Preterm birth (PTB) is the main cause of neonatal mortality and morbidity in the developed world. Historically, the approach for the prevention of PTB has been reactive rather than proactive. With the introduction of new screening tests and a greater emphasis on prevention rather than treatment, a number of new ...

OBJECTIVE: To evaluate the relationship between fetal fibronectin and preterm birth and maternal-to-child transmission of human immunodeficiency virus (HIV) in an African population of predominantly HIV-infected women. METHODS: During a trial of second trimester and intrapartum antibiotics compared with placebo to prevent chorioamnionitis and reduce preterm birth and mother-to-child transmission ...

BACKGROUND: The second trimester is recommended as the optimal time to conduct a surgical procedure on pregnant patients, even though the fetal responses to anesthesia at this age are not known. Here we assessed the responses of preterm fetal sheep to a standard anesthetic regimen of midazolam, thiopental, and isoflurane. ...

OBJECTIVES: To assess the relationship between first-trimester uterine artery Doppler measurements and spontaneous preterm delivery. METHODS: This was a retrospective analysis of uterine artery Doppler findings at 11-14 weeks in 73 singleton pregnancies with spontaneous preterm labor and 2417 pregnancies delivered at term. RESULTS: The uterine artery mean resistance index ...

A 34-years-old primigravida conceived following a fourth attempt at in vitro fertilization and embryo transfer for severe bilateral tubal disease and grade IV endometriosis. Pregnancy progressed well until 17 weeks gestation when she spontaneously ruptured her membranes. She elected to continue with the pregnancy despite the significant risks associated with ...

To examine the relationship between vaginal bleeding during early pregnancy and preterm delivery. Study subjects (N=2678) provided information regarding socio-demographic, biomedical, and lifestyle characteristics. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI). Any vaginal bleeding in early pregnancy was associated with a 1.57-fold ...

BACKGROUND: Preterm birth causes 60% to 80% of neonatal deaths. Survivors can experience life-long complications. The risk of preterm labour in the presence of maternal infection is thought to be 30% to 50%. Probiotics are defined as live micro-organisms which, when administered in an adequate amount, confer a health benefit ...

This study aims at evaluating the outcome of pregnancies complicated by pre-term premature rupture of membrane (PPROM) in a developing country and to highlight the problems of managing such cases and ways of improving future management. This was a retrospective review of 344 patients with PPROM at a University of ...

BACKGROUND: The aim of our study was to evaluate how sociodemographic factors, psychosocial adaptation to pregnancy and well-being levels are associated with the onset of preterm uterine contractions allowing symptomatic preterm labor. METHODS: In a prospective case-control design, 51 consecutive women admitted for threatened preterm labor were enrolled. The patients ...

BACKGROUND: Few studies have investigated the relationship between inflammation and spontaneous preterm delivery (sPTD) in women before preterm labour. The authors examine whether mid-pregnancy plasma cytokine levels are associated with sPTD, and whether associations vary by maternal age, body mass index, prior preterm delivery, or gravidity. METHODS: This case-control study ...

OBJECTIVES: Our objective is to compare maternal plasma procalcitonin concentrations in preterm premature rupture of membranes (pPROM) and premature rupture of membranes (PROM) at term with their levels in uncomplicated pregnancy, and to determine whether these concentrations are useful in the diagnosis of pPROM cases suspected of infection and in ...

BACKGROUND: Preterm premature rupture of membranes (pPROM) complicates up to one-third of preterm deliveries. We studied the Amniotic Fluid Index (AFI) in order to ascertain its validity as a predictive variable of maternal-fetal outcome in pregnancies complicated by pPROM. STUDY DESIGN: One hundred and fourteen pregnant women with gestational age ...

OBJECTIVE: To estimate whether maternal serum interleukin (IL)-6 or granulocyte colony-stimulating factor (G-CSF) obtained daily are elevated in women with preterm premature rupture of membranes who develop funisitis. METHODS: Daily blood samples were obtained from women with preterm premature rupture of membranes and analyzed for IL-6 and G-CSF by enzyme-linked ...

AIMS: Both acute placental inflammation and positive mid-gestational cervico-vaginal fetal fibronectin assays have been independently correlated with preterm delivery. We conducted this study to examine the relationship between positive mid-gestational fetal fibronectin (fFN) assays and histological evidence of acute placental inflammation at delivery among women presenting with symptomatic preterm labor. ...

BACKGROUND: 15% of multiple pregnancies ends in a preterm delivery, which can lead to mortality and severe long term neonatal morbidity. At present, no generally accepted strategy for the prevention of preterm birth in multiple pregnancies exists. Prophylactic administration of 17-alpha hydroxyprogesterone caproate (17OHPC) has proven to be effective in ...

OBJECTIVE: As many as 50% of spontaneous preterm births are infection-related, with Mycoplasma species being the most common microbial isolates from the amniotic cavity. The goal of our study was to evaluate the effect of macrolides, a specific group of antibiotics known to be effective against Mycoplasma species, on the ...

