Does Cervix Conization Increase the Risk of Complications in Subsequent Pregnancies?

Moinian, M.; Andersch, Björn

doi:10.3109/00016348209156537

Cited by 45 publications

(17 citation statements)

References 13 publications

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“…Nevertheless, several explanations can be suggested. First, multiple etiologies can account for the presence of an asymptomatic short cervix56, including intra‐amniotic infection/inflammation34, 39, 41, 57, congenital cervical anomalies58–61, cervical surgery27, 45, 62–69, cervical insufficiency10, 70–72 and others56. It is conceivable that the etiologic factors leading to a sonographic short cervix early in the mid‐trimester (i.e.…”

Section: Discussionmentioning

confidence: 99%

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

Vaisbuch

Romero

Erez

et al. 2010

Ultrasound in Obstet & Gyne

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Section: Discussionmentioning

confidence: 99%

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

Vaisbuch

Romero

Erez

et al. 2010

Ultrasound in Obstet & Gyne

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“…1–15 The earlier the diagnosis of a short cervix, the more likely the patient will deliver preterm. 16–33 Compelling evidence supports the view that this condition is syndromic in nature and has multiple etiologies, 13,34–37 such as a decline in progesterone action, 38–48 prior cervical surgery, 49–57 intra-amniotic inflammation and/ or infection, 58–63 and genuine cervical insufficiency. 35,64 Patients with a mid-trimester sonographic short cervix can be offered treatment with vaginal progesterone 65–73 and, for those with a history of preterm birth, a cervical cerclage 74–80 may be placed.…”

Section: | Introductionmentioning

confidence: 93%

The cytokine network in women with an asymptomatic short cervix and the risk of preterm delivery

Tarca

Fitzgerald

Chaemsaithong

et al. 2017

American J Rep Immunol

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ProblemTo characterize the amniotic fluid (AF) inflammatory-related protein (IRP) network in patients with a sonographic short cervix (SCx) and to determine its relation to early preterm delivery (ePTD).Method of studyA retrospective cohort study included women with a SCx (≤25 mm; n=223) who had amniocentesis and were classified according to gestational age (GA) at diagnosis and delivery (ePTD <32 weeks of gestation).Results(i) In women with a SCx ≤ 22 1/7 weeks, the concentration of most IRPs increased as the cervix shortened; those with ePTD had a higher rate of increase in MIP-1α, MCP-1, and IL-6 concentrations than those delivering later; and (ii) the concentration of most IRPs and the correlation between several IRP pairs were higher in the ePTD group than for those delivering later.ConclusionWomen with a SCx at 16–22 1/7 weeks have a unique AF cytokine network that correlates with cervical length at diagnosis and GA at delivery. This network may aid in predicting ePTD.

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“…Cervical surgery: The loss of connective tissue after a cervical operation such as a conization 102–107 or loop electrosurgical excision procedure (LEEP). 106,107 …”

Section: Causes Of a Sonographic Short Cervixmentioning

confidence: 99%

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

181

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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Does Cervix Conization Increase the Risk of Complications in Subsequent Pregnancies?

Cited by 45 publications

References 13 publications

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

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

The cytokine network in women with an asymptomatic short cervix and the risk of preterm delivery

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

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