Amniocentesis for Selection Before Rescue Cerclage

Interleukin-6 andMycoplasma hominisas markers of preterm birth and related brain damage: Our experience

“…Moreover, the evidence of MIAC relates to other important indexes of preterm delivery; the frequency of MIAC among women with cervical insufficiency is up to 51% [23,24]. If the cervix is short (as determined by sonographic cervical length 525 mm) MIAC occurs in 9% of cases [25].…”

Emergency Cerclage

“…51Y53, 55 Three of these studies compared these markers between women with a dilated cervix who underwent amnioreduction before emergency cerclage and a control group of healthy pregnant women who underwent amniocentesis for chromosomal testing. 51Y53 Weiner et al 51 utilized a proteomic strategy to investigate the role of specific biomarkers as potential predictors.…”

“…Interleukins (IL-1>, IL-1A, and IL-8) were significantly increased in the group with nonsurviving neonates when compared with those whose infants survived (P = 0.010Y0.035). 53 Mays et al 55 showed that the presence of amniotic indicators of infection (low glucose, lactate dehydrogenase levels, positive Gram stain or culture) is associated with worse perinatal outcome in patients undergoing emergency cerclage. The group that had emergency cerclage after amniocentesis had a significantly longer mean admission-to-delivery interval (93.4 T 33.1 vs 16.7 T 20.5 days), higher mean gestational age at delivery (35.2 T 4.2 vs 23.0 T 3.8 weeks), higher mean birth weight (2508 T 900 vs 556 T 302 g), and higher neonatal survival rate (100% vs 28.6%) than did the group that had emergency cerclage without amniocentesis and the group that had no cerclage after amniocentesis (P G .001).…”

“…55 Only 1 study was an RCT with emergency cerclage and expectant management groups. 56 The studies differed in methodology, inclusion and exclusion criteria, and outcome measures.…”

Clinical significance of early (< 20 weeks) vs. late (20–24 weeks) detection of sonographic short cervix in asymptomatic women in the mid‐trimester

“…The importance of identifying women with a sonographic short cervix in the mid‐trimester derives from evidence that those patients, regardless of whether or not they have a history of preterm birth, may be candidates for therapeutic interventions such as vaginal progesterone29–31, cervical cerclage32, 33, antibiotics34 or indomethacin35. However, a short cervix is syndromic in nature and can be caused by multiple etiologies36, 37 such as subclinical intrauterine infection34, 38, 39 and/or inflammation40, 41 and cervical insufficiency. Thus, although results of randomized clinical trials evaluating the use of progesterone or cerclage have been promising29, 33, 42, these therapeutic interventions may be beneficial only in a subset of patients.…”