| Integrating cervical length measurement into routine antenatal screening and only emergency cerclage when indicated. | |
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MedLine Citation:
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PMID: 19400417 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To integrate cervical length measurement into antenatal screening and apply emergency cerclage when indicated to prevent spontaneous deliveries at < 34 weeks of gestation. METHODS: Cervical length measurements of 400 pregnant volunteers were obtained at gestational weeks 12-14, 18-20 and 28-32. Whenever a cervical measurement < 30 mm was observed, vaginal cultures and bacterial vaginosis were investigated, and weekly cervical length measurements were performed thereafter. Emergency cerclage was performed whenever complete cervical effacement and > or = 3 cm cervical dilatation were observed before 32 completed weeks of gestation. We adopted and tested a strategy of only emergency cerclage application when clinically indicated after ultrasound screening and microbial monitoring of short cervices. Patients were given cyclooxygenase-inhibitors, progesterone, and antibiotics in the postoperative period. RESULTS: Spontaneous preterm births at < 34 weeks of gestation occurred in 15 women (3.8%). We performed five emergency cerclages according to the presented screening strategy between 20-28 weeks of gestation all of which reached > 34 weeks. We successfully postponed 62.5% (5/8) of deliveries before 32 completed weeks and 33.3% (5/15) of deliveries before 34 completed weeks. CONCLUSION: Routine cervical length measurement combined with serial transvaginal sonograms and vaginal microbial monitoring of the short cervices will avoid unnecessary prophylactic cerclages while increasing the success of emergency cerclages performed upon solid clinical findings. |
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Authors:
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E Caliskan; Y Cakiroglu; D Dundar; E Doger; S Caliskan; S Ozeren |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical and experimental obstetrics & gynecology Volume: 36 ISSN: 0390-6663 ISO Abbreviation: Clin Exp Obstet Gynecol Publication Date: 2009 |
Date Detail:
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Created Date: 2009-04-29 Completed Date: 2009-06-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802110 Medline TA: Clin Exp Obstet Gynecol Country: Italy |
Other Details:
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Languages: eng Pagination: 40-5 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, Kocaeli University School of Medicine, Kocaeli, Turkey. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Algorithms Body Weights and Measures Cerclage, Cervical / utilization Cervix Uteri / anatomy & histology*, ultrasonography* Female Follow-Up Studies Humans Pregnancy Premature Birth / prevention & control* Prospective Studies Ultrasonography, Prenatal* Vaginosis, Bacterial / diagnosis* Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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