Background: Maternal hypothyroidism in pregnancy is associated with several adverse outcomes. The Endocrine Society guidelines for the management of thyroid diseases in pregnancy were published in 2007; however, impact of the guidelines in the routine clinical practice is unknown. Therefore, we have carried out a survey of members of the ...

PURPOSE OF REVIEW: Thyroid disease is common during pregnancy. There are multiple alterations in maternal thyroid physiology, leading to an increased demand for thyroid hormone during gestation, that have significant implications for both maternal and fetal health. Importantly, pregnant reference ranges must be used for appropriate diagnosis and treatment of ...

The present manuscript provides a definition for, and evaluates the prevalence and maternal/fetal/child impact of, overt hyperthyroidism and overt hypothyroidism. The prevalence of overt hyperthyroidism is 0.5% and the prevalence of overt hyperthyroidism is 0.3%. Overt maternal hyperthyroidism is associated with heart failure, preeclampsia, preterm delivery, still birth, and neonatal ...

PURPOSE OF REVIEW: Examine recent studies on the assessment of thyroid status in pregnancy, approach to thyroid testing, the spectrum of hypothyroidism in pregnancy, and strategies for thyroid replacement in women with known hypothyroidism. RECENT FINDINGS: Trimester-specific references range for thyroid-stimulating hormone (TSH) and free thyroxine in pregnancy must take ...

ABSTRACT: BACKGROUND: The mounting evidence linking hypothyroidism during pregnancy with poor pregnancy outcome underscores the need for screening and, therefore, a search for more reliable and cheaper screening techniques. METHODS: The current study was conducted in two phases. The first phase comprised of healthy women in different stages of pregnancy ...

Background Maternal hypothyroidism (OH and SCH) during early pregnancy is suspected to associate with adverse obstetrical outcomes. Aim The aim of the present study was to investigate whether maternal subclinical hypothyroidism during the early stage of pregnancy increase obstetrical complications and whether treatment results in an improvement in these outcomes. ...

Glaucoma, primarily a disease of the older population, may affect women of childbearing age. Pregnancy affects the intraocular pressure (IOP) of women with pre-existing glaucoma. Both elevations and reductions of IOP have been reported during pregnancy. Additionally, visual field test results may fluctuate during pregnancy. In managing the pregnant glaucoma ...

This case report describes a case of heterotopic cervical ectopic pregnancy in a nulliparous woman that was successfully treated with single-dose local, intra-amniotic methotrexate injection in the gestational sac. Pregnancy was achieved spontaneously. The patient had previously undergone hysteroscopic myomectomy. By using local, single-dose treatment we avoided the continued effects ...

Introduction. Cervical twin ectopic pregnancy after IVF-ET is rare and catastrophic complication. However, here is no consensus on the best treatment strategy. Patient and method. Case report of cervical twin ectopic pregnancy after IVF-ET treated by transvaginal ultrasound-guided aspiration plus systemic single injection of methotrexate, which followed by full-term delivery in next ...

OBJECTIVES: To review the literature on cervical length as a predictor of preterm birth in asymptomatic women with a multiple pregnancy. METHODS: We searched Medline, Embase and reference lists of included articles to identify all studies that reported on the accuracy of cervical length to predict preterm birth in asymptomatic ...

Objectives. To evaluate whether cervical funneling influences pregnancy outcome in women with short cervical length (CL) after cerclage, and to identify funneling parameters associated with pregnancy outcome. Methods. Medical records of women identified to have a short CL with or without funneling after cerclage were reviewed. Women with short CL as well ...

Aim:  To investigate the association between the amount of bleeding during a cesarean section and the effacement of the uterine cervix in patients with placenta previa. Methods:  This study reviewed 115 singleton pregnancies with placenta previa. In cases of placenta previa, the thickness of the uterine muscle and cervical length ...

OBJECTIVE: To determine if high risk asymptomatic women with a short cervical length in their previous pregnancy who delivered at term are at an increased risk of having a short cervical length in the next pregnancy, and whether they are at an increased risk of preterm birth. METHODS: This retrospective ...

Aim:  To study the relationship between cervical lengths measured by ultrasound and risk of preterm delivery. Material & Methods:  We examined 209 women with singleton pregnancies. The inclusion criteria were women who presented with regular and painful contractions (≥2 contractions at intervals of 10 min for at least 1 h). Transvaginal scan ...

Asherman's syndrome is being diagnosed with increasing frequency. Although it usually occurs following curettage of the pregnant or recently pregnant uterus, any uterine surgery can lead to intrauterine adhesions (IUA). Most women with IUA have amenorrhea or hypomenorrhea, but up to a fourth have painless menses of normal flow and ...

A report on a difficult case of first trimester pregnancy bleeding in a 39-year-old woman solved by hysterectomy. The diagnosis was clarified by pathological examination that showed a cervical ectopic pregnancy with perforation.

The cervical mucus plug (CMP) differs from the cervical secretions of non-pregnant women, and is the ultimate sealant of the uterine cavity during pregnancy. Although several studies have analyzed biochemical properties of large glycoproteins in the CMP, comprehensive information about its protein composition is yet unavailable. We hypothesized that protein ...

