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Cervical Examination in Labor

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181. Cervical Ripening (Treatment)

pregnancies go beyond 41 weeks' gestation, induction of labor may provide benefits. In a meta-analysis of studies examining induction of labor versus expectant management of low-risk pregnancies, Sanchez-Ramos et al found that induction of labor at 41 weeks' gestation resulted in a lower cesarean delivery rate (20.1%) than those expectantly managed (22%) with no significant differences in perinatal morbidity. [ ] Therefore, cervical ripening is advised prior to inducting labor in women (...) : Feb 28, 2018 Author: Aaron E Goldberg, MD; Chief Editor: Carl V Smith, MD Share Email Print Feedback Close Sections Sections Cervical Ripening Overview Overview In pregnancy, the uterine cervix serves 2 major functions. First, it retains its physical integrity by remaining firm during pregnancy as the uterus dramatically enlarges. This physical integrity is critical so that the developing fetus can remain in the uterus until the appropriate time for delivery. Second, in preparation for labor

2014 eMedicine.com

182. Cervical Cancer (Treatment)

with stage IB1 disease whose lesions are 2 cm or smaller. [ ] The principal problems with pregnancy after trachelectomy are premature labor and the need to undergo cesarean section for delivery. [ ] In a retrospective review of 62 patients with stage IB1 cervical carcinoma who underwent attempted radical trachelectomy and underwent preoperative magnetic resonance imaging (MRI), Lakhman et al found that pretrachelectomy MRI helped identify high-risk patients who were likely to need radical hysterectomy (...) at . Accessed: April 16, 2012. Everett T, Bryant A, Griffin MF, Martin-Hirsch PP, Forbes CA, Jepson RG. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database Syst Rev . 2011 May 11. CD002834. . Pecorelli S, Zigliani L, Odicino F. Revised FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet . 2009 May. 105(2):107-8. . [Guideline] Qaseem A, Humphrey LL, Harris R, Starkey M, Denberg TD. Screening pelvic examination in adult women: a clinical practice

2014 eMedicine.com

183. Carbon Dioxide Laser Surgery for Cervical Dysplasia (Treatment)

of abnormal cervical cancer screening and cancer precursors were updated in 2012 and published in 2013 in the Journal of Lower Genital Tract Disease. [ ] Previous Next: Follow-up Postoperative patient instructions may vary from one provider to another and may also change in accordance with additional patient medical conditions. General postoperative instructions include (1) pelvic rest (ie, no tampons, douching, or intercourse) until the scheduled postoperative follow-up examination; (2) light activity (...) Although more than 40% of untreated CIN 2 lesions regress without interventional therapy, approximately one third will persist and 22% will progress to carcinoma in situ or invasive cervical disease. [ ] The procedures for cervical ablation or excisional methods can be used to treat women with biopsy confirmed CIN 2, 3 and a satisfactory colposcopic examination. An excisional procedure with positive pathology at the margins followed by an unsatisfactory colposcopy is generally considered a risk factor

2014 eMedicine.com

184. Benign Cervical Lesions (Treatment)

projects into the vagina as the portio vaginalis with the opening of the cervical canal into the vagina called the external cervical os (Latin for mouth). The external os is usually small and round in nulliparous women but can be seen as a transverse slit in those who have had cervical dilation during labor. The anterior and posterior fornices delimit the portio (exocervix). The cervical canal measures approximately 8 mm wide and contains longitudinal ridges. The opening of the cervical canal (...) , the endocervical tissue tends to roll out from the cervical os; this is called cervical eversion (ie, ectropion), and corresponds to the original squamocolumnar junction. In a normal transformation zone, one can find remnants of gland openings and nabothian cysts. In postmenopausal women, the squamocolumnar junction frequently is located within the cervical canal. In this position, it is not visualized through speculum examination or colposcopy, even when using an endocervical speculum. Colposcopy

2014 eMedicine.com

185. Cervical Ripening (Overview)

pregnancies go beyond 41 weeks' gestation, induction of labor may provide benefits. In a meta-analysis of studies examining induction of labor versus expectant management of low-risk pregnancies, Sanchez-Ramos et al found that induction of labor at 41 weeks' gestation resulted in a lower cesarean delivery rate (20.1%) than those expectantly managed (22%) with no significant differences in perinatal morbidity. [ ] Therefore, cervical ripening is advised prior to inducting labor in women (...) : Feb 28, 2018 Author: Aaron E Goldberg, MD; Chief Editor: Carl V Smith, MD Share Email Print Feedback Close Sections Sections Cervical Ripening Overview Overview In pregnancy, the uterine cervix serves 2 major functions. First, it retains its physical integrity by remaining firm during pregnancy as the uterus dramatically enlarges. This physical integrity is critical so that the developing fetus can remain in the uterus until the appropriate time for delivery. Second, in preparation for labor

