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Cervical Examination in Labor

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181. Cerclage for Twins With Short Cervix

Center for Research, Education, Quality and Safety Study Details Study Description Go to Brief Summary: A prospective randomized control trial that will compare cervical cerclage plus vaginal progesterone to vaginal progesterone along in twin pregnancies complicate by a short cervix (Labor With Preterm Delivery, Unspecified Trimester, Fetus 2 Cervical Incompetence Cervical Shortening Procedure (...) : Cervical Cerclage placement Drug: Vaginal Progesterone Phase 2 Phase 3 Detailed Description: A prospective Randomized Trial that will test whether treatment with cervical cerclage plus vaginal progesterone improves pregnancy outcomes among women with twin pregnancy at 16 0/7 to 25 6/7 weeks of gestation who have a cervical length (CL) of 0.1 to 15.0 mm on transvaginal ultrasound exam, the rate of preterm birth at less than 32 weeks of gestation (PTB<32 wks.) and the rate of adverse perinatal outcome

2017 Clinical Trials

182. Value of Measuring Cervical Angle and Length by Ultrasound in Prediction of Successful Induction of Delivery

Posted : July 17, 2017 Sponsor: Cairo University Information provided by (Responsible Party): Eman Omran, Cairo University Study Details Study Description Go to Brief Summary: Seventy ladies indicated for induction of delivery will be recruited. Two ways of assessment of their cervices will be done before actual induction of labor. First, ultrasound will be done to assess the angle and the length of the cervix. Then vaginal examination will be done to assess the characteristics of cervix. Analysis (...) will be done to identify the best predictor of successful induction of labour. Condition or disease Intervention/treatment Phase Induced; Birth Diagnostic Test: Transvaginal ultrasound Diagnostic Test: Vaginal examination Not Applicable Detailed Description: Seventy patients indicated for induction of labor will be recruited. Two ways of assessment of their cervices will be done before actual induction of labor. First, transvaginal ultrasound will be done to assess the posterior angle and the length

2017 Clinical Trials

183. Randomized Control Trial of Intracervical Balloon Placement vs Oxytocin in Women With Term PROM and Unripe Cervices

of membranes (PROM). Prospective randomized studies comparing IBC placement to oxytocin use in induction of labor for term PROM do not exist. Intracervical Balloon Catheter has been shown to reduce duration of labor for women with intact membranes undergoing induction of labor. The practice at this institution is to use oxytocin to start contractions when a woman has PROM. This study will examine IBC compared to oxytocin use in term PROM. This will allow for the evaluation of a cervical ripening method (...) the bag of water prior to onset of labor. The investigators suspect that an intracervical balloon catheter will shorten the time interval from initiation of induction of labor to delivery. Condition or disease Intervention/treatment Phase Premature Rupture of Membrane Unfavorable Cervix Device: Intracervical balloon catheter Drug: Oxytocin Not Applicable Detailed Description: There are not enough studies to support the use of intracervical balloon catheter (IBC) use in term premature rupture

2017 Clinical Trials

184. Cervix Monitor for Elasticity and Length Measurements

learning disabilities, visual and hearing impairments. Spontaneous preterm delivery (SPTD) is often multi factorial event, precocious cervical softening, shortening and dilatation are a common denominator. The majority of preterm births happen spontaneously, though some are due to early induction of labor or cesarean birth, typically due to medical maternal of neonatal conditions. Condition or disease Intervention/treatment Preterm Birth Device: Cervix Monitor Detailed Description: The uterine cervix (...) has to provide structural integrity and mechanical resistance to ensure normal development of the fetus as the uterus expands to accommodate the fetus growth. Preterm delivery is closely related to a premature cervical ripening. The scientific bases for the proposed project is the elasticity modulus of a cervix is a more sensitive parameter characterizing the stage of cervical ripening. The main component of the cervix tissue is a collagen. Cervical ripening is the result of realignment