Aim:  To evaluate the value of sonographic measurement of cervical length as a predictor of abortion or delivery within 24 h by misoprostol in second trimester termination of pregnancy (TOP). Material and Methods:  One hundred and sixty-three women underwent TOP between 14 and 26 weeks of pregnancy due to various indications. The ...

OBJECTIVE: The purpose of this study was to determine whether optical methods can estimate cervix function during pregnancy and whether progestins modify this process. STUDY DESIGN: Photos of the external cervix of timed-pregnant rats were taken every other day from day 13 until postpartum day 5 after daily treatments with ...

The current body of literature concerning cervical conization and its effect on subsequent pregnancy outcome is conflicting. Depending on the type of conization procedure that is examined and the quality of the control group, the results and conclusions vary widely. Because treatment for cervical intraepithelial neoplasia is commonplace among women ...

OBJECTIVE: The purpose of the present study was to examine obstetric outcome of patients following conization and specifically the risk for preterm delivery (PTD). METHODS: A population-based study was performed comparing pregnancies in women following conization with those who had not undergone the procedure. Stratified analysis, using a multiple logistic ...

OBJECTIVE: To present a case of successful management of a heavily bleeding cervical ectopic pregnancy with ultrasound-guided termination procedure of evacuation. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 34-year-old woman, secundigravida with one previous full-term natural childbirth and history of one spontaneous abortion, with a cervical pregnancy. INTERVENTION(S): Prophylactic ...

Anti-Ro/SSA antibodies are associated with neonatal lupus (congenital heart block (CHB), neonatal transient skin rash, hematological and hepatic abnormalities), but do not negatively affects other gestational outcomes, and the general outcome of these pregnancies is now good, when followed by experienced multidisciplinary teams. The prevalence of CHB, defined as an ...

We report a 28-year-old woman presenting with a complete hyaditiform mole localized to the cervix. She had undergone curettage of missed abortion two months previously and the aborted material showed normal placental tissue on histopathologic examination. Two months after curettage she presented with sudden severe vaginal bleeding. Clinical examination revealed ...

A greater understanding of the parturition process is essential in the prevention of preterm birth, which occurs in 12.7% of infants born in the U.S. annually. Cervical remodeling is a critical component of this process. Beginning early in pregnancy, remodeling requires cumulative, progressive changes in the cervical extracellular matrix (ECM) ...

The objective was to compare the reproductive performance of a new PGF(2α)-based timed artificial insemination (TAI) protocol in sheep (Synchrovine®: two doses of PGF(2α), 7 d apart) to a traditional progesterone-eCG (P4-eCG) protocol, considering the effects of seminal state, AI-times, and AI-pathway. Three experiments involving 1297 multiparous Australian Merino ewes ...

OBJECTIVE: To evaluate the use of uterine artery embolization (UAE) in conjunction with methotrexate in the conservative treatment of cervical ectopic pregnancy (CEP). DESIGN: Case series. SETTING: Tertiary-care university hospital. PATIENT(S): Cases of CEP treated at Hutzel Women's Hospital between January 1997 and December 2008. INTERVENTION(S): Multidose methotrexate treatment with ...

OBJECTIVES: The objective of the study was to determine the prevalence and clinical significance of atypical glandular cells (AGC) or atypical glandular cells of undetermined significance (AGUS) diagnosed in pregnant and postpartum women. STUDY DESIGN: Smears having a diagnosis of AGC or AGUS, taken from pregnant and postpartum (within six ...

Systemic lupus erythematosus (SLE) primarily affects women of reproductive age. Here we summarize the scientific evidence supporting recently developed quality indicators (QIs) pertaining to reproductive health. We used a modification of the RAND/UCLA Appropriateness Method to develop QIs for SLE. We performed systematic reviews of the literature pertaining to each ...

To evaluate pregnancy outcomes after electrosurgical conization. We retrospectively analyzed the outcomes of 56 singleton pregnancies after electrosurgical conization of the uterine cervix. Of the 56 cases, 25 women underwent prophylactic cerclage with McDonald procedure (cerclage group), and 31 were managed expectantly (expectant group). Pregnancy outcomes including rate of preterm ...

OBJECTIVE: To determine whether routine 2(nd) trimester transvaginal cervical length ultrasound in low risk singleton pregnancies is a cost-effective strategy. METHODS: We developed a decision analysis model to compare the cost-effectiveness of two strategies to identify pregnancies at risk for preterm birth: 1) no routine cervical length screening and 2) ...

Current methodologies to assess the process of labor, such as tocodynamometry or intrauterine pressure catheters, fetal fibronectin, cervical length measurement and digital cervical examination, have several major drawbacks. They only measure the onset of labor indirectly and do not detect cellular changes characteristic of true labor. Consequently, their predictive values ...

To describe a rare case of a heterotopic pregnancy with a gestational sac in the cervix and one in the uterine cavity, managed successfully with subsequent delivery of a healthy newborn. Case report and review of the literature. Tertiary university hospital. A woman with heterotopic twin gestation after stimulation treatment ...