To evaluate the impact of clinical and histopathologic correlates related to maternal and fetal inflammatory responses (MIR and FIR) on degree of preterm birth. Pathology reports and clinical data from 577 singleton preterm births (<37 weeks of gestation) that took place between 1998 and 2004 were analyzed according to decreasing ...

Inflammation has been implicated in the mechanisms responsible for preterm and term parturition, as well as fetal injury. Out of all of the suspected causes of preterm labor and delivery, infection and/or inflammation is the only pathological process for which both a firm causal link with preterm birth has been ...

The increasing incidence of moderate preterm births (32-36 gestation weeks) might reflect a more general tendency toward a shortening of the gestational length occurring also in the term births (37 + gestation weeks). We examined all Italian 1st live born singletons (n = 2,356,365) and found that from 1990 to ...

BACKGROUND: The electrical activity of the uterine muscle is representative of uterine contractility. Its characterization may be used to detect a potential risk of preterm delivery in women, even at an early gestational stage. METHODS: We have investigated the effect of the recording electrode position on the spectral content of ...

A 32-year-old Caucasian woman of body mass index (BMI) 46 presented with urinary symptoms to accident and emergency (A&E). Acute pyelonephritis was the diagnosis. Transabdominal scan revealed a live term fetus. Both the partners were unaware of the ongoing pregnancy until diagnosed. She underwent emergency cesarean under general anaesthesia (GA) ...

Perinatal outcomes differ by week of gestational age. However, it appears that how measures to examine these outcomes vary among various studies. The current paper explores how perinatal complications are reported and how they might differ when different denominators, numerators, and comparison groups are utilized. One issue that can clearly ...

OBJECTIVE: To evaluate subsequent pregnancy outcomes in women with a previous mid-trimester (12-24 weeks) pregnancy termination by dilation and evacuation (D&E) as compared to women without a previous D&E. METHOD: Medical records for women who underwent a D&E between 1995 and 2003 were identified and reviewed. Women with subsequent pregnancies ...

Preterm prelabour rupture of the membranes (PPROM) is defined as prelabour rupture of the membranes prior to 37 weeks of gestation. It occurs in approximately 3% of pregnancies and is responsible for one-third of all preterm births. Effective treatment relies on accurate diagnosis, and it is gestational age dependent because ...

While preterm contractions occur almost as often extremely preterm as they do closer to term, birth due to spontaneous preterm labour before 27 weeks of gestation is rare, accounting for 0.05-0.7% of all births in different populations. Although the likelihood that uterine contractions before 27 weeks of gestation represent true ...

The incidence of spontaneous preterm labour and preterm birth has increased, and its management worldwide remains suboptimal. While considerable debate remains as to whether long-term maintenance tocolysis is appropriate after an episode of spontaneous preterm labour, many practitioners support its use. Several drugs have been used for maintenance tocolysis, but ...

In gynaecology, specialist menopause, urogynae, colposcopy, infertility, pelvic pain and cancer, rapid access clinics exist at many teaching and busy district general hospitals in the UK. Similarly, in obstetrics many busy maternity units have fetal medicine clinics, dedicated twins clinics and maternal medicine clinics, incorporating various general medical conditions and ...

Preterm birth is never low risk and there are advantages gained by prolonging gestation even at relatively advanced stages of pregnancy. This means that high-value treatments should not just be reserved for high-risk pregnancies. Some women treated with tocolytics will experience adverse events, and some adverse events are particularly associated ...

There is little doubt that all methods of assisted reproduction increase the likelihood of multiple pregnancy and, as a result, increase the likelihood of preterm birth. Data from the East Flanders Prospective Twin Study clearly show that the proportion of spontaneous to iatrogenic twins has changed from 25:1 to 1:1 ...

The major burden of preterm birth is in the developing world, where most of the increasing death and morbidity is secondary to infectious diseases such as malaria, HIV, tuberculosis, bacterial vaginosis and intestinal parasites. In some developing countries, the growth of medical care has outstripped the growth of preventive public ...

BACKGROUND: Few studies have examined the potential effects of periodontal treatment during pregnancy on pregnancy outcomes, periodontal status, and inflammatory biomarkers. METHODS: A randomized, delayed-treatment, controlled pilot trial was conducted to evaluate the effects of second-trimester scaling and root planing and the use of a sonic toothbrush on the rate ...

The late preterm infant represents a significant portion of preterm deliveries. Historically, this cohort has been referred to as near-term, which may not address adequately the increased perinatal morbidity these neonates experience. The changing demographics of pregnant women also are increasing the number of inductions in this gestational age group. ...

Today's dogma states that tocolytics can be used to prolong pregnancy for just 48 hours, allowing corticosteroids to be administered and transportation of the mother to a tertiary care centre. Surveys have shown that up to 30% of practitioners use maintenance tocolysis. Theoretically, maintenance tocolysis should be able to improve ...

Perinatal outcomes, such as preterm delivery, low birth weight and some obstetric complications, are increased significantly after in-vitro fertilization (IVF) compared with spontaneously conceived pregnancies. The degree of difference is greater for singletons than for twins, especially with regard to preterm delivery which is increased two fold in IVF singletons ...

