| 1. |
- Grobman, William A, et al.
(author)
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FIGO good practice recommendations on the use of pessary for reducing the frequency and improving outcomes of preterm birth.
- 2021
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In: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. - : Wiley. - 1879-3479. ; 155:1, s. 23-25
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Research review (peer-reviewed)abstract
- A pessary is a device made of synthetic material that is placed in the vagina and has been used for prevention of preterm birth. It has been suggested that a potential mechanism of the pessary is alteration of the cervico-uterine angle to a more posterior position, which reduces cervical compression in women with a singleton pregnancy and a short cervical length. Pessaries should not be used in routine clinical care to reduce the frequency of preterm birth or to improve outcomes (e.g. neonatal outcomes) related to preterm birth. In women with a twin pregnancy-regardless of cervical length-pessaries should not be used in routine clinical care to reduce the frequency of preterm birth or to improve outcomes (e.g. neonatal outcomes) related to preterm birth. Presently there is no sufficient evidence suggesting that pessaries should be used as a standard treatment to prevent preterm birth; their use should be reserved for study populations.
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| 2. |
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| 3. |
- Hall, Megan, et al.
(author)
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Effective and simple interventions to improve outcomes for preterm infants worldwide: The FIGO PremPrep-5 initiative.
- 2024
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In: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. - 1879-3479.
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Research review (peer-reviewed)abstract
- Preterm birth remains the leading cause of mortality among under-5's and is a major contributor to the reduction in quality-of-life adjusted years and reduction in human capital. Globally, there are many interventions and care bundles that aim to reduce the impact of preterm birth once preterm labor has ensued and into the neonatal period; not all of these are applicable in all settings. Here, we introduce the FIGO PremPrep-5 initiative, which aims to disseminate key information on the most simple and effective interventions with the aim of increasing implementation globally. Before delivery, we recommend a course of antenatal corticosteroids, and intrapartum magnesium sulfate. At delivery, we recommend delayed cord clamping. Postnatally, we recommend early feeding with breast milk and immediate kangaroo care. While there are many other interventions that may improve outcomes at the time of labor and after preterm birth, these are clinically effective and relatively inexpensive options that can be practiced in most settings and supplemented with more advanced care. We include examples of a training video and infographics that will be used for dissemination.
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| 4. |
- Mol, Ben W, et al.
(author)
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FIGO good practice recommendations on reduction of preterm birth in pregnancies conceived by assisted reproductive technologies.
- 2021
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In: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. - : Wiley. - 1879-3479. ; 155:1, s. 13-15
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Research review (peer-reviewed)abstract
- FIGO (the International Federation of Gynecology and Obstetrics) supports assisted reproductive technologies (ART) to achieve pregnancy and supports their availability in all nations. However, the increased frequency of preterm birth must be taken into account. Therefore, before in vitro fertilization (IVF) is started, other approaches, including expectant management, should be considered. Single embryo transfer is the best approach to ensure a live, healthy child. However, increased risks for preterm birth are also associated with a singleton IVF pregnancy and should be discussed and contrasted with spontaneous conception. Increased preterm birth and other adverse pregnancy outcomes in singleton IVF cycles warrant investigations to elucidate and mitigate. Minimizing embryo manipulation during cell culture is recommended. Increased risk of preterm birth and other pregnancy complications in ART could reflect the underlying reasons for infertility. This information should be discussed and further explored.
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| 5. |
- Sakabe, Noboru J, et al.
(author)
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Transcriptome and regulatory maps of decidua-derived stromal cells inform gene discovery in preterm birth.
- 2020
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In: Science advances. - : American Association for the Advancement of Science (AAAS). - 2375-2548. ; 6:49
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Journal article (peer-reviewed)abstract
- While a genetic component of preterm birth (PTB) has long been recognized and recently mapped by genome-wide association studies (GWASs), the molecular determinants underlying PTB remain elusive. This stems in part from an incomplete availability of functional genomic annotations in human cell types relevant to pregnancy and PTB. We generated transcriptome (RNA-seq), epigenome (ChIP-seq of H3K27ac, H3K4me1, and H3K4me3 histone modifications), open chromatin (ATAC-seq), and chromatin interaction (promoter capture Hi-C) annotations of cultured primary decidua-derived mesenchymal stromal/stem cells and in vitro differentiated decidual stromal cells and developed a computational framework to integrate these functional annotations with results from a GWAS of gestational duration in 56,384 women. Using these resources, we uncovered additional loci associated with gestational duration and target genes of associated loci. Our strategy illustrates how functional annotations in pregnancy-relevant cell types aid in the experimental follow-up of GWAS for PTB and, likely, other pregnancy-related conditions.
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| 6. |
- Shennan, Andrew, et al.
(author)
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FIGO good practice recommendations on cervical cerclage for prevention of preterm birth.
- 2021
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In: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. - : Wiley. - 1879-3479. ; 155:1, s. 19-22
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Research review (peer-reviewed)abstract
- Cervical cerclage is an intervention which when given to the right women can prevent preterm birth and second-trimester fetal losses. A history-indicated cerclage should be offered to women who have had three or more preterm deliveries and/or mid-trimester losses. An ultrasound-indicated cerclage should be offered to women with a cervical length <25mm if they have had one or more spontaneous preterm birth and/or mid-trimester loss. In high-risk women who have not had a previous mid-trimester loss or preterm birth, an ultrasound-indicated cerclage does not have a clear benefit in women with a short cervix. However, for twins, the advantage seems more likely at shorter cervical lengths (<15mm). In women who present with exposed membranes prolapsing through the cervical os, a rescue cerclage can be considered on an individual case basis, taking into account the high risk of infective morbidity to mother and baby. An abdominal cerclage can be offered in women who have had a failed cerclage (delivery before 28weeks after a history or ultrasound-indicated [but not rescue] cerclage). If preterm birth has not occurred, removal is considered at 36-37weeks in women anticipating a vaginal delivery.
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| 7. |
- Shennan, Andrew, et al.
(author)
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FIGO good practice recommendations on progestogens for prevention of preterm delivery.
- 2021
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In: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. - : Wiley. - 1879-3479. ; 155:1, s. 16-18
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Research review (peer-reviewed)abstract
- Women at high risk of preterm birth (either a previous spontaneous preterm birth and/or sonographic short cervix) with a singleton gestation should be offered daily vaginal progesterone or weekly 17-OHPC treatment to prevent preterm birth. Benefit is most significant in those with prior history of preterm birth and a short cervix. For women with a previous spontaneous preterm birth and a cervix ≥30mm the effectiveness of progesterone is uncertain. In asymptomatic women with no prior history of previous preterm birth, no mid-trimester loss, or no short cervical length, progesterone therapy is not recommended for the prevention of preterm birth. For those with unselected multiple pregnancies, progesterone therapy is not recommended for the prevention of preterm birth. Daily vaginal progesterone or weekly 17-OHPC treatment can be used for the prevention of preterm birth. The preparation used should be decided by the woman and her clinician. There is no evidence of neurological or developmental benefit or harm in babies whose mothers use progestogens for preterm birth prevention antenatally.
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