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Sci Rep 2019 Apr 10;9(1):5861. Epub 2019 Apr 10.

Parturition Research Group, Institute of Reproductive and Developmental Biology, Imperial College London, Du Cane Road, London, W12 0NN, UK.

Preterm birth (PTB) is the leading cause of infant death and disability worldwide. The onset of preterm uterine contractions is preceded by asymptomatic cervical remodelling and ripening, which can be seen on trans-vaginal ultrasound as cervical shortening. This study aimed to identify plasma miRNA biomarkers that predict preterm birth and/or cervical shortening. Read More

Sci Rep 2019 Apr 8;9(1):5792. Epub 2019 Apr 8.

Imperial College London, Parturition Research Group, IRDB, Du Cane Road, London, W12 0NN, UK.

Oxytocin receptor antagonists (OTR-A) have been developed as tocolytics for the management of preterm labour due to the significant role of oxytocin (OT) in the onset of both term and preterm labour. Similar to OT, prostaglandins (PGs) play key roles in myometrial contractility and cervical ripening. Inhibition of PG synthesis/activity is used to delay preterm birth. Read More

FASEB J 2019 Mar 27:fj201802642R. Epub 2019 Mar 27.

Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Human amnion fibroblasts produce abundant prostaglandin E2 (PGE2), which plays a crucial role in parturition by stimulating not only myometrial contraction and cervical ripening but also the expression of the rate-limiting enzyme in PGE2 synthesis-namely, cyclooxygenase-2 (COX-2). This feed-forward induction of COX-2 expression by PGE2 is mediated via its receptors coupled with the cAMP and PKA pathway and subsequent phosphorylation of the transcription factors cAMP-response element binding protein (CREB) and signal transducer and activator of transcription 3 (STAT3). Although prostaglandin E receptor (EP)-2 and EP4 for PGE2 are coupled with activation of the cAMP and PKA pathway, the exact roles of these 2 receptors in the regulation of COX-2 expression in amnion fibroblasts remain to be determined. Read More

Minim Invasive Ther Allied Technol 2019 Mar 25:1-7. Epub 2019 Mar 25.

a Ningbo No. 2 Hospital , Ningbo , People's Republic of China.

Objective: To compare the effectiveness of misoprostol administration orally or vaginally for cervical ripening in women before operative hysteroscopy surgery.

Material And Methods: Two hundred seventy-five women eligible for operative hysteroscopy were recruited for a controlled, blinded, randomized trial. Twenty-two women were excluded from the study. Read More

J Obstet Gynaecol India 2019 Feb 8;69(1):37-42. Epub 2018 Jan 8.

Department of Obstetrics and Gynecology, Seth G. S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra India.

Background: Objectives of the current study were to find the most effective method of induction of labour in case of intrauterine foetal death (IUFD), with efficacy described as least induction-to-delivery time, and the agent with the best safety profile, i.e. least maternal complications. Read More

J Matern Fetal Neonatal Med 2019 Mar 11:1-5. Epub 2019 Mar 11.

a Department of Obstetrics and Gynecology , WellSpan Health , York , PA , USA.

Objective: To determine if differences exist among nulliparous overweight and obese gravidas undergoing cervical ripening employing three different agents (dinoprostone, misoprostol, or cervical catheter).

Methods: A retrospective cohort study of nulliparous overweight and obese women who underwent induction of labor at two south-central Pennsylvania hospitals between January 2014 and December 2017. Nulliparous gravidas, ≥37 weeks' gestational age, with singleton pregnancies in the vertex presentation, were included in the study. Read More

Am J Obstet Gynecol 2019 Mar 18;220(3):275.e1-275.e9. Epub 2019 Feb 18.

Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX.

Objective: The objective of the study was to test the hypothesis that Dilapan-S is not inferior to the Foley balloon for preinduction cervical ripening at term.

