OBJECTIVE: To describe pregnancy outcomes following elective (history-indicated), urgent (ultrasound-indicated) or emergent (physical-exam indicated) cerclage placement. MATERIALS AND METHODS: Study design was retrospective chart review. Women with singleton gestation and cervical cerclage were categorised into: elective, urgent and emergent group. RESULTS: One hundred and thirty-three women were included; 89 in ...

There is growing evidence that chronic periodontitis may be a risk factor for pre-term birth. The goal of this intervention study was to determine the effect of periodontal treatment on the pregnancy outcome in women with threatening pre-term birth and initial localized chronic periodontitis. Forty-one women with a singleton pregnancy ...

OBJECTIVES: To present cases exhibiting possible effects of angiotensin II receptor blockers (ARBs) received in pregnancy on the fetus. METHODS: Retrospective analysis included women who delivered between 2002 and 2006 at Department of Obstetrics and Gynaecology Ljubljana. RESULTS: Antihypertensive medications were prescribed to 346 of the 26,735 women. ARBs were ...

OBJECTIVE: Our objective was to explore the relation between the pro- and antiinflammatory cervical cytokine balance in early pregnancy and subsequent early preterm birth. STUDY DESIGN: In this prospective cohort of 218 pregnant women who were enrolled in the first trimester, we assayed cervical concentrations of interleukin-1alpha, -1beta, -6, -4, ...

Progesterone plays a central role in the mechanisms of parturition in many species. Despite remarkable advances in our understanding of this hormone's mechanism of action, its roles in human pregnancy maintenance and parturition are not fully appreciated. Proper scientific hypothesis testing of progestins to prevent preterm birth has been limited ...

OBJECTIVE: To determine the obstetric outcomes of women diagnosed with a primary intracranial neoplasm prior to or during pregnancy and the puerperium. METHODS: Demographic data, neurologic, obstetric, and neonatal outcomes were extracted retrospectively from charts identified from two hospital databases. RESULTS: Twenty-two patients with 25 pregnancies were identified. Thirteen patients ...

Each year in the United States about one million (17%) of all pregnancies experience complications that result in fetal loss. Of the five million pregnancies that end in a live birth approximately 12% are born prematurely. Vaginal disorders and infections during pregnancy, particularly bacterial vaginosis (BV), are known risk factors ...

AIMS: To measure the amniotic fluid index (AFI) in cases of preterm premature rupture of membranes (PPROM). METHODS: A retrospective study of pregnancies complicated with PPROM was performed. Data collected included maternal age, parity, gestational age at PPROM and at birth, and AFI on admission. Gestational age matched AFIs were ...

The effect of maternal age on the outcome of threatened miscarriage after ultrasound has confirmed fetal heart (FH) pulsation was assessed. At a university teaching hospital, 138 women presenting with bleeding before 12 weeks' gestation were followed up until delivery or pregnancy loss. Those with multiple or ectopic pregnancy, social ...

OBJECTIVE: To determine whether a history of terminations of pregnancy influences subsequent pregnancies in terms of pregnancy risks, prematurity and neonatal biometrics. PATIENTS AND METHODS: Based on the perinatal statistics of eight German federal states, data of 247,593 primiparous women with singleton pregnancies born between 1998 and 2000 were analyzed. ...

BACKGROUND: The existence of a "placental clock" which determines the duration of gestation has been previously proposed. It is related to placental CRH secretion and is active from an early phase in human pregnancy. Urocortin is a specific ligand for the corticotropin-releasing factor (CRF) receptor expressed by human trophoblast and ...

OBJECTIVE: To assess the neonatal outcome and four-year follow-up of pregnancies complicated by preterm prelabor rupture of membranes (PPROM) before 24 weeks. DESIGN: Retrospective study. SETTING: University Hospital of Saint Etienne, tertiary level center, France. METHODS: Obstetric and neonatal records of 38 pregnancies and 44 fetuses born between 1999 and ...

