Objective: To evaluate the risk of preterm birth in low-risk women with cervical length (CL) ≤25 mm on transvaginal ultrasound (TVUS) managed with vaginal progesterone (VagP) therapy versus cerclage.
Study Design: This is a retrospective cohort of women with no prior history of preterm birth or cervical insufficiency and CL ≤ 25 mm on TVUS, managed with either VagP therapy alone or cerclage (with or without VagP). The primary outcome was rate of preterm delivery < 37 weeks gestational age (GA). Secondary outcomes included delivery at ≤ 32 or ≤ 28 weeks GA, premature preterm rupture of membranes, pregnancy latency, GA at delivery, and composite neonatal outcome.
Results: Women undergoing cerclage placement ( = 31) were older and had an earlier GA at the time of diagnosis of short cervix compared with women receiving VagP ( = 62). Delivery at < 37 weeks occurred in 21/62 (33.9%) in the VagP group and 14/31 (45.2%) in the cerclage group (adjusted odds ratio: 1.72, 95% confidence interval: 0.52, 5.66). There were no differences in secondary outcomes.
Conclusion: Cerclage compared with VagP therapy did not decrease risk of preterm birth in women with CL ≤ 25 mm. Further research is needed to determine optimal management in such women given a residual 40% risk of preterm birth despite optimal therapy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1055/s-0038-1668547 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Scabiosa artropurperea var.maritima aqueous extracts improve in vivo fertility parameters and in vitro granulosa cell steroidogenesis in Ewe.
Theriogenology
December 2024
CNRS, INRAE, Université de Tours, PRC, Nouzilly, France. Electronic address:
Scabiosa artropurperea, a member of the Dipsacaceae family and Scabiosa genus, is renowned for its medicinal properties. In the present study, we investigated the impact of Scabiosa artropurperea aqueous extract (AES) on the in vivo reproductive functions in Queue Fine de l'Ouest ewes, and on in vitro ovine granulosa cells. Ewes were synchronized for 14 days with intra-vagina progesterone (P4) devices (FGA, 20 mg) and divided into four groups receiving daily oral doses of 0, 1, 2, and 4 mg of AES/kg Live Body Weight (LBW), respectively.
View Article and Find Full Text PDFReduced number of regulatory T cells in maternal circulation precede idiopathic spontaneous preterm labor in a subset of patients.
Am J Obstet Gynecol
December 2024
Department of Gynecology, Obstetrics and Neonatology, General University Hospital in Prague and First Faculty of Medicine, Charles University, Prague, Czech Republic. Electronic address:
Background: Accumulating evidence suggests that spontaneous preterm labor is a syndrome caused by multiple pathological processes. The breakdown of maternal-fetal tolerance has been proposed as a key mechanism of idiopathic spontaneous preterm labor, often viewed as a chronic inflammatory process resulting from the maternal immune system's impaired tolerance of the fetus from early pregnancy. Regulatory T cells are crucial for maintaining maternal-fetal tolerance.
View Article and Find Full Text PDFCase report: Carcinosarcoma of uterus in nulliparous women.
Front Oncol
December 2024
Gynecologic Oncology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Article Synopsis
- Uterine carcinosarcoma (UCS) is a rare cancer combining both carcinoma and sarcoma features, often resembling endometrial carcinoma, with a potential link to nulliparity (never having given birth) as a risk factor.
- A 55-year-old woman presented with postmenopausal vaginal bleeding and was diagnosed after surgery, revealing well-differentiated adenocarcinoma and osteosarcoma components, along with multiple positive immunohistochemical markers.
- Following a series of surgical interventions and treatments, including chemotherapy and radiotherapy, the patient demonstrated no signs of tumor recurrence and had a disease-free survival of seven months as of July 2024.
Perinatal outcomes of progesterone in natural frozen-thawed embryo transfer pregnancies: insights from two randomized controlled trials.
Fertil Steril
December 2024
Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden; Reproduction Center, Uppsala University Hospital, 751 85 Uppsala, Sweden; Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 171 77 Stockholm, Sweden.
Objective: To explore whether progesterone supplementation during luteal phase and early pregnancy following a natural frozen-thawed embryo transfer cycle (NC-FET) affects perinatal outcomes.
Design: A secondary data analysis study based on two randomized control trials taking place during 2008-2011 and 2013-2018 at two university hospitals in Sweden.
Subjects: A total of 923 women undergoing a natural FET cycle.
A 12-h Difference in Exogenous Progesterone Initiation Does Not Have an Impact on Ongoing Pregnancy Rates in Artificial Cycles, as Long as Luteal Phase Support Starts Five Days Before Blastocyst Transfer.
Reprod Sci
December 2024
Global Research Alliance - IVI Foundation (IIS La Fe). Research Department, Avinguda de Fernando Abril Martorell, 106. 46026, Valencia, Spain.
Purpose: To elucidate if morning or evening start of exogenous progesterone (P4) five days before blastocyst embryo transfer (ET) impacts ongoing pregnancy rates (OPR) in artificial cycles.
Methods: Single-centre retrospective cohort study of 6493 artificial cycles for an ET (oestrogens and luteal phase support [LPS] with micronized vaginal progesterone [MVP] 400 mg/12 h), conducted at an infertility clinic, December 2018-July 2022. LPS was given from five days before ET.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!