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.

Postpartum use of long-acting reversible contraception in a military treatment facility.

Objective: To determine the rate at which long-acting reversible contraception (LARC) is desired immediately postpartum and utilized within 12 weeks of delivery at our institution.

Methods: This prospective cohort study analyzed 400 consecutive postpartum patients between January 2009 and March 2009. We followed contraceptive desire prior to discharge and actual contraception utilized within 12 weeks postpartum.

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.

Complete trisomy 21 vs translocation Down syndrome: a comparison of modes of ascertainment.

Objective: To compare the indications for invasive prenatal testing resulting in the detection of translocation Down syndrome and complete trisomy 21.

Study Design: This case control study was based on a large amniocentesis and chorionic villi samples database (n = 534,795). All specimens with translocation Down syndrome (n = 203) comprised the translocation group and were compared with a maternal age-matched group (4 to 1, n = 812) in which complete trisomy 21 was detected.

A systematic technique using 3-dimensional ultrasound provides a simple and reproducible mode to evaluate the corpus callosum.

Objective: The aim of this study was to evaluate a rapid 3-dimensional ultrasound-assisted technique for evaluation of the corpus callosum as an integral part of the anatomic survey.

Study Design: Transabdominal 3-dimensioal gray scale and power Doppler volumes of the fetal brain were acquired in 102 consecutive healthy fetuses at 20-23 postmenstrual weeks. Offline analysis was performed by 2 of the authors using a systematic approach of "volume manipulation.

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

A randomized trial of cerclage vs. 17 alpha-hydroxyprogesterone caproate for treatment of short cervix.

Objective: To determine pregnancy outcome in patients with short cervix on transvaginal ultrasound between 16 and 24 weeks' gestation treated with McDonald cerclage compared to weekly intramuscular injections of 17 alpha-hydroxyprogesterone caproate (17OHP-C).

Methods: From November 2003 through December 2006, asymptomatic, singleton pregnancies were screened with transvaginal ultrasound between 16-24 weeks' gestation. Patients with a cervical length (CL) < or =25 mm were offered enrollment.

Comparison of modes of ascertainment for mosaic vs complete trisomy 21.

Objective: We sought to compare the indications for amniocentesis leading to the detection of either mosaicism of trisomy 21 (mosaic-T21) or complete trisomy 21 (T21).

Study Design: A retrospective review of a large amniocentesis database (n = 494,163) was conducted. All specimens with mosaic-T21 (n = 124) were compared with a maternal age-matched group of T21 fetuses (n = 496).

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

Universal tuberculosis screening in pregnancy.

We reviewed our practice of universal tuberculosis (TB) screening in an at-risk pregnant population with regards to utility and patient compliance. The Gouverneur Healthcare Services prenatal database was analyzed for compliance with TB screening. Age, ethnicity, country of origin, and education level were also analyzed.

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.