OBJECTIVE: This study was undertaken to compare success rates of vaginal birth after cesarean (VBAC) delivery, and uterine rupture as well as maternal/perinatal outcomes between women with preterm and term pregnancies undergoing trial of labor (TOL), and to compare maternal and neonatal morbidities in those women with preterm pregnancies undergoing ...

OBJECTIVE: To evaluate the joint impact of pregnancy risk and the timing of referral of high-risk pregnancies from obstetricians to maternal fetal medicine (MFM) sub-specialists on gestational age (GA) at delivery. METHODS: For the period 1992-2002, 2567 consecutive deliveries from pregnancies of at least 23 weeks gestational age (GA) from ...

BACKGROUND: We determined the incidence, clinical course, risk factors, and outcomes of community-acquired pneumonia complicating pregnancy. METHODS: A prospective study was performed of pregnant and nonpregnant patients in the same age range who presented to any of 6 hospitals in Edmonton, Alberta, with signs and symptoms of pneumonia together with ...

Placental abruption complicates about 1% of pregnancies and is a leading cause of vaginal bleeding in the latter half of pregnancy. It is also an important cause of perinatal mortality and morbidity. The maternal effect of abruption depends primarily on its severity, whereas its effect on the fetus is determined ...

BACKGROUND: Increasing evidence suggests that maternal gingivitis and periodontitis may be a risk factor for preterm birth and other adverse pregnancy outcomes. TYPES OF STUDIES REVIEWED: To clarify the possible mechanisms behind the association between periodontal disease and preterm delivery, the authors reviewed studies of the effect of infection with ...

BACKGROUND: A case-control study was undertaken to detect whether initial chronic localized periodontitis could be a risk factor for preterm birth (PB) and foetal growth restriction. METHODS: A PB case was defined if a patient had a threatening premature event during pregnancy pre-term premature rupture of membranes, or spontaneous pre-term ...

OBJECTIVE: The aim of this study was to report outcome of subsequent pregnancy after early-onset preeclampsia in first pregnancy, and to evaluate potential risk factors for recurrence of preeclampsia and preterm delivery. STUDY DESIGN: Reproductive follow-up data were obtained for women with a history of early-onset preeclampsia, resulting in delivery ...

Preterm birth represents a major problem for modern obstetrics due to its increasing frequency and the accompanying socioeconomic impact. Although several maternal characteristics related to preterm birth have been identified, the etiology in most cases remains inadequately understood. Various microorganisms have been linked to the pathogenesis of preterm birth. Microbes ...

OBJECTIVE: Despite the increased tendency of preterm birth to recur, little is known with regard to recurrence risks for spontaneous and medically indicated preterm birth as well as recurrence risks in relation to severity of preterm birth. We examined the recurrence of spontaneous and medically indicated preterm birth. STUDY DESIGN: ...

OBJECTIVE: To evaluate whether the use of 17alpha-hydroxyprogesterone caproate for the prevention of recurrent preterm deliveries is cost-effective. METHODS: Using decision-analysis modeling, we compared the cost-effectiveness of using 17alpha-hydroxyprogesterone caproate in four subgroups: 1) Prior preterm deliveries less than 32 weeks; 2) prior preterm deliveries 32-37 weeks; 3) prior term ...

OBJECTIVES: The aim of this research is to study the complications of pregnancy associated with anencephaly. STUDY METHODS: Thirty-five mothers who delivered an anencephalic baby (as a case group) and forty-three mothers who delivered a non-anencephalic baby (as a control group)were included in this analytical research study. All cases and ...

OBJECTIVE: We examined the hypothesis that a single course of antenatal betamethasone influences the maternal-fetal insulin-IGF-GH axis. DESIGN: A prospective, observational, pilot study consisting of four groups of pregnant women: (I) received betamethasone and delivered <2 weeks post treatment; (II) received betamethasone and delivered >2 weeks post treatment; (III) untreated ...

Conventional wisdom holds that complications of immature organ systems such as respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia are the primary causes of the high neonatal morbidity and mortality attendant preterm delivery. However, recent evidence suggests that a major cause of prematurity-associated neonatal pathology is the fetal ...

OBJECTIVE: For unknown reasons, a previous preterm birth (PTB) is a major risk factor for PTB in the current pregnancy. Our goal is to evaluate placental histology for clues related to the recurrent nature of PTB. STUDY DESIGN: Four hundred fifty-seven mother/infant dyads delivering between 23 and 32 weeks were ...

OBJECTIVES: The aim of our study was to define the benefits and risks related to expectant management in the midtrimester rupture of membranes and to assess the prognostic factors in order to give objective informations to parents facing these obstetrical situations. STUDY DESIGN: We conducted a retrospective study. The study ...

A growing body of evidence implicates inflammatory pathways in adverse reproductive outcomes. This expanding evidence suggests that anti-inflammatory interventions may hold promise in reducing the maternal and neonatal morbidities and mortalities associated with these obstetrical complications. Preterm birth, preeclampsia, pregnancy loss and adverse neonatal outcomes have all been associated with ...