2017 Clinical Trials

185. Randomized Clinical Trial Evaluating the Efficacy of Topical Imiquimod in High Grade Cervical Intraepithelial Lesions

rate of elimination of the infection. Immediate, an agent that stimulates like dendritic cells to producer cytokines and activates epithelial T cells. Imiquimode, when used in vulvar neoplasias, has been shown to be effective, presenting satisfactory results without treatment of CIN 2/3 of the uterine cervix, requiring a better scientific compilation. Based on these data, this study aims to evaluate the efficacy of topical immunomodulatory treatment for high-grade cervical intraepithelial lesions (...) previous treatment, who will be selected in the preventive clinic of the Hospital de Cancer de Barretos-SP (HCB ). Eligible patients will be identified at the return visit, when they will come to the hospital to check the result of the examination. In this study the patients will be randomized into two groups: Group 1: Control, where standard treatment will be offered, which is the conization of the uterine cervix with loop electrosurgical excision procedure(LEEP); Group 2: experimental group, which

2017 Clinical Trials

186. Preterm Induction of Labor: Predictors of Vaginal Delivery and Labor Curves. (Full text)

divided into 4 groups based on gestational age (GA): group A, 24-27+6 weeks; B, 28-30+6 weeks; C, 31-33+6 weeks; and D, 34-36+6 weeks. Pregnant women with a contraindication to VD, IOL ≥37 weeks of gestation, and without data from cervical examination on admission were excluded. Analysis of variance was used to assess differences between GA groups. Multiple logistic regression was used to assess predictors of VD. A repeated measures analysis was used to determine average labor curves.Rates of vaginal (...) live births increased with GA, from 35% (group A) to 76% (group D). Parous women (odds ratio, 6.78; 95% confidence interval, 6.38-7.21) and those with a favorable cervix at the start of IOL (odds ratio, 2.35; 95% confidence interval, 2.23-2.48) were more likely to deliver vaginally. Analysis of labor curves in nulliparous women showed shorter duration of labor with increasing GA; the active phase of labor was, however, similar across all GAs.Most women who undergo medically indicated preterm IOL

2014 American Journal of Obstetrics and Gynecology PubMed abstract

187. Cervical Cerclage for Preventing Spontaneous Preterm Birth in Singleton Pregnancies Without Prior Spontaneous Preterm Birth and With Short Transvaginal Ultrasound Cervical Length

Volunteers: No Criteria Inclusion Criteria: 18-50 ages Singleton pregnancy Cervical length <=25mm between 18(0) and 23(6) weeks Exclusion Criteria: Multiple pregnancy Prior spontaneous preterm birth or second trimester losses between 16(0) and 36(6) weeks Cerclage in situ Painful regular uterine contraction and/or preterm labor Ruptured membranes Major fetal defects Active vaginal bleeding Placenda previa and/or accreta Cervical dilation >1.5 cm and/or visible membranes by pelvic exam Suspicion (...) setting, and it is easily removed when necessary. However, a recent systematic review and meta-analysis of randomized clinical trials showed that in singleton pregnancies with short cervix, prophylactic use of the pessary did not reduce the rate of spontaneous preterm delivery or improve perinatal outcome. The evidence supports the use of vaginal progesterone in singleton pregnancies with short cervix, while cervical cerclage seems to be beneficial only in the subgroup of women with both prior SPTB

2016 Clinical Trials

188. Labor induction abortion in the second trimester

misoprostol alone. 7. Does the use of osmotic dilators affect the abortion time? Labor induction abortion studies using natural prosta- glandins found that placing osmotic dilators 4–24 h before inductiondecreasedabortiontime[30,83–88].However,this adjunctive benefit does not occur when modern prostaglan- din analogues are used. Two randomized studies examined the use of cervical preparation with laminaria at the time of misoprostol induction [2,15]. One study used feticide with hypertonic saline prior (...) rate of incomplete abortion and operative procedures as com- pared to pregnancies greater than 20 weeks. Unlike most other studies, these authors had follow-up data through 6 weeks postinduction. 2. How does labor induction abortion compare to surgical abortion? Where both methods are available, the choice between induction and D&E may be made for either personal or medical reasons. In some instances, the woman may wish to see or hold her fetus. Examination of an intact fetus may improve

