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TRAN NHAT THANG

BV Bai hoc Y Duoc TPHCM

BM Phy san, BHYD TPHCM

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Asympomatisinghton pregnancy with no previous
spontaneous preterm ith

{SUG Practice Guidelines role of ultrasound inthe Single measurement of CL w ing transvaginal ultrasound
betwoun 18 and 24 gestational weeks
prtiton of pontancous preterm bith

Recommendation (L29im Routine antenatal
Daly vaginal progesterone
0 Fo gum oma i women witthh singleton pregnancy care
unl 36 week’ station
without prior spontaneous PTB and with TVS
FollCLowmea-suyrempent
CL<25 nm before 24 weeks, administration of natural every -Dwets

vaginal progesterone is ecommended from the tineof unl 24 weeks gestation

detection ofthe shot cerviy unt $6 weeks (GRADE

OF RECOMMENDATION: A)

(Ltn

Conside cervical cera

sei Unt

Gren Gude Na. (mwrtlylb

jn dnd Shennan, BOG, 2022

May ong CTC dya vd tién cn? GPP Good qualty data are curently aking to
infor ths practe
{tis unknown if the specific characteristics. 4
ofthe previous adverse event are helpful
Inthe dectoiplasce oa hinstory
Indicated crcag, (e.g, painless

dilatation, rupof mtemburanres,eprior

cvs

SEMI EK ộ Toran

ying aR Mini

neh tan

Vaginal progesterone for prevention of preter birth in asymptomatic

higtmrisk wornen with anormal cervical ength; a systematic review and
mneta-anlyis

| Pun KP Wins chu WK Mari FB nde’ ea and

CE Penne”

AJGMMM Vaginal Progeuterone — Placebo Nk Ratio: Wik Rat
en 2007 ƠU - HA MU HH MAMEHMMSRUNO
Ww mW mm MỊ 100008, 124) MAMEREN—O—-
Conga 0 1 7 Ú MIN 080M)

al 968 Mm Me M JW HN 76 (04,158)

Tale +11 (Ms 04 4+ 1ð 50) Í TW wot †
Na eid Ni ok
tp Ta 2» 076M» 045)

Tet omael

Figure 3, Efect of vaginal progesterone on women with sk factor(s) for preterm and a know normal midajestaton cervical

Tength »25mm on preterm bith «3? weeks,

‘Vaginal Mogeione Placebo Nik ato vk Rao
Sd browns Tol Cons Tough (hieĐnA
Coringor 2010 1 Ú 9 M II (000M, Mi tad159 C1
wn 06 A MONS 180
—

Toul 98 14ND 10000410109)
‘Toaal events u "
Hetuagney Ta!» O42 CN?» 30 | «0M TH
st Hor oral eck: 2» 0.08 O35) MFo6 aga | Fao PeoW W

Figure 4, tfet of vaginal progesterone on wornen with Mk factor) for pete and a known normal midestation ceria
Iength »-25mm on preterm bith «34weeks, Study by Norman eta, Includes fetal death in utero as part of cutcome; individual

patient data not avalabl,

Fogeteone ig im gi yc th on tac nh hn te
ching CCK gi (28m)

hay belay hg Siglton pregnancy with previos Sinton pregnancy with previous
pontaneous sngeton
spontaneous igeton misartage
or preter bith tween preter bith betwen
and 27ytational weeks
Wand So gestational weeks

EU Practice Gide: ole of utrasound in the Consider dal vagina

prtofispoontnaneous preteritmh progesterone rom 16 036

wens of gestation’

Ironman Transvaginal ultrasound Transvaginal ulasound

Ahh ede isl ii woe mneaurementof CL mncasuremoefnCtL

With sigeton gation an po spontaneous PT, at dveeks at Loweeks

traent with vagina progesterone ery night fom
U6 to Shwe, snelne and teatment in
thowiwth CL ¢25mm,shouldbe considered (GOOD