Study Design: Pregnant women ≥37 weeks scheduled for induction with unfavorable cervix (≤3 cm dilated and ≤60% effaced) were randomly assigned to 12 hours of either Foley balloon inflated with 60 mL saline or Dilapan-S for cervical ripening. If the cervix remained unfavorable, then 1 more round of the assigned dilator was used. Read More

J Obstet Gynaecol Res 2019 Feb 13. Epub 2019 Feb 13.

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.

Aim: In this study, we aimed to investigate whether there was a significant prognostic difference between single and multiple cervical dilations when inducing second-trimester abortion.

Methods: We conducted a retrospective review of 238 pregnant women who underwent termination of pregnancy at 12-21 weeks of gestation at Osaka University Hospital in Osaka, Japan, between January 2010 and May 2018. Termination of pregnancy was performed by vaginal administration of 1 mg gemeprost every 3 h for up to five doses per day after uterine cervical dilation using lamicel. Read More

J Obstet Gynaecol 2019 May 12;39(4):461-467. Epub 2019 Feb 12.

b Department of Neonatology , Post Graduate Institute of Medical Education & Research , Chandigarh , India.

Prostaglandins and intracervical catheters are similarly effective for cervical ripening and for an induction of labour (IOL). Studies comparing the combined use with either method alone have administered repetitive doses of prostaglandins vaginally, which may increase the risk of tachysystole and chorioamnionitis. These disadvantages may be offset by co-administering a single dose of prostaglandin. Read More

J Matern Fetal Neonatal Med 2019 Feb 10:1-16. Epub 2019 Feb 10.

a Facultad de Medicina , Hospital Universitario Lozano-Blesa, Universidad de Zaragoza , Zaragoza , Spain.

Objective: To compare the effect of misoprostol combined with a cervical single or double-balloon catheter versus misoprostol alone for labor induction of singleton pregnancies with an unfavorable cervix.

Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs) regarding the comparison of two schemes for labor induction of singleton cephalic pregnancies with a Bishop score ≤7 and no contraindication for vaginal delivery. Six research databases were searched for articles published in all languages up to 10 May 2018 comparing misoprostol (oral or vaginal) in combination with a cervical placed single or double balloon catheter versus misoprostol treatment alone. Read More

J Matern Fetal Neonatal Med 2019 Feb 10:1-8. Epub 2019 Feb 10.

a Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Donald Barbara Zucker School of Medicine at Hofstra/Northwell , Manhasset , NY, USA.

Objective: To determine if vaginal misoprostol is more effective than oral misoprostol for cervical ripening in obese women.

Study Design: A retrospective cohort study of obese women undergoing induction of labor from Jan 2013 to Dec 2016 with singleton, viable pregnancies beyond 37 completed weeks of gestational age. Women with an initial Bishop score of 7 or less, with a cervical dilatation of less than 2 cm, who received either vaginal or oral misoprostol as a cervical ripening agent, were included. Read More

Arch Gynecol Obstet 2019 Mar 7;299(3):765-771. Epub 2019 Feb 7.

Rabin Medical Center, Helen Schneider Hospital for Women, 39 Zabotinski St, 4941492, Petach Tikva, Israel.

Objective: To compare pregnancy outcomes following induction of labor with prostaglandins versus extra-amniotic balloon catheter indicated for term isolated oligohydramnios.

Study Design: Retrospective cohort study of all women who underwent induction of labor due to term isolated oligohydramnios at a university affiliated medical center (2007-2016). The cohort was divided into two subgroups, according to induction method: vaginal prostaglandins E2 versus extra-amniotic balloon catheter. Read More

Acta Obstet Gynecol Scand 2019 Feb 5. Epub 2019 Feb 5.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Introduction: The lowest incidence of perinatal morbidity and mortality occurs around 39-40 weeks. Therefore, some have advocated induction of uncomplicated singleton gestations once they reach full-term. The aim of the study was to evaluate the risk of cesarean delivery, and any maternal and perinatal effects of a policy of induction of labor in women with full-term uncomplicated singleton gestations. Read More

Acta Obstet Gynecol Scand 2019 Feb 5. Epub 2019 Feb 5.