2011 Society of Family Planning

189. Cervical Pessary vs Vaginal Progesterone in Preventing Preterm Birth Among Women Presenting With Short Cervix: An Open-label Randomized Controlled Trial

vaginal progesterone is superior to vaginal progesterone alone in decreasing preterm delivery rate, and improving perinatal outcome, among women presenting with an asymptomatic mid-pregnancy short cervix, in singleton and twin gestations. All women with singleton or twin pregnancies undergoing routine ultrasonography up to 24 completed weeks of gestation (for examination of fetal anatomy and growth) and diagnosed with cervical length of ≤25 mm in singleton, or ≤38 mm in twins, will be invited (...) Cervical Pessary vs Vaginal Progesterone in Preventing Preterm Birth Among Women Presenting With Short Cervix: An Open-label Randomized Controlled Trial Cervical Pessary vs Vaginal Progesterone in Preventing Preterm Birth Among Women Presenting With Short Cervix: An Open-label Randomized Controlled Trial - 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

2015 Clinical Trials

190. Mechanical and Pharmacologic Methods of Labor Induction: A Randomized Controlled Trial. (Full text)

Mechanical and Pharmacologic Methods of Labor Induction: A Randomized Controlled Trial. To evaluate the effectiveness of four commonly used induction methods.This randomized trial compared four induction methods: misoprostol alone, Foley alone, misoprostol-cervical Foley concurrently, and Foley-oxytocin concurrently. Women undergoing labor induction with full-term (37 weeks of gestation or greater), singleton, vertex-presenting gestations, with no contraindication to vaginal delivery, intact (...) membranes, Bishop score 6 or less, and cervical dilation 2 cm or less were included. Women were enrolled only once during the study period. Our primary outcome was time to delivery. Neither patients nor health care providers were blinded to assigned treatment group because examinations are required for placement of all methods; however, research personnel were blinded during data abstraction. A sample size of 123 per group (n=492) was planned to compare the four groups pairwise (P≤.008) with a 4-hour

2016 Obstetrics and Gynecology Controlled trial quality: predicted high PubMed abstract

191. Association of Early Amniotomy After Foley Balloon Catheter Ripening and Duration of Nulliparous Labor Induction. (Abstract)

Association of Early Amniotomy After Foley Balloon Catheter Ripening and Duration of Nulliparous Labor Induction. To evaluate the association between early amniotomy after ripening with a Foley balloon catheter and duration of labor induction.In this retrospective matched cohort study, 546 nulliparous women with a singleton viable gestation undergoing cervical ripening with a Foley balloon catheter were compared based on timing of amniotomy after catheter removal: early (defined as artificial (...) rupture of membranes less than 1 hour after Foley removal) compared with no artificial rupture of membranes in the first hour. Women in the early amniotomy group were matched to women in the control group according to health care provider type, cervical examination after Foley removal, and indication for induction in a one-to-one ratio. Bivariable and multivariable analyses were performed to determine whether early amniotomy was associated with vaginal delivery within 24 hours and other adverse

2016 Obstetrics and Gynecology

192. Prediction of delivery time in the second stage of labor using transperineal ultrasound. (Full text)

Prediction of delivery time in the second stage of labor using transperineal ultrasound. To investigate whether the transperineal sonographic (TPS) parameters angle of progression (AoP) and midline angle (MLA) can predict the time remaining in the second stage of labor.We evaluated prospectively women with a singleton pregnancy in cephalic presentation at term between October 2013 and September 2014. TPS volumes were obtained immediately after confirmation by digital vaginal examination (...) of a fully dilated cervix. AoP and MLA were measured offline by analyzing the ultrasound volumes. Progression of labor was evaluated every hour during the second stage. The associations of AoP and MLA with the interval between TPS assessment and delivery were evaluated using multivariable Cox proportional hazards analyses in nulliparous and parous women separately.A total of 557 women were evaluated. An AoP ≥ 160° (adjusted hazard ratio (aHR), 2.52 (95% CI, 1.98-3.19)) and MLA ≤ 10° (aHR, 1.79 (95% CI

