Technique de cerclage prophylactique précoce des cols hypoplasiques après exposition au DES in utero

Raynal, P.; Meaux, J.-P. Le; Epelboin, Sylvie; Tournaire, Michel

doi:10.1016/s0368-2315(05)82882-0

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…75 Indeed, Stys et al 89 demonstrated a functional dissociation between the effects of progesterone in the myometrium and those in the cervix. The effect of vaginal progesterone in the prevention of preterm birth is thought to be related to a pharmacologic correction of the decline in progesterone action, which manifests itself clinically as a sonographic short cervix. A congenital short cervix: Cervical hypoplasia after in utero exposure to diethylstilbestrol (DES) has been reported, 90–97 and so has dysgenesis of the cervix (i.e fragmented cervix with separations of segments, and a thin fibrous core). 98–101 These disorders are rare, and, in most cases, of unknown etiology.…”

Section: Causes Of a Sonographic Short Cervixmentioning

confidence: 99%

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A blueprint for the prevention of preterm birth: vaginal progesterone in women with a short cervix

Romero¹,

Yeo²,

Miranda

et al. 2013

Journal of Perinatal Medicine

184

103

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Preterm birth is the leading cause of perinatal morbidity and mortality worldwide, and is the most important challenge to modern obstetrics. A major obstacle has been that preterm birth is treated (implicitly or explicitly) as a single condition. Two-thirds of preterm births occur after the spontaneous onset of labor, and the remaining one-third after “indicated” preterm birth; however, the causes of spontaneous preterm labor and “indicated” preterm birth are different. Spontaneous preterm birth is a syndrome caused by multiple etiologies, one of which is a decline in progesterone action, which induces cervical ripening. A sonographic short cervix (identified in the midtrimester) is a powerful predictor of spontaneous preterm delivery. Randomized clinical trials and individual patient meta-analyses have shown that vaginal progesterone reduces the rate of preterm delivery at <33 weeks of gestation by 44%, along with the rate of admission to the neonatal intensive care unit, respiratory distress syndrome, requirement for mechanical ventilation, and a composite score of neonatal morbidity/mortality. There is no evidence that 17-alpha-hydroxyprogesterone caproate can reduce the rate of preterm delivery in women with a short cervix, and therefore, the compound of choice is natural progesterone (not the synthetic progestin). Routine assessment of the risk of preterm birth with cervical ultrasound coupled with vaginal progesterone for women with a short cervix is cost-effective, and implementation of such a policy is urgently needed. Vaginal progesterone is as effective as cervical cerclage in reducing the rate of preterm delivery in women with a singleton gestation, history of preterm birth, and a short cervix (<25mm).

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Section: Causes Of a Sonographic Short Cervixmentioning

confidence: 99%

“…A congenital short cervix: Cervical hypoplasia after in utero exposure to diethylstilbestrol (DES) has been reported, 90–97 and so has dysgenesis of the cervix (i.e fragmented cervix with separations of segments, and a thin fibrous core). 98–101 These disorders are rare, and, in most cases, of unknown etiology.…”

Section: Causes Of a Sonographic Short Cervixmentioning

confidence: 99%