Unit of Maternal-Fetal Medicine, Department of Obstetrics, Miguel Servet University Hospital, Zaragoza, Spain.

Introduction: The aim of this study was to compare the efficacy and safety of a low-dose protocol of vaginal misoprostol and vaginal dinoprostone insert for induction of labor in women with post-term pregnancies.

Material And Methods: We designed a prospective, randomized, open-labeled trial with evaluators blinded to the end-point, including women of at least 41 weeks of gestational age with uncomplicated singleton pregnancies and a Bishop score <6. They were randomized into dinoprostone or misoprostol groups in a 1:1 ratio. Read More

Acta Obstet Gynecol Scand 2019 Feb 5. Epub 2019 Feb 5.

Division Women and Baby, Department of Obstetrics, Birth Center Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.

Introduction: When women with a previous cesarean section and an unfavorable cervix have an indication for delivery, the choice is to induce labor or to perform a cesarean section. This study aims to assess the effectiveness and safety of a balloon catheter as a method of induction of labor in women with one previous cesarean section and an unfavorable cervix compared with an elective repeat cesarean section.

Material And Methods: We performed a prospective cohort study in 51 hospitals in the Netherlands on term women with one previous cesarean section, a live singleton fetus in cephalic position, an unfavorable cervix and an indication for delivery. Read More

Am J Perinatol 2019 Jan 23. Epub 2019 Jan 23.

Department of Obstetrics and Gynecology, Christiana Hospital, Newark, Delaware.

J Midwifery Womens Health 2019 Jan 16;64(1):55-67. Epub 2019 Jan 16.

Introduction: Studies have shown that women with obesity have longer labors. The purpose of this systematic review and meta-analysis is to examine existing evidence regarding labor induction in women with obesity, including processes and outcomes. The primary outcome was cesarean birth following labor induction. Read More

Indian J Pharmacol 2018 Sep-Oct;50(5):260-265

Department of Nursing, Faculty of Health Science, Bandirma Onyedi Eylül University, Balikesir, Turkey.

Objective: The aim of this study is to examine the effectiveness and adverse effects of local glyceryl trinitrate (GTN) application during labor compared with a placebo group.

Methods: The study consisted of 70 pregnant women with overdue pregnancies who presented to the hospital for labor induction between January 2009 and January 2011 in the Obstetrics Clinic of Istanbul Süleymaniye Gynecology and Obstetrics Education and Training Hospital. Vaginal suppositories-containing GTN (36/70) or placebo (34/70) was administered to the participants in a randomized fashion. Read More

BMC Pregnancy Childbirth 2019 Jan 8;19(1):14. Epub 2019 Jan 8.

Department of Obstetrics and Gynecology, Araba University Hospital, Jose Atxotegui s/n, 01009, Vitoria-Gasteiz, Spain.

Background: Among the various methods available, the administration of prostaglandins is the most effective for inducing labour in women with an unfavourable cervix. Recent studies have compared treatment with various titrated doses of oral misoprostol with vaginal misoprostol or dinoprostone, indicating that the use of an escalating dose of an oral misoprostol solution is associated with a lower rate of caesarean sections and a better safety profile. The objective of this study is to assess which of these three therapeutic options (oral or vaginal misoprostol or vaginal dinoprostone) achieves the highest rate of vaginal delivery within the first 24 h of drug administration. Read More

Eur J Obstet Gynecol Reprod Biol 2019 Feb 30;233:38-42. Epub 2018 Nov 30.

Obstetrics and Gynecology Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France.

Objectives: Adrenal vein thrombosis during pregnancy is a rare thromboembolic event but is not exceptional. The objective of this study was to described the symptoms, diagnosis, treatment and follow-up of patients with this condition.

