Short cervix syndrome: current knowledge from etiology to the control

Filho, Hélio Antônio Guimarães; Júnior, Edward Araujo; Pires, Cláudio Rodrigues; Nardozza, Luciano Marcondes Machado

doi:10.1007/s00404-013-2740-0

Cited by 13 publications

(9 citation statements)

References 51 publications

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“…In pregnant women with short cervix, strategies that have been shown to be effective in reducing preterm labor included prophylactic progesterone therapy, cervical cerclage and insertion of cervical pessaries [7]. The primary results from a randomized clinical trial on women with history of preterm birth showed that vaginal progesterone administration was associated with low recurrence rate of preterm birth [8] and in two secondary analyses; vaginal progesterone administration was associated with delayed cervical shortening as pregnancy progressed [9], and lower frequency of admission to the neonatal intensive care unit (NICU) [10].…”

Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: Vaginal progesterone for prevention of preterm labor in asymptomatic twin pregnancies with sonographic short cervix: a randomized clinical trial of efficacy and safety

El-refaie

Abdelhafez

Badawy

2015

Arch Gynecol Obstet

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Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: Vaginal progesterone for prevention of preterm labor in asymptomatic twin pregnancies with sonographic short cervix: a randomized clinical trial of efficacy and safety

El-refaie

Abdelhafez

Badawy

2015

Arch Gynecol Obstet

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“…Preterm labor is a syndrome characterized by the combination of increased uterine contractility, cervical remodeling (ie, ripening and dilatation), and decidual membrane activation, caused by multiple pathologic processes . One of the mechanisms of disease implicated in preterm parturition is a breakdown of immune tolerance, which may evolve into maternal anti‐fetal rejection …”

Section: Introductionmentioning

confidence: 99%

CXCL10 and IL‐6: Markers of two different forms of intra‐amniotic inflammation in preterm labor

Romero

Chaemsaithong

Chaiyasit

et al. 2017

American J Rep Immunol

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ProblemTo determine whether amniotic fluid (AF) CXCL10 concentration is associated with histologic chronic chorioamnionitis in patients with preterm labor (PTL) and preterm prelabor rupture of the membranes (PROM).Method of StudyThis study included 168 women who had an episode of PTL or preterm PROM. AF interleukin (IL)‐6 and CXCL10 concentrations were determined by immunoassay.Results(i) Increased AF CXCL10 concentration was associated with chronic (OR: 4.8; 95% CI: 1.7‐14), but not acute chorioamnionitis; (ii) increased AF IL‐6 concentration was associated with acute (OR: 4.2; 95% CI: 1.3‐13.7) but not chronic chorioamnionitis; and (iii) an increase in AF CXCL10 concentration was associated with placental lesions consistent with maternal anti‐fetal rejection (OR: 3.7; 95% CI: 1.3‐10.4). (iv) All patients with elevated AF CXCL10 and IL‐6 delivered preterm.ConclusionIncreased AF CXCL10 concentration is associated with chronic chorioamnionitis or maternal anti‐fetal rejection, whereas increased AF IL‐6 concentration is associated with acute histologic chorioamnionitis.

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“…“Sludge” has also been reported by others as an independent risk factor for preterm birth in “short cervix” patients 27‐29 . In our study, we conducted a joint analysis of cytokines and “sludge” and failed to see an independent effect of “sludge” on our primary outcome (late miscarriage) when adjusted for cytokine levels, possibly due to low statistical power.…”

Section: Discussionmentioning

confidence: 59%

Amniotic immune biomarkers as risk factors in women with different symptoms of threatened late miscarriage

Meng

Wang

Reilly

et al. 2020

American J Rep Immunol

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Problem:To investigate risk factors that can help identify the possibility of pregnancy loss in threatened late miscarriage (TLM) patients with and without spontaneous uterine contractions. Method of study:Amniotic immune biomarkers (IL2β receptor, IL6, IL8, IL10, IL1β, and TNFα) were assayed, and "sludge" was assessed. Patients without intrauterine infections were treated and followed up until delivery, and pregnancy outcomes were recorded. The two groups were compared for the differences in biomarker levels and "sludge," and the independent associations of biomarkers, "sludge," and other maternal factors with late miscarriage were investigated. Results:The amniotic levels of IL2βR, IL8, and TNFα were higher in the group with contractions (P < .05). When considered alone, each of the six biomarkers was significantly associated with late miscarriage in the no-contractions group and four of these (IL8, IL10, IL1β, and TNFα) in the contractions group (P < .05). Biomarker levels were correlated, and in multivariate Cox regression analysis, there was an independent effect only for IL8 in the no-contractions group (HR = 18.16, 95% CI: 5.75-57.43) andTNFα in the contractions group (HR = 4.11, 95% CI: 1.68-10.08). For patients with contractions, IL10, IL8, and IL1β were different in those with and without "sludge," but no such difference was seen in the no-contractions group. Conclusion:For TLM patients without intrauterine infections, amniotic immune biomarkers differ between patients with different symptoms, not only for their levels but also for the impact of these biomarkers on the risk of late miscarriage. These findings suggest that the symptoms of TLM should be considered in the study of miscarriage risk. K E Y W O R D S amniotic fluid sludge, IL6, IL8, independent risk factors, threatened late miscarriage, transvaginal ultrasoundThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Short cervix syndrome: current knowledge from etiology to the control

Abstract: The successful management of pregnant women presenting a short cervix depends on the understanding that cervical shortening is the final common path for several causes of preterm delivery. The best approach should be individualized to each patient.

Cited by 13 publications

References 51 publications

RETRACTED ARTICLE: Vaginal progesterone for prevention of preterm labor in asymptomatic twin pregnancies with sonographic short cervix: a randomized clinical trial of efficacy and safety

RETRACTED ARTICLE: Vaginal progesterone for prevention of preterm labor in asymptomatic twin pregnancies with sonographic short cervix: a randomized clinical trial of efficacy and safety

CXCL10 and IL‐6: Markers of two different forms of intra‐amniotic inflammation in preterm labor

Amniotic immune biomarkers as risk factors in women with different symptoms of threatened late miscarriage

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