The relationship between autoimmunity and reproduction has long been recognized. This relationship is bidirectional and includes many diverse issues, but in this review article, we focus on which autoimmune disturbances are the basic cause of recurrent pregnancy losses in patients with autoimmune diseases. The antiphospholipid antibodies seem to be clearly ...

Recurrent fetal loss affects 1-5% of women of childbearing age. Immunological mechanisms may account for 40% of recurrent miscarriages, and in particular, the antiphospholipid syndrome (APS) appears to be implicated in 7-25% of the cases. Because antiphospholipid (aPL) antibodies have thrombogenic properties, fetal loss in patients with APS has been ...

Anti-paternal HLA-antibodies are considered a harmless phenomenon during most pregnancies, whereas their role in recurrent miscarriage (RM) patients is disputed. In contrast to primary RM, patients with secondary RM have carried a fetus to term pregnancy prior to a series of miscarriages, which increases the chance that allogeneic fetal cells ...

This review discusses how inflammatory rheumatic diseases [rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus (SLE)] of the mother can influence the course of pregnancy and the development of the fetus. Antirheumatic drug therapy of the mother and strategies to prevent fetal complications namely in SLE must be considered with care. ...

Objective. To evaluate whether insulin-like growth factor binding protein-1 (IGFBP-1) assessed in cervical secretion can predict successful induction and spontaneous onset of labor in post-term pregnancy, compared to ultrasound measurement of cervical length and Bishop score. Design. Cohort study, originating from a randomized controlled trial. Setting. Obstetric department of a ...

To compare the efficacy of manual vacuum aspiration (MVA) with electric vacuum aspiration (EVA) and to evaluate whether cervical priming with misoprostol facilitates cervical dilation and reduces complications associated with first-trimester medical abortion performed up to 10weeks of pregnancy. A total of 600 women who requested termination of pregnancy were ...

PURPOSE: The objective of this study was to determine if transvaginal ultrasound (TVUS) examination of cervical length correlates to digital pelvic examination and if it can predict time to and mode of delivery in term pregnancies. METHODS: We conducted a prospective cohort study of 726 consecutive non-laboring, term pregnant women ...

Although a large portion of the capitate is supplied by a single nutrient vessel, avascular necrosis of the capitatum is a rare condition. Its etiology is not clear, but a number of factors are linked to its pathogenesis including: repetitive trauma, dorsal instability of the carpus, Gaucher disease, systemic lupus ...

To classify cervical ectopic pregnancies including previous cesarean section scar pregnancies and to describe the management of cervical ectopic pregnancies. This was a retrospective analysis of all cervical ectopic pregnancies, including previous cesarean scar pregnancies, diagnosed at the Korea University Guro Hospital, Seoul, Korea, between January 1997 and October 2009 ...

Anti-PP1P(k) is a rare, biphasic antibody with the ability to cause immediate hemolytic transfusion reactions and early spontaneous abortions. The antibody is formed by individuals with the p phenotype. A blood donor with anti-PP1P(k) and the p phenotype was identified through routine donor screening. A sister was found to also ...

The aim of this study was to examine the pregnancy outcomes in patients with systemic lupus erythematosus (SLE) and the effect of SLE flare and treatment on pregnancy outcomes. We performed a retrospective evaluation of all pregnancies occurring in patients with SLE during the 27-year period from 1980 to 2006. ...

Objectives. Anti-β2 glycoprotein 1 (a-β2GP1) was added to the criteria for antiphospholipid syndrome (APS) in 2005. However, its clinical significance with respect to complications of pregnancy is not well established. The aim of this study was to evaluate the association of laboratory findings of a-β2GP1 with events of thromboembolism or obstetric ...

The aim of this study was to investigate anti-fibrillin-1 autoantibody in patients with a history of recurrent pregnancy loss (RPL) and during normal pregnancy. Anti-fibrillin-1 IgG and IgM antibodies were measured by a home made ELISA in serum samples of 48 medically and obstetrically normal pregnant women, classified to three ...

Antiphospholipid syndrome (APS) is a multisystemic disorder of coagulation-causing thrombosis in the arterial and venous system as well as pregnancy-related complications such as miscarriage, stillbirth, preterm delivery and pre-eclampsia. The disease is characterized by the autoimmune production of antibodies against phospholipid, a substance found in the cell membrane. We here ...

Cervical and prolapsed submucosal leiomyomas are rarely seen in pregnancy. Depending on the size threshold used to diagnose a leiomyoma, the prevalence of uterine leiomyomas in pregnancy is approximately 3% to 10%. The prevalence of clinically evident cervical leiomyomas in pregnancy is less than 1%. Contrary to prior thought, the ...

Studies of the impact of systemic lupus erythematosus (SLE) and its pregnancy complications have yielded conflicting results. Major limitations of these studies relate to their small numbers of patients and retrospective designs. The aim of this study was to perform a systematic literature review of pregnancy outcomes in women with ...

Systemic lupus erythematosus (SLE) is one of the common autoimmune disorders that affect women during their childbearing years. Disease activity frequently increases during pregnancy and the postpartum period, representing a challenge for both the patient and the treating physician(s). We report a case of successful management of lupus nephritis flare ...