2014 eMedicine.com

186. Benign Cervical Lesions (Overview)

projects into the vagina as the portio vaginalis with the opening of the cervical canal into the vagina called the external cervical os (Latin for mouth). The external os is usually small and round in nulliparous women but can be seen as a transverse slit in those who have had cervical dilation during labor. The anterior and posterior fornices delimit the portio (exocervix). The cervical canal measures approximately 8 mm wide and contains longitudinal ridges. The opening of the cervical canal (...) , the endocervical tissue tends to roll out from the cervical os; this is called cervical eversion (ie, ectropion), and corresponds to the original squamocolumnar junction. In a normal transformation zone, one can find remnants of gland openings and nabothian cysts. In postmenopausal women, the squamocolumnar junction frequently is located within the cervical canal. In this position, it is not visualized through speculum examination or colposcopy, even when using an endocervical speculum. Colposcopy

2014 eMedicine.com

187. Cervical Radiculopathy (Overview)

anteriorly and of the facet joints posteriorly. Factors associated with increased risk include heavy manual labor requiring the lifting of more than 25 pounds, smoking, and driving or operating vibrating equipment. Other, less frequent causes include tumors of the spine, an expanding cervical synovial cyst, synovial chondromatosis in the cervical facet joint, giant cell arteritis of the cervical radicular vessels, and spinal infections. [ , ] The purpose of this article is to provide information (...) , Carragee EJ, Hogg-Johnson S, et al for the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Assessment of neck pain and its associated disorders: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine . 2008 Feb 15. 33(4 suppl):S101-22. . Furusawa N, Baba H, Miyoshi N, et al. Herniation of cervical intervertebral disc: immunohistochemical examination and measurement of nitric oxide production. Spine . 2001 May 15

2014 eMedicine.com

188. Carbon Dioxide Laser Surgery for Cervical Dysplasia (Follow-up)

of abnormal cervical cancer screening and cancer precursors were updated in 2012 and published in 2013 in the Journal of Lower Genital Tract Disease. [ ] Previous Next: Follow-up Postoperative patient instructions may vary from one provider to another and may also change in accordance with additional patient medical conditions. General postoperative instructions include (1) pelvic rest (ie, no tampons, douching, or intercourse) until the scheduled postoperative follow-up examination; (2) light activity (...) Although more than 40% of untreated CIN 2 lesions regress without interventional therapy, approximately one third will persist and 22% will progress to carcinoma in situ or invasive cervical disease. [ ] The procedures for cervical ablation or excisional methods can be used to treat women with biopsy confirmed CIN 2, 3 and a satisfactory colposcopic examination. An excisional procedure with positive pathology at the margins followed by an unsatisfactory colposcopy is generally considered a risk factor

2014 eMedicine.com

189. Cervical Ripening (Follow-up)

pregnancies go beyond 41 weeks' gestation, induction of labor may provide benefits. In a meta-analysis of studies examining induction of labor versus expectant management of low-risk pregnancies, Sanchez-Ramos et al found that induction of labor at 41 weeks' gestation resulted in a lower cesarean delivery rate (20.1%) than those expectantly managed (22%) with no significant differences in perinatal morbidity. [ ] Therefore, cervical ripening is advised prior to inducting labor in women (...) : Feb 28, 2018 Author: Aaron E Goldberg, MD; Chief Editor: Carl V Smith, MD Share Email Print Feedback Close Sections Sections Cervical Ripening Overview Overview In pregnancy, the uterine cervix serves 2 major functions. First, it retains its physical integrity by remaining firm during pregnancy as the uterus dramatically enlarges. This physical integrity is critical so that the developing fetus can remain in the uterus until the appropriate time for delivery. Second, in preparation for labor

2014 eMedicine.com

190. Cervical Cancer (Follow-up)

with stage IB1 disease whose lesions are 2 cm or smaller. [ ] The principal problems with pregnancy after trachelectomy are premature labor and the need to undergo cesarean section for delivery. [ ] In a retrospective review of 62 patients with stage IB1 cervical carcinoma who underwent attempted radical trachelectomy and underwent preoperative magnetic resonance imaging (MRI), Lakhman et al found that pretrachelectomy MRI helped identify high-risk patients who were likely to need radical hysterectomy (...) at . Accessed: April 16, 2012. Everett T, Bryant A, Griffin MF, Martin-Hirsch PP, Forbes CA, Jepson RG. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database Syst Rev . 2011 May 11. CD002834. . Pecorelli S, Zigliani L, Odicino F. Revised FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet . 2009 May. 105(2):107-8. . [Guideline] Qaseem A, Humphrey LL, Harris R, Starkey M, Denberg TD. Screening pelvic examination in adult women: a clinical practice

