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Indomethacin as a diagnostic and therapeutic tool in the management of progressive cervical shortening diagnosed by trans-vaginal sonography.
MedLine Citation:
PMID:  20350239     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective. To evaluate the role of indomethacin in discriminating between preterm labour and cervical insufficiency-related cervical shortening. Methods. Retrospective analysis of all cases of cervical shortening on singleton gestations. All patients were treated according to our protocol with one or more of the following three modalities: (1) bed rest only, (2) bed rest and indomethacin and (3) cervical cerclage, bed rest, and indomethacin. Outcomes: foetal loss <24 weeks, birth weight, delivery <34 weeks, and delivery <37 weeks. Results. We treated 342 patients: 167 (48.8%) with bed rest only, 21 (6.1%) with cerclage, and 154 (45.1%) with indomethacin. By 28 weeks 56 (16.3%) remained stable or improved with bed rest only, 91 (26.6%) failed indomethacin and required cerclage, and the remaining 173 (50.6%) responded well to indomethacin and nifedipine. Birth weight was 3119 g ± 651 (SD) and GA at delivery 37.4 weeks ± 2.5 (SD). Of the 342 patients, 4 (1.2%) aborted <24 weeks, 1 was terminated (achondroplasia), 320 (93.6%) patients delivered >34 weeks and 301 (88.1%) >37 weeks. Conclusions. Use of indomethacin in patients with cervical shortening discriminates patients with cervical insufficiency from those in premature labour and improves outcomes in comparison to existing published reports.
Authors:
Alexander Kofinas; Jason Kofinas
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Publication Detail:
Type:  Journal Article     Date:  2010-03-30
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  24     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  79-85     Citation Subset:  IM    
Affiliation:
New York Methodist Hospital, Brooklyn, NY, USA and Cornell University Weill College of Medicine, New York, NY, USA.
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