BACKGROUND: Topical corticosteroids are the most frequently prescribed dermatological treatment and are frequently used by pregnant women with skin conditions. However, little is known about their safety in pregnancy. OBJECTIVES: To assess the effects of topical corticosteroids on pregnancy outcomes. SEARCH STRATEGY: On 5th May 2009 we searched the Cochrane ...

BACKGROUND: A Cochrane review in 2006 concluded that further knowledge is required before recommendation can be made with regard to progesterone in the prevention of preterm birth. OBJECTIVE: To provide an update on the preventive effect of progesterone on preterm birth in singleton pregnancies. SEARCH STRATEGY: A search in the ...

Multiple pregnancies are at high risk for preterm birth, and therefore an important cause of infant mortality and morbidity. A pessary is a simple and potentially effective measure for the prevention of preterm birth. Small studies have indicated its effectiveness, but large studies with sufficient power on the subject are ...

We evaluated outcomes following tocolysis discontinuation in singleton pregnancies between 33.0 and 36.9 weeks' gestation. We performed a retrospective analysis of singleton pregnancies prescribed continuous subcutaneous terbutaline tocolysis. Patients without indicated preterm delivery discontinuing treatment between 33.0 and 36.9 weeks were evaluated ( N = 4253). Data were grouped by ...

Antenatal corticosteroid therapy to enhance fetal lung maturity in threatened preterm delivery has a number of non-pulmonary side-effects, both beneficial and undesirable. This review focuses on the short-term (transient) effects of betamethasone and dexamethasone on aspects of fetal circulation and behaviour which are used clinically as markers of fetal well-being. ...

BACKGROUND: Measurement of mid-gestation cervix length has become a common screening tool for preterm birth. Our study was designed to assess the value of cervix length and serum relaxin in the prediction of spontaneous preterm birth at < 35 and < 37 weeks' gestation in a general obstetric population. METHODS: ...

AIM: While delayed initiation of childbearing is associated with adverse perinatal outcomes, whether or not risk persists and whether interpregnancy interval (IPI) affects the subsequent pregnancy remains unclear. Objectives: To examine second-pregnancy perinatal outcomes for women initiating childbearing age > or = 30 compared to those initiating childbearing aged 20-29, ...

The global rate of preterm delivery (before 37 completed weeks of pregnancy) is increasing and there are no effective means available to prevent this rise. Prematurity is the principal cause of neonatal mortality and a major cause of pediatric morbidity and long-term disability. Current strategies to prolong pregnancy are based ...

BACKGROUND: This cross-sectional study explores associations between preterm delivery and demographic, clinical and occupational characteristics of women employed within a university and health system. METHODS: A comprehensive surveillance system linking individual-level data from Human Resources, medical insurance claims and a job-exposure matrix was used to identify women with a single ...

OBJECTIVES: To characterize neonatal morbidity and mortality rates in extreme preterm deliveries (between 23 and 27 weeks' gestation) with and without PPROM, and to evaluate the association between PPROM and chorioamnionitis. METHODS: A retrospective population-based study was conducted on preterm singleton pregnancies delivered between 23 and 27 weeks' gestation from ...

BACKGROUND:: Prior studies have linked the Utah Valley Steel Mill closure that took place between August 1986 and September 1987 to improvements in several health outcomes. So-called natural experiments ease concerns over confounding and exposure misclassification, concerns that are common in studies of air pollution and pregnancy outcome. METHODS:: We ...

We aimed to determine the relationship of douching prior to pregnancy and bacterial vaginosis (BV) during pregnancy on preterm birth, addressing individual and joint effects. We used a prospective cohort study and assessed vaginal microflora using gram stains and Nugent's criteria. Douching behaviour was based on self-report about the 12 ...

To evaluate the association of early pregnancy concentrations of thrombin-antithrombin III complex with subsequent spontaneous preterm birth. In a nested case-control study, thrombin-antithrombin III complex was measured in plasma before 20 weeks of gestation (mean 9.9 weeks) among women without chronic conditions, preeclampsia, or growth restriction. C-reactive protein and non-high-density ...

