Cervical pessary for preventing preterm birth in twin pregnancies with maternal short cervix after an episode of threatened preterm labor: randomised controlled trial.

Background: No intervention has proved effective to date in reducing the spontaneous preterm birth rate in twin pregnancies following an episode of threatened preterm labor and with a short cervix remaining. This study was designed to ascertain whether cervical pessaries are useful in preventing spontaneous preterm birth in women with twin pregnancies and a short cervix remaining after a threatened preterm labor episode.

Study Design: This open, randomized, controlled trial was conducted in 132 pregnant women who had not delivered 48 hours after a threatened preterm labor episode and had a short cervix remaining (≤20 mm between 24 and 29 weeks and ≤10 mm between 30 and 33 weeks).

Prevention of spontaneous preterm birth.

Background: It is estimated that globally, approximately 13 million preterm infants are born annually and a much higher number of pregnancies are characterized by threatening preterm birth.

Findings: A proportional inverse correlation between gestational age at delivery and neonatal mortality has been observed which is more prevalent in countries without high standard neonatal care. The socioeconomic burden of preterm birth is enormous, as preterm neonates are particularly prone to severe morbidity that may expand up to adulthood.

Intraobserver and interobserver variability in first-trimester transvaginal ultrasound cervical length.

To determine intraobserver and interobserver variability in the measurement of different cervical length (CL) components at the first trimester (endocervical canal and isthmus), describe the optimum measurement method (single line or two lines) and establish a normality curve of first trimester CL in our population. Women who attended the first-trimester US scan, between 11.0 and 13.

Cervical pessary to reduce preterm birth <34 weeks of gestation after an episode of preterm labor and a short cervix: a randomized controlled trial.

Background: To date, no intervention has proved effective in reducing the spontaneous preterm birth rate in singleton pregnancies following an episode of threatened preterm labor and short cervix remaining.

Objective: This study was designed to ascertain whether cervical pessaries could be useful in preventing spontaneous preterm birth in women with singleton pregnancies and a short cervix after a threatened preterm labor episode.

Study Design: This open randomized controlled trial was conducted in 357 pregnant women (between 24-33 weeks) who had not delivered 48 hours after a threatened preterm labor episode and had a short cervix remaining (≤25 mm at 24-29 weeks; ≤15 mm at 30-33 weeks).

Modification of cervical length after cervical pessary insertion: correlation weeks of gestation.

Objectives: To observe the modifications in cervical length (CL) in patients with and without cervical pessary (Arabin® ASQ 65/25/32) and correlate these modifications with gestational age at delivery.

Study Design: Prospective study of asymptomatic singleton pregnancies (PECEP-Trial) between weeks 20 + 0 and 23 + 6 with maternal short cervix (<25 mm) randomised into two groups: expectant management and cervical pessary.

Results: This study included 380 pregnant women: 190 with pessary and 190 without pessary.

Cervical pessary to prevent preterm birth in women with twin gestation and sonographic short cervix: a multicenter randomized controlled trial (PECEP-Twins).

Background: Spontaneous preterm birth (SPB) is the leading cause of perinatal morbidity and mortality. In twins, the rate of preterm birth is higher than in singletons; interventions to prevent preterm birth are needed in this high-risk population.

Objective: We sought to test whether a cervical pessary reduces the preterm birth rate in twin pregnancies with sonographic short cervix.

Physical examination-indicated cerclage in singleton and twin pregnancies: maternal-fetal outcomes.

Objectives: To study maternal and perinatal outcomes after physical examination-indicated cerclage in both singleton and twin pregnancies and evaluate the possible risk factors associated.

Study Design: Retrospective review of all women undergoing physical examination-indicated cerclage at the Hospital Vall d'Hebro, Barcelona from January 2009 to December 2012 after being diagnosed with cervical incompetence and risk of premature birth.

Results: During the study period, 60 cases of women diagnosed with cervical incompetence who were carrying live and morphologically-normal fetuses (53 singleton and 7 twin pregnancies), and who had an imminent risk of premature birth were evaluated.

Predictors of obstetric complications in women with heart disease.