2014 eMedicine.com

191. Vaginal Progesterone for Prevention of Preterm Birth After an Episode of Preterm Labor

labor will be admitted and given the standard treatment for preterm labor, i.e. tocolysis for 48 hours, and antenatal steroids. Those who will remain undelivered for 48 hours and will be found to have a cervical length of 25mm or less will be offered entrance into the study. Preterm labor will be defined as at least 4 contractions in 30 minutes with cervical change assessed by digital cervical examination. Exclusion Criteria: Patients with preterm premature rupture of membranes (PPROM (...) supplementation by examining its effect on the two components of parturition: cervical ripening and myometrial contractility. The investigators will utilize transvaginal ultrasound to assess the changes in the cervical tissue, and non-invasive trans-abdominal uterine EMG to assess the uterine muscle activity. The investigators will also look at the effect of progesterone on contraction frequency by tocodynamometer (TOCO), though EMG is expected to provide much more information. Condition or disease

2012 Clinical Trials

192. Buccal Versus Vaginal Misoprostol for Third Trimester Induction of Labor

: University of California, Los Angeles Information provided by (Responsible Party): Ram Parvataneni MD, MPH, University of California, Los Angeles Study Details Study Description Go to Brief Summary: Approximately 22% of term pregnancies are induced. Misoprostol, a prostaglandin E1 analogue, is a widely accepted induction agent, that has been proven safe and effective for induction of labor. It stimulates both cervical ripening and uterine contractions, thus making it an ideal induction agent (...) for unfavorable cervices. Research has examined the pharmacokinetics of different administration routes and effects on uterine contractility, side effects, and safety. Vaginal misoprostol has been shown to be superior over oral administration however patients often prefer a more tolerable route. Buccal administration has already been shown to be as effective as vaginal misoprostol for cervical ripening and induction in both first trimester and second trimester abortions. There is minimal research comparing

2012 Clinical Trials

193. Role of Serum Total Antioxidant Level in Preterm Labor

: A total of 70 pregnant women attending the outpatient obstetric clinic and inpatient of Obstetrics and Gynecology department or when they will be admitted to the delivary room of Ain Shams university hospital. Patient will be divided in to two groups. Group A: 35 pregnant women diagnosed with preterm labor(Preterm labor pain at least 3 contraction every 20 minutes ,cervical dilatation < 2cm and effacement< 50%) which will deliver within one week maximum after hospitalization. Group B: 35 pregnant (...) Role of Serum Total Antioxidant Level in Preterm Labor Role of Serum Total Antioxidant Level in Preterm Labor - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Role of Serum Total Antioxidant Level in Preterm

2012 Clinical Trials

194. Comparing Sedara to Butorphanol in Early Labor

countries. We have obtained several Sedara devices for use in the West Penn Allegheny Health System (WPAHS) Department of Anesthesiology and would like to examine its efficacy in our target population of women experiencing pain during early labor. Hypothesis - Sedara will provide equivalent or superior pain relief among term, adult parturients in early labor (less than 5cm cervical dilation) compared to intravenous butorphanol. Primary aim - Compare Sedara versus butorphanol in a single-blinded (...) available for: Arms and Interventions Go to Arm Intervention/treatment Experimental: Butorphanol The main study arm will be examining how well a 50% Nitrous Oxide/50% Oxygen gas mixture is in reducing labor pains in term labor patients with less than 5 cm cervical dilation, compared to 2mg of Butorphanol (a common synthetic opiod used for labor pains in this setting). Drug: 50% Nitrous Oxide/50% Oxygen The gas mixture is provided via the Sedara portable gas delivery system. This system is equipped

2012 Clinical Trials

195. Preterm Labor

or bicornuate s (DES) exposure in utero Genitourinary Infection (40% of preterm births) Vaginal infections ( ) vaginalis Infections with possible risk urealyticum hominis References VI. Symptoms Keep a high index of suspicion Contraction frequency does not predict risk Symptoms do not predict risk Pelvic pressure Vaginal pain Menstrual-like cramps Backache or fluid leakage (see ) VII. Signs Examine as soon as possible Assess and dilation Avoid cervical exam until labor if confirmed Examine Assess for e (...) Check for firm, tender with minimal relaxation VIII. Evaluation: Five key concerns Precautions Preterm Labor patients who deliver within 6 days of presentation: <10% Assessment goal is to differentiate the patients at high risk of delivery Avoid digital vaginal exam UNLESS delivery is imminent (risk of infection) Perform sterile speculum exam and cervical instead Is patient preterm (<37 weeks)? Review and prior s (especially earliest s) Late preterm: 34 to 37 weeks Early preterm: 32 to 34 weeks Very