OBJECTIVE: To examine the possible association of maternal serum a disintegrin and metalloprotease (ADAM12) in the first trimester of pregnancy and subsequent development of preeclampsia, delivery of small for gestational age (SGA) neonates, and spontaneous preterm delivery. METHODS: The maternal serum concentration of ADAM12 at 11 0/7 to 13 6/7 ...

OBJECTIVE: We conducted a metaanalysis to determine whether antibiotics prolong pregnancy and reduce neonatal morbidity in preterm premature rupture of membranes (PPROM) and preterm labor (PTL) at 34 weeks or less. STUDY DESIGN: Randomized trials comparing antibiotic therapy with placebo in PPROM or PTL at a gestation of 34 weeks ...

OBJECTIVE: To evaluate the effect of N-acetyl cysteine (NAC) on gestational age at delivery in women with previous preterm labor and bacterial vaginosis. METHODS: A randomized, double-blind, placebo-controlled trial with 280 women between 16 and 18 weeks of pregnancy who had 1 previous preterm birth and had just been successfully ...

We compared neonatal outcomes from singleton pregnancies in women hospitalized with preterm labor (PTL) at 32 0/7 to 34 6/7 weeks managed with and without acute tocolysis. Women enrolled for outpatient surveillance who were hospitalized and diagnosed with PTL between 32 0/7; to 34 6/7 weeks' gestation without conditions necessitating ...

Our objective was to determine whether preterm birth of a singleton is associated with an increased risk of preterm birth of twins in a subsequent pregnancy. We identified all women who delivered a singleton followed by twins at Northwestern Memorial Hospital during a 10-year period. Using a cohort study design, ...

AIM: The primary objective of this study was to compare the rates of spontaneous and indicated preterm delivery at less than 37 weeks of gestation. A second objective was to identify prenatal events associated with preterm delivery at less than 35 weeks of gestation in women with diabetes mellitus (DM). ...

AIM: To examine the clinical utility of several prognostic factors for predicting preterm delivery. METHODS: One hundred and nineteen patients with a singleton pregnancy admitted to our hospital because of symptoms of preterm labor were included in this study. Maternal serum C-reactive protein (CRP), transvaginal sonographic measurement of cervical length ...

OBJECTIVE: The purpose of this study was to determine if antioxidant supplementation during pregnancy reduces the incidence of premature rupture of the membranes (PROM). STUDY DESIGN: A placebo-controlled, double-blind trial was conducted. PROM and preterm PROM (PPROM) were planned secondary outcomes of the trial. Women between 12(0/7) and 19(6/7) weeks ...

OBJECTIVE: To document triggering receptors of myeloid cells (TREM-1) expression in fetal membranes and to estimate soluble TREM-1 (sTREM-1) concentrations in the amniotic fluid (AF) from spontaneous preterm birth (PTB). METHODS: Fetal membranes at term not in labor placed in an organ explant system were stimulated with lipopolysaccharide (LPS). Membranes ...

PROBLEM: We evaluated associations between a length polymorphism in intron 2 of the gene coding for IL-1ra (gene symbol IL1RN) and pregnancy outcome in a population with a high rate of preterm birth. METHOD OF STUDY: Subjects were pregnant women in Maceio, Brazil and their newborns. DNA was tested for ...

OBJECTIVE: To investigate a causal link between infection and preterm birth in women with a shortened cervix induced by prior laser conization. METHODS: We conducted a retrospective review of the outcomes of 47 singleton pregnancies with a history of laser conization. Cervical length was measured between 17 and 23 weeks ...

BACKGROUND: An association between a woman's own birthweight and her fecundity has been suggested, but no empirical data have been published on the association between maternal birthweight and waiting time to pregnancy (TTP). METHODS: In the Danish National Birth Cohort (1996-2002), which is an ongoing study of 92 274 women ...