Objectives: The objective of this study is to evaluate obstetric outcomes in women with heart disease and determine whether current multidisciplinary management approaches adversely affect the mother, the neonate, or both. Also to compare the accuracy of several risk scores (RS) including the modified World Health Organization classification (mWHO) and CARPREG to predict obstetric and neonatal complications and to study the addition value of Uteroplacental-Doppler flow (UDF) parameters to predict obstetric complications.

Methods: A prospective cohort study examined outcomes in women with heart disease (HD), the majority of whom had corrective surgery and delivered between January 2007 and March 2012.

Obesity in obstetrics.

Obesity is a rising global epidemic. Obesity during pregnancy is associated with increased maternal and fetal risks, which is inversely correlated with the severity level of obesity. Other comorbidities are common (diabetes mellitus, hypertensive disorders, etc.

Premature rupture of membranes before 34 weeks managed expectantly: maternal and perinatal outcomes in singletons.

Objectives: To ascertain the risk factors for imminent delivery and infection in pregnant women with premature rupture of membranes (PPROM) before 34 weeks of gestation, evaluate maternal and fetal outcomes and identify obstetric factors for determining which patients meet the criteria for home follow-up.

Methods: Medical charts of all women with PPROM admitted to the Vall d'Hebron Hospital (HVH) between January 2006 and December 2010 were retrospectively reviewed.

Results: During the study period, 216 women were admitted with a diagnosis of PPROM <34 weeks of gestation with a singleton, live, structurally-normal fetus.

Cervical pessary in pregnant women with a short cervix (PECEP): an open-label randomised controlled trial.

Background: Most previous studies of the use of cervical pessaries were either retrospective or case controlled and their results showed that this intervention might be a preventive strategy for women at risk of preterm birth; no randomised controlled trials have been undertaken. We therefore undertook a randomised, controlled trial to investigate whether the insertion of a cervical pessary in women with a short cervix identified by use of routine transvaginal scanning at 20-23 weeks of gestation reduces the rate of early preterm delivery.

Methods: The Pesario Cervical para Evitar Prematuridad (PECEP) trial was undertaken in five hospitals in Spain.

Inherited antithrombin deficiency and pregnancy: maternal and fetal outcomes.

Objective: To describe the outcome of pregnancy in women with inherited antithrombin (AT) deficiency.

Study Design: A descriptive retrospective study was performed. Medical records were reviewed in order to collect data about maternal thrombotic complications and pregnancy outcomes.

Cerebral venous blood flow in growth restricted fetuses with an abnormal blood flow in the umbilical artery before 32 weeks of gestation.

Objective: To evaluate the brain venous circulation in fetuses with severe intrauterine growth restriction (IUGR) before 32 weeks of gestation.

Study Design: Fifty fetuses with severe IUGR diagnosed between 27 and 32 weeks of gestation and 50 appropriate-for-gestational age (AGA) fetuses matched by gestational age were evaluated. IUGR fetuses were classified according to their hemodynamic deterioration pattern in relation to the Doppler examination of the umbilical artery (UA), middle cerebral artery (MCA) and ductus venosus (DV).

Cervical pregnancy complicated with group B streptococcal meningitis.

Maternal group B streptococcal infection is an uncommon entity. Herein we describe a case of a 27-year-old-woman who presented life-threateniing group B streptococcus meningitis with an ectopic cervical pregnancy. No other infectious focus have been found.

Placental angiogenic growth factors and uterine artery Doppler findings for characterization of different subsets in preeclampsia and in isolated intrauterine growth restriction.

Objective: The purpose of this study was to evaluate possible relationships between placental markers and endothelial dysfunction in preeclampsia and intrauterine growth restriction.

Study Design: A prospective study was conducted in 76 patients with preeclampsia and 37 patients with intrauterine growth restriction that were classified as early onset (<34 weeks of gestational age) or late onset, and 40 control subjects. Plasma levels of placental growth factor, soluble fms-like tyrosine kinase-1, vascular cell adhesion molecule-1, and uterine artery Doppler indices were measured.