2015 FP Notebook

196. Beta-2 adrenoceptor genotype and progress in term and late preterm active labor. (PubMed)

genotyping. Digital cervical examinations with paired examination times were collected from intrapartum records. Rate of cervical dilatation in active labor was determined using linear regression. Rates were compared between genotype groups.Among 401 subjects with satisfactory genotype and intrapartum data, overall rate of active labor was 0.76±0.01 cm/h. When labor was compared by genotype, homozygous Arg/Arg16 subjects progressed at a slower rate (0.64±0.03 cm/h) than all other pooled genotypes (0.8 (...) Beta-2 adrenoceptor genotype and progress in term and late preterm active labor. We sought to evaluate whether beta-2 adrenoceptor (β2AR) genotype at a functional polymorphic site encoding for amino acid residue 16 influences rate of cervical dilatation in term and late preterm active labor.Subjects who underwent vaginal delivery at ≥34 weeks' gestational age from May 2006 through August 2007 were identified. Each subject had provided venous blood from which DNA was extracted for β2AR

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2011 American Journal of Obstetrics and Gynecology

197. Use of uterine electromyography to diagnose term and preterm labor. (PubMed)

Use of uterine electromyography to diagnose term and preterm labor. Current methodologies to assess the process of labor, such as tocodynamometry or intrauterine pressure catheters, fetal fibronectin, cervical length measurement and digital cervical examination, have several major drawbacks. They only measure the onset of labor indirectly and do not detect cellular changes characteristic of true labor. Consequently, their predictive values for term or preterm delivery are poor. Uterine (...) contractions are a result of the electrical activity within the myometrium. Measurement of uterine electromyography (EMG) has been shown to detect contractions as accurately as the currently used methods. In addition, changes in cell excitability and coupling required for effective contractions that lead to delivery are reflected in changes of several EMG parameters. Use of uterine EMG can help to identify patients in true labor better than any other method presently employed in the clinic.© 2010

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2011 Acta Obstetricia et Gynecologica Scandinavica

198. Uterine Electrical Activity Before and After Progesterone Treatment for Preterm Labor

: August 11, 2017 Sponsor: St. Joseph's Hospital and Medical Center, Phoenix Information provided by (Responsible Party): St. Joseph's Hospital and Medical Center, Phoenix Study Details Study Description Go to Brief Summary: This study will examine the effects of various formulations of progesterone on uterine electromyographic (EMG) activity in pregnant patients in premature labor to determine if progesterone will suppress uterine electrical activity and which formulation may be best for inhibition (...) between 24 to 34 weeks of gestation presenting to St. Joseph's Hospital and Medical Center. Preterm labor is defined as at least 6 contractions in 60 minutes with a cervix either dilated to 2 centimeters or effaced to 80% and a cervical length measured by ultrasound of less than 3 centimeters, and a positive fetal fibronectin. Maternal ages will be within 17 to 40 year-old range. Exclusion Criteria: Patients with preterm premature rupture of membranes (PPROM) will be excluded from the study, due

2011 Clinical Trials

199. Maternal and Perinatal Outcome in Women With History of Premature Labor in Previous Pregnancy

Feitosa Gondo, UPECLIN HC FM Botucatu Unesp: Pregnancy vulvovaginitis uterine cervicitis pregnancy outcome Additional relevant MeSH terms: Layout table for MeSH terms Obstetric Labor, Premature Vulvovaginitis Uterine Cervicitis Obstetric Labor Complications Pregnancy Complications Vaginitis Vaginal Diseases Genital Diseases, Female Vulvitis Vulvar Diseases Uterine Cervical Diseases Uterine Diseases (...) Maternal and Perinatal Outcome in Women With History of Premature Labor in Previous Pregnancy Maternal and Perinatal Outcome in Women With History of Premature Labor in Previous Pregnancy - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one

2011 Clinical Trials

200. Two Methods of Diagnosing Preterm Labor

by (Responsible Party): Conrad Chao, University of California, San Francisco Study Details Study Description Go to Brief Summary: Use of modern diagnostic tools e.g. fetal fibronectin and ultrasound measurement of cervical length to diagnose preterm labor can result in improved outcomes compared to traditional diagnosis based on digital examination to measure cervical change. Condition or disease Intervention/treatment Phase Preterm Labor Preterm Delivery Procedure: Diagnosis by cervical length (...) and fibronectin Procedure: Cervical change Phase 3 Detailed Description: Symptomatic preterm labor patients will be randomized to diagnosis of preterm labor by serial digital examination versus an algorithm incorporating transvaginal ultrasound measurement of cervical length and vaginal fetal fibronectin. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 136 participants Allocation: Randomized Intervention Model: Parallel Assignment

2011 Clinical Trials

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