Effectiveness and short-term safety of modified sodium hyaluronic acid-carboxymethylcellulose at cesarean delivery: a randomized trial.

Background: The rising cesarean birth rate has drawn attention to risks associated with repeat cesarean birth. Prevention of adhesions with adhesion barriers has been promoted as a way to decrease operative difficulty. However, robust data demonstrating effectiveness of such interventions are lacking.

Efficacy of midtrimester short cervix interventions is conditional on intraamniotic inflammation.

Background: Midtrimester ultrasound is a valuable method for identifying asymptomatic women at risk for spontaneous preterm delivery (PTD). However, response to various treatments (cerclage, progestogen) has been variable in the clinical setting. It remains unclear how other biomarkers may be used to guide intervention strategies.

Characteristics of participants in peripartum interventional research.

Objective: To identify characteristics of pregnant women potentially influencing the decision to participate in peripartum interventional research.

Methods: Women screened as eligible to participate in two prospective interventional trials conducted in the labor and delivery unit at a single center were included. Characteristics of eligible women were compared based on their decision whether to participate or not.

Amniotic fluid inflammatory score is associated with pregnancy outcome in patients with mid trimester short cervix.

Objective: We propose a novel amniotic fluid inflammatory score from a comprehensive cytokine analysis of patients with mid-trimester short cervix.

Study Design: Amniotic fluid from singleton gestations (n = 44) with a cervical length of ≤25 mm between 16-24 weeks was assayed for 25 inflammatory mediators. Patient data were stratified according to gestational age at delivery (<34 vs ≥34 weeks).

Controlled fine needle biopsy of the uterine cervix during pregnancy.

Objective: Cervical sampling could furnish tissue-based information regarding premature cervical ripening and effacement. This report assesses the effect of cervical fine needle biopsy (FNB) in the evaluation of cervical shortening.

Methods: Retrospective cohort study evaluating adverse events during the first week following FNB in women with short cervix.

Comprehensive amniotic fluid cytokine profile evaluation in women with a short cervix: which cytokine(s) correlates best with outcome?

Objective: The objective of this study was to determine whether an expanded amniotic fluid cytokine profile predicts spontaneous preterm birth in patients with short cervix in the midtrimester.

Study Design: Amniocentesis was performed on singleton gestations between 16-24 weeks with a cervical length View Article and Find Full Text PDF

Is midtrimester short cervix a sign of intraamniotic inflammation?

Objective: We sought to determine the relationship between the degree of cervical shortening and intraamniotic inflammation in patients presenting with a midtrimester short cervix.

Study Design: Amniocentesis was performed on singleton pregnancies between 16-24 weeks' gestation with a sonographic cervical length (CL) View Article and Find Full Text PDF

Fetal fibronectin testing in patients with short cervix in the midtrimester: can it identify optimal candidates for ultrasound-indicated cerclage?

Objective: The objective of the study was to determine the relationship between fetal fibronectin (fFN) testing prior to ultrasound-indicated cerclage and obstetric outcome.

Study Design: Singleton pregnancies between 18 and 24 weeks' gestation with an ultrasound-diagnosed short cervix (< 25 mm) and funneling (> 25%) of the chorioamniotic membranes into the endocervical canal were analyzed. The fFN testing was performed and patients were randomized to cerclage or no-cerclage.

The utility of fetal fibronectin in the prediction and prevention of spontaneous preterm birth.

Spontaneous preterm birth remains a significant problem in the United States despite intense research to decrease its prevalence. Strategies have been limited by inability to identify patients at risk for preterm birth, as the majority of patients do not have historical risk factors. The development of an assay to detect vaginal fetal fibronectin, along with the use of transvaginal ultrasonography to determine cervical length, has greatly increased our ability to identify those patients at highest risk.