Study Design: This was a retrospective descriptive study of 14 cases (13 patients, one recurrence) that occurred in the three university maternity hospitals in Lyon (France) from 2008 to 2016. Read More

Medicine (Baltimore) 2018 Nov;97(48):e13251

Clinical Medicine College, Soochow University, Suzhou Jiangsu, China.

Background: Successful labor induction depends on the cervical status at the time of induction. Currently, both a Foley catheter and a dinoprostone insert are used for effective cervical ripening. This study compared the efficacy and safety of the intracervical Foley catheter and dinoprostone insert for cervical ripening to achieve successful labor induction. Read More

Obstet Gynecol Surv 2018 Nov;73(11):641-649

Professor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Wright State University, Boonshoft School of Medicine, Dayton, OH.

Importance: Cervical stenosis is a challenging clinical entity that requires prompt identification and management in order to avoid iatrogenic injury at the time of endocervical canal cannulation.

Objective: The aim of this study was to identify cervical stenosis and discuss associated etiologies, risk factors, and review medical and surgical approaches for overcoming cervical stenosis.

Evidence Acquisition: Computerized searches of MEDLINE and PubMed were conducted using the key words "cervix", "cervical stenosis," "embryo transfer," "hysteroscopy complications," "misoprostol," and "ultrasound. Read More

Eur J Pharmacol 2019 Jan 14;843:27-33. Epub 2018 Nov 14.

Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Eötvös u. 6., H-6720 Szeged, Hungary; Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Dóm tér. 12., H-6720 Szeged, Hungary. Electronic address:

Improper cervical function may lead premature or late-term birth. The RhoA/Rho-kinase (ROCK) signalling pathway takes part in cellular functions including smooth muscle contraction. No information is available about the cervical expression of the RhoA/ROCK system during pregnancy. Read More

J Pharmacol Exp Ther 2019 Feb 15;368(2):292-298. Epub 2018 Nov 15.

Department of Pharmacodynamics and Biopharmacy, University of Szeged, Hungary; and Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Hungary

Vitamin E and their analogs as antioxidant and lipid-soluble compounds can have diverse effects on the physiologic processes. By binding to receptors and enzymes, they may modify the action of drugs. It has been proved that -tocopherol succinate modifies the effects of agonist terbutaline and cyclooxygenase (COX) inhibitors on rat trachea and myometrium. Read More

Midwifery 2019 Feb 18;69:10-16. Epub 2018 Oct 18.

Department of Obstetrics and Gynaecology, Westmead Hospital, Westmead, Australia; Department of Medicine and Public Health, University of Sydney, Camperdown, Australia. Electronic address:

Background: The effectiveness of continuity of care during the perinatal period is well documented, but implementing continuity of care model to practice requires evaluation.

Aim: To evaluate the effect of a caseload midwifery program (CMP) on birth outcomes and rates of perinatal interventions at a metropolitan tertiary hospital in Australia, compared with standard midwifery-led care (SMC).

Methods: This was a retrospective, matched-cohort study. Read More

Gynecol Obstet Fertil Senol 2018 12 30;46(12):1068-1075. Epub 2018 Oct 30.

Clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 4489 - environnement périnatal et croissance, université de Lille, 1, place de Verdun, 59000 Lille, France. Electronic address:

Objective: To identify the ideal gestational age at delivery for preterm premature rupture of membranes and modalities of birth.

Method: To identify studies, research was conducted using Pub-Med, Embase and Cochrane databases.

Results: Prolonged latency duration after pPROM does not worsen neonatal prognosis (NP3). Read More

AJP Rep 2018 Oct 29;8(4):e307-e314. Epub 2018 Oct 29.

Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

Cervical ripening is often the first component of labor induction and is used to facilitate the softening and thinning of the cervix in preparation for labor. Common methods used for cervical ripening include both mechanical (e.g. Read More

Case Rep Obstet Gynecol 2018 25;2018:4171604. Epub 2018 Sep 25.

