21 weeks' gestation.

Treating pregnant patients with a verified malignant disease represents a great clinical problem. Pregnancy-associated invasive cervical cancer is usually diagnosed at an early stage (approximately 70%). A 27-year-old patient was given the diagnosis of a pathohistologically verified cervical carcinoma, International Federation of Gynecology and Obstetrics stage IB1, in the 17th ...

Preservation of fertility is a major concern for premenopausal women after diagnosis of cervical cancer. Successful surrogate pregnancy after treatment for cervical cancer has very rarely been reported. In the present report, a case of successful surrogate pregnancy after radical hysterectomy, lymphadenectomy and ovarian transposition for cervical cancer, followed by ...

OBJECTIVE: To describe a cervical intramural ectopic pregnancy. DESIGN: Case report. SETTING: Maternity hospital. PATIENT(S): A 28-year-old multiparous woman was seen with vaginal bleeding and a positive urinary pregnancy test after delayed menstruation. Ultrasonography and pelvic examination revealed an empty uterine cavity and a hyperechoic focus within an enlarged cyanotic ...

OBJECTIVE: We sought to compare the outcomes of cervicoisthmic (CI) cerclage using traditional transabdominal (TA) approach vs the lesser used transvaginal (TV) approach. STUDY DESIGN: We conducted a retrospective cohort study of women who underwent placement of a CI cerclage. RESULTS: Before CI placement, the abdominal group had a total ...

OBJECTIVE: To present two successful pregnancy results following cervical cerclage before blastocyst transfer in patients who had cryopreserved ET and in whom cervical insufficiency was diagnosed. DESIGN: Case report. SETTING: Assisted reproduction unit in a university hospital. PATIENT(S): Two patients with infertility and cervical insufficiency. Both patients signed informed consent. ...

OBJECTIVES: Preterm delivery is the leading cause of major perinatal morbidity and mortality associated with triplet pregnancies. The objective of this study was to evaluate the efficacy of ultrasound-indicated cervical cerclage in triplet pregnancies that are diagnosed with cervical shortening on biweekly transvaginal sonography (TVS). METHODS: A retrospective review of ...

BACKGROUND: True primary cervical pregnancies are rare. Although these can cause massive hemorrhage, most of these abort during the first trimester without having been diagnosed. However, cervico-isthmic and cervico-isthmic corporeal pregnancies are more likely to persist to an advanced gestation in the second and third trimester and cause profuse bleeding ...

OBJECTIVE: To date no diagnostic tool is yet available to objectively assess the in vivo biomechanical properties of the uterine cervix during gestation. METHODS: We show the first clinical application of an aspiration device to assess the in vivo biomechanical properties of the cervix in pregnancy with the aim to ...

OBJECTIVE: The cervix is the lower portion of the uterus. It is composed of fibrous tissue and its mechanical integrity is crucial for maintaining a healthy gestation. During normal pregnancy, the cervical extracellular matrix (ECM) remodels in preparation for labor. The objective of this study was to investigate the biochemical ...