Is there an interaction between cervical length and cervical microbiology in the pathogenesis of preterm labour?

Dowd, Jennifer; Permezel, Michael; Garland, Suzanne M.; Crespigny, Lachlan de

doi:10.1111/j.1479-828x.2001.tb01204.x

Cited by 8 publications

(3 citation statements)

References 13 publications

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“…In a prospective follow‐up study of 316 women between 18 and 28 weeks' gestation a strong correlation was found between a shortened cervix and preterm delivery at 18 weeks' gestation, especially if the woman also has cervical pathogens (111). Cervical length <20–15 mm at 23–24 weeks' gestation is reported to be associated with increased risk of preterm birth (109,112).…”

Section: Measurement Of Cervical Lengthmentioning

confidence: 99%

Preterm delivery: an overview

Haram¹,

Mortensen²,

Wollen³

2003

Acta Obstet Gynecol Scand

119

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Preterm delivery is the leading factor causing neonatal mortality and morbidity. We have conducted a PubMed literature search to obtain an update on the etiology, diagnostic problems and therapeutic considerations of preterm delivery. Approximately 5-10% of all births are premature. Preterm labor is associated with preterm rupture of membranes, cervical incompetence, polyhydramnion, fetal and uterine anomalies, infections, social factors, stress, smoking, heavy work and other risk factors. The diagnosis is made on the patients presenting symptoms, clinical findings and of progressive effacement and dilatation of the cervix. Biochemical markers of preterm delivery are of minor importance in daily clinical work. Measurement of the cervix, however, is a practical and valuable tool to predict preterm delivery. Cervical cerclage can be useful in selected cases. Antibiotics may help to prevent preterm labor in cases of known etiologic agents (e.g. preterm rupture of membranes and urinary infection). The use of tocolytic agents such as beta-sympathetic receptor stimulators can be advocated for a few days. There is evidence that their long-term use is not beneficial and could even be harmful to the fetus. Calcium channel blockers (nifedipine) and a new selective oxytocin receptor antagonist, atosiban, appear to be as effective as beta-sympathomimetic drugs on uterine contractions with fewer side-effects. Prostaglandin synthetase inhibitors such as indomethacin may prevent uterine contractions and can be used prior to the 32nd week of pregnancy. A single course of corticosteroid treatment in two doses of 12 mg betamethasone or 6 mg of dexamethasone is important for the prevention of respiratory distress between the 24th and 34th weeks of pregnancy. Multiple doses may be harmful and should be avoided. In these cases management should depend on gestation age (fetal maturity). Uterine contractions after 34 weeks' gestation are not an indication for tocolytic treatment.

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Section: Measurement Of Cervical Lengthmentioning

confidence: 99%

Preterm delivery: an overview

Haram¹,

Mortensen²,

Wollen³

2003

Acta Obstet Gynecol Scand

119

View full text Add to dashboard Cite

show abstract

“…125 Further, women with a short cervix and bacterial vaginosis have a significantly higher risk of preterm delivery than women with just one of these risk factors. 162 The interaction between cervical and infective risk factors would be anticipated to be highest prior to chorio-decidual fusion. During later pregnancy this factor could differentially affect the dependent memberanes and induce the local mechanism associated with term LROM.…”

Section: Cervical 'Incompetence'mentioning

confidence: 99%

The Fetal Membranes and Mechanisms Underlying Their Labour-Associated and Pre-Labour Rupture During Pregnancy

McParland

Bell

2004

Fet. Matern. Med. Rev.

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“…In a prospective follow-up study of 316 women between 18 and 28 weeks' gestation a strong correlation was found between a shortened cervix and preterm delivery at 18 weeks' gestation, especially if the woman also has cervical pathogens (111). Cervical length <20-15 mm at 23-24 weeks' gestation is reported to be associated with increased risk of preterm birth (109,112).…”

Section: Measurement Of Cervical Lengthmentioning

confidence: 99%

Preterm delivery: an overview

Haram¹,

Mortensen²,

Wollen³

2003

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

Preterm delivery is the leading factor causing neonatal mortality and morbidity. We have conducted a PubMed literature search to obtain an update on the etiology, diagnostic problems and therapeutic considerations of preterm delivery. Approximately 5-10% of all births are premature. Preterm labor is associated with preterm rupture of membranes, cervical incompetence, polyhydramnion, fetal and uterine anomalies, infections, social factors, stress, smoking, heavy work and other risk factors. The diagnosis is made on the patients presenting symptoms, clinical findings and of progressive effacement and dilatation of the cervix. Biochemical markers of preterm delivery are of minor importance in daily clinical work. Measurement of the cervix, however, is a practical and valuable tool to predict preterm delivery. Cervical cerclage can be useful in selected cases. Antibiotics may help to prevent preterm labor in cases of known etiologic agents (e.g. preterm rupture of membranes and urinary infection). The use of tocolytic agents such as b-sympathetic receptor stimulators can be advocated for a few days. There is evidence that their longterm use is not beneficial and could even be harmful to the fetus. Calcium channel blockers (nifedipine) and a new selective oxytocin receptor antagonist, atosiban, appear to be as effective as b-sympathomimetic drugs on uterine contractions with fewer side-effects. Prostaglandin synthetase inhibitors such as indomethacin may prevent uterine contractions and can be used prior to the 32nd week of pregnancy. A single course of corticosteroid treatment in two doses of 12 mg betamethasone or 6 mg of dexamethasone is important for the prevention of respiratory distress between the 24th and 34th weeks of pregnancy. Multiple doses may be harmful and should be avoided. In these cases management should depend on gestation age (fetal maturity). Uterine contractions after 34 weeks' gestation are not an indication for tocolytic treatment.

show abstract

Is there an interaction between cervical length and cervical microbiology in the pathogenesis of preterm labour?

Cited by 8 publications

References 13 publications

Preterm delivery: an overview

Preterm delivery: an overview

The Fetal Membranes and Mechanisms Underlying Their Labour-Associated and Pre-Labour Rupture During Pregnancy

Preterm delivery: an overview

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