Department of Obstetrics and Gynecology, University of Yaoundé 1, Yaoundé, Cameroon.

Background: There are increasing reports of term live abdominal pregnancies even though the diagnosis of abdominal pregnancy is made preoperatively only in 45% of cases which partly explains the high maternal and perinatal morbidity and mortality associated with abdominal pregnancy.

Case Report: We report a rare case of misdiagnosed term abdominal pregnancy complicated by fetal demise due to cord round neck in a 29-year-old G3P2002 at 39-week and 1-day gestation. She noticed reduced fetal movements for which upon examination fetal death was diagnosed. Read More

Drugs 2018 Oct;78(15):1615-1624

Springer, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand.

Dinoprostone vaginal insert (Cervidil; Propess), a retrievable vaginal pessary containing 10 mg of dinoprostone [prostaglandin E (PGE)] in a controlled-release drug delivery device, is approved in many countries worldwide for the initiation (or continuation) of cervical ripening in patients at term prior to labour induction. The device is designed to provide a constant and sustained release of dinoprostone to the cervix to promote the complex processes involved in cervical ripening. The vaginal insert is attached to a retrieval system that facilitates easy removal of the device at the onset of labour or in the event of complications. Read More

Arch Gynecol Obstet 2019 Jan 12;299(1):7-12. Epub 2018 Oct 12.

Chongqing Health Center for Women and Children, No. 120 LongShan Road, Yubei District, Chongqing, 401147, China.

Objective: To assess the efficacy and safety of a double-balloon catheter versus dinoprostone insert for labour induction.

Study Design: PubMed, MEDLINE, Embase, ClinicalTrials.gov, and the Cochrane Central Register of Clinical Trials databases were searched from 1985 to April 2018. Read More

Zhonghua Fu Chan Ke Za Zhi 2018 Sep;53(9):602-607

Gynecologic Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100006, China.

To evaluate the effectiveness of carboprost methylate suppository for cervical ripening before diagnostic hysteroscopy in premenopausal women. From July 2014 to July 2015, 1 614 women who were undergone diagnostic hysteroscopy in 12 hospitals were randomly assigned into study group (1 209) and control group (405) . The cases in study group were given 1 mg carboprost methylate suppository in vagina before hysteroscopy, the cases in control group were given 1 mg placebo. Read More

Reprod Sci 2018 Oct 3:1933719118799208. Epub 2018 Oct 3.

1 Department of Histology and Embryology, Akdeniz University School of Medicine, Antalya, Turkey.

The complex and multifactorial mechanisms that initiate and sustain the early labor process in the human uterus and cervix are still not well defined. Cervical maturation or ripening is likely to play a key role in preparing for birth. Prostaglandins have many different functions, including the regulation of uterine contractility and structure during pregnancy. Read More

Obstet Gynecol Sci 2018 Sep 9;61(5):636-640. Epub 2018 Aug 9.

Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Korea.

Misoprostol is widely used in daily practice for induction of labor and cervical dilatation prior to intrauterine procedures, including dilatation and curettage or hysteroscopy. Anaphylactic shock to intravaginal misoprostol can occur not only in pregnant women, as reported in 2 previous cases, but also in a non-pregnant, perimenopausal woman, as in the case described herein. A 49-year-old woman received vaginal misoprostol for cervical ripening prior to hysteroscopic myomectomy and experienced anaphylactic shock. Read More

Fetal Diagn Ther 2018 Sep 24:1-8. Epub 2018 Sep 24.

Objective: To compare vaginal delivery rate and perinatal outcomes of fetuses with late-onset fetal growth restriction (FGR) undergoing labor induction, depending on the method for cervical ripening (dinoprostone vs. Foley balloon).