2016 Ultrasound in Obstetrics and Gynecology PubMed abstract

193. The "occiput - spine angle": a new sonographic index of fetal head deflexion during the first stage of labor. (Full text)

The "occiput - spine angle": a new sonographic index of fetal head deflexion during the first stage of labor. Fetal head "attitude" (relationship of fetal head to spine) in the first stage of labor may have a substantial impact on labor outcome. The diagnosis of fetal head deflexion traditionally is based on digital examination in labor, although the use of ultrasound to support clinical diagnosis has been recently reported.The aims of this study were: (1) to quantify the degree of fetal head (...) deflection via the use of sonography during the first stage of labor; and (2) to determine whether a parameter derived from ultrasound examination (the occiput-spine angle) has a relationship with the course and outcome of labor.This was a prospective multicentric, cross-sectional study conducted at the Maternity Unit of the University of Bologna and Parma from January 2014 to April 2015. A nonconsecutive series of women with uncomplicated singleton pregnancies at term gestation (37 weeks or more) were

2016 American Journal of Obstetrics and Gynecology PubMed abstract

194. Interleukin (IL)‐1 in rat parturition: IL‐1 receptors 1 and 2 and accessory proteins abundance in pregnant rat uterus at term – regulation by progesterone (Full text)

Interleukin (IL)‐1 in rat parturition: IL‐1 receptors 1 and 2 and accessory proteins abundance in pregnant rat uterus at term – regulation by progesterone The role of interleukin-1 (IL-1), a pro-inflammatory cytokine, in parturition is typically noted by changes in its concentrations. Studying the expression of its receptor family, IL-1 receptor (IL-1R) 1, IL-1R2, IL-1R accessory protein (IL-1RAcP), and its predominantly brain isoform, IL-1RAcPb, during late gestation in the uterus (...) in the Long-Evans rat is another. We assessed changes in their mRNA and protein relative abundance in the uterus and compared IL-1RAcP and IL-1RAcPb mRNA abundance in uterus, cervix, ovaries, placenta, and whole blood of Long-Evans rats during late gestation or in RU486 and progesterone-treated dams using quantitative real-time PCR and western immunoblotting. IL-1R1, IL-1RAcP, and IL-1RAcPb mRNA abundance significantly increased in the uterus at delivery whereas IL-1R2 mRNA abundance significantly

2016 Physiological reports PubMed abstract

195. Different Types of Progesterone in the Prevention of Preterm Labor

suppositories and dydrogesterone oral tablets in prevention of preterm labor in high risk women. All women will be counseled regarding mode of intervention and informed consent will be obtained. All cases will be subjected to complete history taking, routine antenatal examination and investigations, treatment of genital or urinary tract infections if diagnosed. Routine obstetric ultrasound examination and measurement of cervical length by transvaginal ultrasound will be carried out at 16-18weeks (...) : No Criteria Inclusion Criteria: Singleton pregnancy Living fetus with gestational age 16-18weeks (calculated according to date of last menstrual period confirmed with earlier ultrasound examination). Presence of risk factor for preterm labor: Previous spontaneous preterm labor in previous singleton Pregnancy, OR Previous spontaneous second trimestric miscarriage less than 3 times, OR Short cervix less than 25mm diagnosed during midtrimesteric transvaginal ultrasound examination at 16-18 weeks

2016 Clinical Trials

196. Assessment of Fetal Position in Active Labor

Summary: Vaginal exams are used routinely in labor to assess cervical dilation and position of the baby (facing anterior, facing to the right or left side, facing towards maternal spine). This technique has a widely variable accuracy rate (24.0-85.6%). Ultrasound has been used to help confirm or correct the vaginal assessment by obstetricians, but has not been used to assess the utility of immediate feedback to improve the accuracy of vaginal assessment by physicians in training. The investigators (...) separate. Paper copies will be kept in a locked cabinet, in a locked office, in a locked suite. Study Design Go to Layout table for study information Study Type : Observational Actual Enrollment : 12 participants Observational Model: Cohort Time Perspective: Prospective Official Title: Ultrasound Examination as a Teaching Tool for Vaginal Exam Assessment of Fetal Position in Active Labor Actual Study Start Date : August 2016 Actual Primary Completion Date : September 2017 Actual Study Completion Date

