The incidence of preterm labor and specific risk factors

Article Abstract:

Surveillance of patients classified as high-risk for preterm labor can include home monitoring of uterine activity (contractions) and an assessment of patient-perceived signs and symptoms of labor. The rates of preterm labor and delivery were reviewed in four groups of high-risk patients: 119 women with a pregnancy involving more than one fetus; 58 women with a malformed uterus; 115 women with an incompetent cervix; and women with a previous preterm delivery (104 women had one previous preterm delivery, 71 had two and 38 had more than three). Preterm labor developed in 46 percent of the women with twins, 19 percent of the women with a malformed uterus, 25 percent of the women with an incompetent cervix, and between 41 and 68 percent of the women with a history of preterm delivery. Preterm delivery occurred in 36 percent of the women with twins, 14 percent of the women with malformed uterus, 17 percent of the women with an incompetent cervix, and between 30 to 47 percent of the women with a history of preterm delivery. Oral drugs to arrest labor, tocolytic agents, were not effective in prolonging pregnancies when given prophylactically. Contrary to findings from other studies, women who smoked cigarettes were not more likely to develop early labor, except for those carrying twins. The overall preterm delivery rates were lower in this study than other studies. This may be partially explained by an improvement in the early diagnosis of preterm labor with home monitoring devices (which can record uterine contractions and transmit information over the telephone for interpretation by perinatal nurses), increased patient teaching of the signs and symptoms of labor, frequent physical examinations and daily nursing contact. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Risk factors, Premature labor, Premature birth

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Pregnancy after successful vaginoplasty and cervical stenting for partial atresia of the cervix

Article Abstract:

The case report is presented of a woman who delivered a normal baby after being born without a vagina (vaginal agenesis) and with a partially atretic (closed) cervix; the uterus and fallopian tubes, however, were normal. First examined at the age of 11, the girl underwent reconstructive surgery with the insertion of a stent into the modified cervix (a device to hold the cervical canal open). After surgery, the patient began regular menstruation. She married at the age of 18 and became pregnant soon thereafter when she stopped taking an oral contraceptive. The cervix was not judged competent to support a pregnancy, so it was reinforced with a cerclage (an encircling loop). The patient was advised to restrict activity and the fetus was monitored at home. The infant was delivered at 38 weeks' gestation with no complications. Women with partial or complete atresia of the cervix are rarely capable of bearing children, and this is the first report of a successful pregnancy in a patient with both cervical atresia and vaginal agenesis. It is likely that early recognition and treatment of the condition contributed to the successful outcome. Methodological issues in reconstructive surgery of this sort are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Abnormalities, Complications and side effects, Birth defects, Surgery, Plastic, Plastic surgery, Cervix uteri, Vagina, Cervical conization

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Comparison of anterior colporrhaphy and retropubic urethropexy for patients with genuine stress urinary incontinence

Article Abstract:

Stress urinary incontinence in women may be surgically corrected more successfully by retropubic urethropexy than by anterior colporrhaphy. Genuine stress urinary incontinence is the involuntary loss of urine when a certain threshold of pressure in the urethra is reached. Researchers contacted 76 women who had undergone surgery to correct stress urinary incontinence in the previous four years and asked if the surgery was successful. Retropubic urethropexy was performed on 20 women, and 15 of them (75%) had not experienced incontinence since their surgery. Twenty-six out of 56 women (46.4%) who underwent anterior colporrhaphy were cured after surgery. Resident gynecologists had less success, particularly with anterior colporrhaphy, than did gynecologists who had finished their training.

Urinary stress incontinence, Urethra, Urologic surgery

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