Document Detail

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:  MEDLINE    
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.
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:  2011-04-01     Revised Date:  2014-07-30    
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    
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MeSH Terms
Cerclage, Cervical
Cervical Length Measurement*
Indomethacin / diagnostic use*,  therapeutic use
Obstetric Labor, Premature / diagnosis*
Retrospective Studies
Tocolytic Agents / diagnostic use*,  therapeutic use
Uterine Cervical Incompetence / diagnosis*,  therapy
Reg. No./Substance:
0/Tocolytic Agents; XXE1CET956/Indomethacin

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