2016 Clinical Trials

197. Comparison of Vaginal Misoprostol Plus Supracervical Balloon Versus Vaginal Misoprostol Alone for Induction of Labor

is achieved in less time compared with vaginal misoprostol alone. Condition or disease Intervention/treatment Phase Induction of Labor Cervical Ripening Pregnancy Drug: Misoprostol Device: Foley catheter Phase 4 Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 80 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: Prospective Randomized (...) misoprostol every 4 hours up to a maximum of 5 doses. Misoprostol will be stopped in case of a favorable cervix or if the patient is in active labor. In case of no progression after 5 doses of misoprostol, intravenous oxytocin will be perfused 4 hours after the last dose of misoprostol according to local protocols Drug: Misoprostol Administration of 25 mcg of vaginal misoprostol every 4 hours up to 5 doses Other Name: Misofar Experimental: Vaginal misoprostol + Foley catheter Women in this group

2016 Clinical Trials

198. Efficacy of Oral Progesterone and Vaginal Progesterone After Tocolytic Therapy in Threatened Preterm Labor

cervical changes as determined by digital pelvic examination. Preterm labor was defined as the simultaneous presence of regular uterine contractions and cervical changes, shortening and/or softening, or dilatation, as determined by digital pelvic examination. The women with preterm labor underwent standard tocolysis, which was administered for at least 48 hours, to allow corticosteroid promote fetal lung maturation. The patients who had proven membranes ruptured, and ultrasonographically found placenta (...) ). All patients were digitally pelvic examined for evaluation of Bishop score and assessed cervical length by transvaginal ultrasound at enrollment and follow up visit at two weeks apart. Cervical length was measured by standard technique with a covered probe inserted into vagina after each woman had emptied her bladder. Excessive pressure on cervix was avoided. The mean value of 3 consecutive measurements was used for analysis. Informed consent and demographic data were obtained at the enrollment

2016 Clinical Trials

199. Nipple Stimulation for Labor Induction

): Hadassah Medical Organization Study Details Study Description Go to Brief Summary: This study will examine the use of nipple stimulation for cervical ripening in women who present to the labor and delivery ward after their water has broken but have a contraindication to prostaglandins. Condition or disease Intervention/treatment Phase Delivery Delayed Other: nipple stimulation Not Applicable Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated (...) . For general information, Layout table for eligibility information Ages Eligible for Study: 18 Years to 45 Years (Adult) Sexes Eligible for Study: Female Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria: Week 37 + 0 and on PROM (premature rupture of membranes) Multiparity (birth sixth or higher) or TOLAC (trial of labor after Caesarean section) Not in active labor - without regular contractions fetal monitor, cervical dilation < 4 cm and effacement < 80%. Exclusion Criteria: Water break > 24

2016 Clinical Trials

200. Intermittent Ropivacaine Bolus for Epidural Labor Analgesia

-up administration (breakthrough pain) Condition or disease Intervention/treatment Labor Pain Drug: Ropivacaine Detailed Description: Patients were explained about the procedure and written informed consent was obtained. Healthy term primi or second gravid parturients (aged >18 years) with a singleton, live fetus in vertex presentation when in active stage of labor with cervical dilation of 3-5 cm were recruited in the study after they requested epidural for pain relief. PIEB epidural analgesia (...) Ages Eligible for Study: 18 Years to 40 Years (Adult) Sexes Eligible for Study: Female Accepts Healthy Volunteers: No Sampling Method: Non-Probability Sample Study Population healthy term primi or second gravid parturients aged 18-30 years with a singleton, live fetus in vertex presentation when in active stage of labor with cervical dilation of 3-5 cm Criteria Inclusion Criteria: healthy term primi or second gravid parturients aged 18-30 years singleton, live fetus vertex presentation active stage

2016 Clinical Trials

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