Material And Methods: We conducted a retrospective cohort study of 148 consecutive singleton gestations diagnosed with stage I late-onset FGR and Bishop score < 7, in which labor induction was indicated at ≥37 + 0 weeks. Read More

Midwifery 2018 Dec 17;67:57-63. Epub 2018 Sep 17.

Department of Women's and Newborn Health, Westmead Hospital, Westmead, New South Wales 2145, Australia; Sydney Medical School Westmead, University of Sydney, Sydney, New South Wales, Australia.

Objective: To examine discomfort/pain associated with the Foley catheter insertion process and explore factors affecting discomfort/pain.

Design: This cohort study conducted in the context of larger randomised clinical trial comparing silicone and latex Foley catheters.

Setting: A tertiary hospital in Western Sydney. Read More

J Turk Ger Gynecol Assoc 2018 Sep 17. Epub 2018 Sep 17.

Department of Obstetrics and Gynecology, Ankara University School of Medicine, Ankara, Turkey.

Objective: The aim of the present study is to compare the effectiveness and safety of oxytocin and cervical ripening balloon in women with unfavorable cervices for inducing labor.

Material And Methods: Total of eighty pregnant women between 37-41 gestational weeks having singleton pregnancies and intact membranes with unfavorable cervix were randomized in two groups, cervical ripening balloon (n=40) and oxytocin infusion (n=40). The primary outcomes were the labor time and the route of delivery. Read More

Singapore Med J 2018 08;59(8):419-424

Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore.

Introduction: Evidence has shown that balloon catheters are as effective as prostaglandins (PGE) in achieving vaginal delivery within 24 hours of the start of induction of labour (IOL), with lower rates of uterine hyperstimulation, and similar Caesarean section and infection rates. International guidelines recommend mechanical methods as a method of IOL. We designed a prospective randomised controlled study to evaluate patient acceptance of the cervical ripening balloon (CRB) for IOL. Read More

Integr Gynecol Obstet J 2018 28;1(2). Epub 2018 Jun 28.

Lawrence D. Longo Center for Perinatal Biology, Loma Linda University School of Medicine, Loma Linda University. Loma Linda, California, USA.

We report on development of a rapid, quantitative analysis technique of collagen fibers in cross-linked structures to assess remodeling of the cervix during the transition from soft to ripening in preparation for birth. Optical density analysis of picrosirius red stain tissue using circular polarized birefringence light from fixed paraffin-embedded or frozen cervix from pregnant mice during phases of remodeling prior to birth. Data were analyzed using NIH Image J and extended recently to include studies of prepartum cervix in peripartum women. Read More

Int J Womens Health 2018 21;10:459-465. Epub 2018 Aug 21.

Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt,

Umbilical cord prolapse (UCP) is an uncommon obstetric emergency that can have significant neonatal morbidity and/or mortality. It is diagnosed by seeing/palpating the prolapsed cord outside or within the vagina in addition to abnormal fetal heart rate patterns. Women at higher risk of UCP include multiparas with malpresentation. Read More

BJOG 2018 09;125(10):1342-1343

Department of Reproductive Health and Research, UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.

Am J Perinatol 2019 Mar 21;36(4):406-421. Epub 2018 Aug 21.

Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas.

Objective:  To assess available evidence regarding the use of oxytocin in conjunction with Foley balloon (FB) for cervical ripening.

Methods:  Databases from MEDLINE (U.S. Read More

Contraception 2019 Jan 17;99(1):10-15. Epub 2018 Aug 17.

Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, KS-3, Boston, MA 02215. Electronic address:

Objectives: To assess whether first-trimester aspiration abortion practices of US providers agree with evidence-based policy guidelines.

Study Design: We sent surveys by mail or electronically to all abortion facilities in the United States identified via professional networks and websites from June through December 2013. Administrators reported on the volume of procedures performed at their site(s) through 13 weeks 6 days' gestation and on clinic services. Read More

Taiwan J Obstet Gynecol 2018 Aug;57(4):560-566

Pharmacy Department, Armed Forces Hospitals Southern Region, Khamis Mushait, Saudi Arabia.

