ClinicalTrials.gov, www.clinicaltrials.gov, NCT00579839.

Weekly intramuscular administration of hydroxyprogesterone caproate and daily vaginal administration of a progesterone suppository exhibited similar efficacy in reducing the rate of recurrent preterm birth. ClinicalTrials.gov: NCT00579553.

(Abstracted from Int J Gynecol Obstet 2016;134:169–172) Preterm birth (PTB) is responsible for most of the neonatal deaths that occur in the absence of congenital anomalies. It is also a major cause of long-term disabilities, including cerebral palsy, blindness, and deafness in childhood.

Women were included with a singleton pregnancy from 24-34 wks, who were deemed at high risk for PTD based on symptoms of premature contractions or a history of previous PTD. The ultrasound examination was done using a mid-sagittal transvaginal view of the cervix, without applying pressure. Elastogram of the internal os was measured along with cervical length and presence of sludge or funnelling. Elastogram was graded according to colour intensity into high risk (level 3-4) or low risk (level 1-2). The correlation between sonographic cervical factors and PTD were calculated using Pearson chi square test, as well as a multifactorial regression analysis to exclude confounding factors. Results: The study included 127 women. PTD occurred in 15 cases (11.8%). A statistically significant correlation was found between PTD with elastogram of the cervix and funnelling. Women in the high risk group had a PTD risk of 3.2x (23% vs 7%, p=0.037). Women with cervical funnelling delivered early in 55% of cases versus 9.7% (p=0.003). Objectives: To analyse the influence of gestational age and other clinical factors on cervical length (CL) throughout gestation in singleton and twin pregnancies. Methods: Retrospective analysis of 7556 CL measurements taken from 1572 singleton pregnancies and 4213 CL measurements taken from 436 twin pregnancies throughout gestation. All CL measurements were performed in a single Institution. Results: Twins showed greater CL than singletons at 12-13 (P<0.002) and 17-18 weeks (P<0.03). CL remained quite unchanged in singletons and twins until 20-22 weeks but decreased gradually thereafter. Twin pregnancies exhibited a greater and sharper CL decrease in the second half of pregnancy (P<0.002). A lower CL throughout pregnancy was observed in cases of previous preterm delivery, uterine malformations and low body mass index (BMI). CL throughout pregnancy was not influenced by method of conception, smoking habit, maternal age or parity. Conclusions: CL remained quite stable in singletons and twins until mid-gestation but twins had a greater gradual CL decrease in the second half of pregnancy. Women with a previous preterm delivery, uterine malformations and/or low BMI had lower CL throughout pregnancy. Objectives: Preterm birth (birth before 37 weeks of completed gestation) is the leading cause of neonatal death, and has an incidence of 5-13% which is believed to be on the rise. The objective of this study was to determine the rate of spontaneous preterm birth and investigate the relationship between preterm birth and cervical length in a pregnant Asian population. Methods: 1000 women with single viable pregnancies at less than 14 weeks of gestation were recruited between September 2010 and November 2013. Cervical length was measured using ultrasound at each of the 4 antenatal visits (Visit 1: > 14 weeks, Visit 2: 18-22 weeks, Visit 3: 28-32 weeks and Visit 4: > 34 weeks) using the Fetal Medicine Foundation protocol. Results: There was a significantly shorter cervical length both in the 2nd trimester (18 to...

Local anesthetic lidocaine significantly lowers maternal perceived pain during genetic amniocentesis.