OBJECTIVE: To determine the maternal and fetal outcomes of women complicated with thalassemia syndrome. STUDY DESIGN: Retrospective descriptive study. MATERIALS AND METHODS: The database of Maternal-Fetal Medicine unit and medical records, between January 2001 and April 2008, were reviewed to search for pregnant women complicated with thalassemia syndrome and medical ...

Some spontaneous preterm deliveries (PTD) are caused by occult infections of the fetal membranes (histologic chorioamnionitis [HCA]). High levels of infection-related markers, including some cytokines, sampled from maternal circulation in mid-pregnancy have been linked to PTD, but whether these specifically identify HCA has not been established. We have tested associations ...

We examined outcomes of twin pregnancies complicated by recurrent preterm labor receiving nifedipine tocolysis. In a retrospective study design, twin pregnancies receiving outpatient preterm labor surveillance services and oral nifedipine tocolysis following a diagnosis of preterm labor were identified from a database ( N = 1421). Eligible for inclusion were ...

Premature delivery occurs in 12% of all births and accounts for nearly half of long-term morbidity. Current therapeutic approaches to preterm delivery are ineffective and present serious risks to both mother and fetus. The single most common cause of preterm birth is infection. Previous in vitro investigations have shown that ...

To evaluate the maternal and fetal outcomes in renal transplant female recipients who became pregnant from 1989 to 2005 in our center, we retrospectively studied 20 incident pregnancies in 12 renal transplant recipients; 5 (41.7 %) of them from living related, 4 (33.3%) from deceased, and 3 (25%) from living ...

OBJECTIVE: To examine the impact of maternal prepregnancy body mass index (BMI) on rates of recurrent preterm delivery (PTD) in women receiving 17alpha-hydroxyprogesterone caproate (17P) prophylaxis. STUDY DESIGN: The study population was identified from a large perinatal database containing prospectively collected information from women at high risk for PTD. We ...

In recent years, there has been increasing concern regarding the safety of in vitro fertilization (IVF) because of the potential health impact on these infants. Multiple pregnancy contributes the vast majority of morbidity associated with IVF and, initially, many thought that adverse outcomes after IVF were solely attributable to the ...

Midtrimester premature rupture of membranes (PROM) is an unusual complication of multiple gestation that most often results in poor obstetric outcome. Presented are four cases of twin pregnancy complicated by preterm PROM and umbilical cord prolapse at 16 to 21 weeks' gestation. After a period of expectant management, dilation and ...

BACKGROUND: Conception is discouraged during the period of maximal weight loss following Roux-en-Y gastric bypass (RYGB) because of speculative maternal and fetal concerns. We therefore performed a retrospective cohort study of obstetrical and neonatal outcomes by surgery-to-conception interval. METHODS: Women with RYGB were stratified into two groups by surgery-to-conception interval ...

OBJECTIVE: To describe outcomes in twin pregnancies with preterm premature rupture of membranes (PPROM). METHODS: Dichorionic twin pregnancies complicated by PPROM at <34 weeks of gestation for the period 2003 to 2006 were identified. Outcomes were obtained through chart review. The relationship between gestational age at premature rupture of membranes ...

OBJECTIVE: To evaluate whether measurement of the thickness of the fetal membranes by high-resolution ultrasound is a useful marker to predict preterm delivery. METHODS: One hundred and fifty-eight women with singleton pregnancies at 18-35 gestational weeks were enrolled consecutively at our referral center for obstetric care and the thickness of ...

OBJECTIVE: Preeclampsia, characterized by widespread endothelial damage and dysfunction, systemic toxicity, coagulation defects, and an increased systemic inflammatory response, poses some risk factors for hearing loss. STUDY DESIGN: A case-control study. SUBJECTS AND METHODS: Two groups with 37 preeclamptic and 38 healthy pregnant women were matched by age. Other factors ...

AIM: Preterm transition from foetal to neonatal circulation might permanently alter aortic growth and development. To test this hypothesis, we measured aortic dimensions in adolescents born very preterm. METHODS: Eighty-six healthy 15-year-old subjects were studied; 45 born very preterm at an average gestational age of 28 weeks (birth weight < ...