Objective: The current study compared the safety and efficacy of two different dinoprostone preparations (dinoprostone vaginal tablets & dinoprostone slow release retrievable vaginal insert) to ripen the cervix at term.

Materials And Methods: Women admitted for pre-induction cervical ripening were included in a randomized controlled trial. Eligible women were randomly assigned to receive Dinoprostone either in the form of vaginal tablets or slow release retrievable vaginal insert. Read More

Eur J Obstet Gynecol Reprod Biol 2018 Oct 3;229:70-75. Epub 2018 Aug 3.

Ex-Medicem International, Prague, Czech Republic. Electronic address:

Introduction: To evaluate the effects of synthetic osmotic dilators (Dilapan-S/ Dilasoft) in women who required induction of labour in a large prospective multicentre international observational study.

Materials And Methods: Primary outcomes were duration of Dilapan-S/Dilasoft insertion (hours), total induction - delivery interval (hours) and the rate of vaginal deliveries within 24 h (%). Secondary outcomes were the number of dilators inserted, Bishop score increase after extraction of Dilapan-S/Dilasoft, complications during induction (uterine contractions, uterine tachysystole and hyperstimulation, effect on the fetus) and post induction (infections and neonatal outcomes), agents / procedures used for subsequent induction of labour, immediate rate of spontaneous labours following cervical ripening period, rate of spontaneous vaginal deliveries, rate of instrumental vaginal deliveries and caesarean sections. Read More

J Ultrasound Med 2019 Mar 12;38(3):785-793. Epub 2018 Aug 12.

New York University Langone Health, New York, New York, USA.

The efficacy of treating cesarean scar pregnancies and cervical pregnancies with the Cook® cervical ripening balloon catheter, in a multicenter office-based setting is reported. Thirty-eight women were treated. Insertion of the catheter was performed under real-time ultrasound guidance. Read More

J Obstet Gynaecol Res 2018 Dec 10;44(12):2149-2155. Epub 2018 Aug 10.

Department of Obstetrics and Gynecology, Zeynep Kamil Maternity and Children's Health Training & Research Hospital-İstanbul, Turkey.

Aim: Prostaglandins have a dual action of cervical ripening and induction of uterine contraction. This study was designed to compare the effectiveness of vaginal washing just before insertion of intravaginal dinoprostone.

Methods: A randomized controlled trial was conducted at the Zeynep Kamil Women and Children's Health Training and Research Hospital. Read More

Acta Biomater 2018 09 29;78:308-319. Epub 2018 Jul 29.

Department of Mechanical Engineering, Columbia University, New York, NY 10027, USA. Electronic address:

A well-timed modification of both the collagen and elastic fiber network in the cervix during pregnancy accompanies the evolution of tissue mechanical parameters that are key to a successful pregnancy. Understanding of the cervical mechanical behaviour along normal and abnormal pregnancy is crucial to define the molecular events that regulate remodeling in term and preterm birth (PTB). In this study, we measured the mechanical response of mouse cervical tissue to a history of cyclic loading and quantified the tissue's ability to recover from small and large deformations. Read More

Int J Pharm 2018 Oct 24;549(1-2):124-132. Epub 2018 Jul 24.

School of Pharmacy, Queen's University Belfast, Belfast BT9 7BL, UK. Electronic address:

Intravaginal rings (VRs) have been widely reported for administration of pharmaceutical drugs - most notably estrogens, progestogens and antiretrovirals - to the vagina for clinical benefit. Here, for the first time, we describe the design, manufacture and preclinical testing of VRs for sustained/controlled release of the cervical ripening agents isosorbide mononitrate (ISMN) and misoprostol (MP), either singly or in combination. Matrix-type silicone elastomer VRs containing ISMN showed declining daily release rates, ranging from 31 to 168 mg (Day 1) to 3-25 mg (Day 11). Read More