PRACTICE POINT

"meas Repeat CL measurement ,

Rat CL mas Ị nh tiltitrtoltudụt

ees, , h and maintain dy vagina

unt 24 cs, unl 24 weeks, progesterne®

wile Clrema>i3n0msm} | Wh CLemai26-n29smm

Wn Ct Cpl 20 1470477 a

Elective cercag vs, ulrasound indicated cerclage 40% CTC KhGng ngan dl

inhigh-sk pregnancies a neuy ( SN van thi J

mee

M.S.T04,V.PALANTAPPAN' C.SKENTOU!D, GIBB and KH, NICOLAIDES*

Theo disy thay di nu thé no a phi hop? |

Unacund srl S244, 11946 vb 20-234 reels
Tot,
Gestation at Eletve cerca, Corie No cece
Ne#n(h)
delery (wees) Nedln(h) Ñ:Xn(M N:l7nU)

J3) li 1ÍII\ HÌN| II

1M ŸIII) ((IlJ| 6(240) 000)

oM 35.854) II 18(692) 16 (4.1)
9) II) 1(53)
Total 4 (LA)

KhiCTC nan: qud mu!

(31918)

SA itl 12tudn cb he thondgo dac ling

vacunObd Gyre2!0 1h: dd

Cervical length and fune23lweeiks nof ggttiton in
thepreofcsipocntatneiouos enarly preterm delivery

W.8T0,C. ENTOU, A.W, LIAO, A.CACHO and H, NICOLAIDES

LB rong kg hl yu t6 tn dodn dc ip [cn quan tim hn CTcCbn đứng tia thật

Dimhay cla cu chm trong cho én dodn SN «35 tuna 25% uomgtu gt CTC8 20 mm

CTC deb md ib trong: hing tng

nguy cO SN

Figure Travail asnday of ceri Inbth astheera anak 16th mel a eri

anand mos ca be tnt etn hyn edea an nthe th ih i

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adi ita tena) OL 1)

Pte of he Month (Ì\úi

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R ROMERO'Y4,1 P KUSANOVIC'Y, J ESANOZA'Y, F, GOTSCH'E, CL. NHANCHANG',
(EREZ'Y,(. J KIM'§,N, KHALEK, P. MITTAL,
LF. GONCALVES', C. SCHAUDINN, $$ HASSAandNW, COSTERTONG,

Fg Gran inom dy eenth
pie ide han many Gan gti ca

0t tho i0

Arnniocentesis for Selection Before Rescue Chg itingén quan gia tng SN

[thụ

JONATHAN K, MAYS, MD, REINALDO FIGUEROA, MD, JALPA SHAH, MD,
HAMIDA KHAKOO, MD, SARI KAMINSKY, MD), AND NERGESH TEJAN MD

(bse Gynecol 2000 Rescue cele Rescue crclage, No cerelage ater
afer amniocentesis 1 amniocentesis amniceness
P
(i=l) z7] IIz7

Maternal ge) M563 Mai 11+ 4
Novo primiravidas |
llluy I 1 4

No.of women wih tem deliveries 5 4 4

Nov of women th reste ls ì h ì

No.of women wth Ittrimester abortions 1 ( j

No.of women who had cone bopsles 1 1

Cervical lataton (em) Ube 11+) 1]+U

WHC count (X10'/ml) M3227

Mean GA on adinision (wk) M31

Mean GA at delivery (nk) 3:9

Mean interval (4) Ih 005

No.of suvving neon I

=wie lod cl GA = osation ae,

wih the othe tno groups

Pin Me 201 dy 6,415), 5040, 1151p A, Nu r exgesd as (peptin) or mean inerqurie ange),

Petlens with aoute cervical insufcleney without itraxamnioti i) pial or comparionbetveen groups an,

infectioninflammation treated with cerlage have a good ee

prognosis ' {rales orconparon betwen groups 2 and,
Wau Wincebug, Rael aks! un Kusano, MaSnhopuelyh,
tì ‹ .
nl ot! Ph aS Pa Us Dales for conpaion ten groups and 3,

Robt Romar", Seba E>

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incon rita iatinate odo pnw item
ples item a iat mena infecton/infanmation presenting wth ceria

yu oP oto Ro Yin Pa, Kn ah HO ini
at PA, Ag Ca i PH Hn, AD Aj nh, Pat nO as Po, a
An Creu P,P Hr PO, on, MP
tetera ae ARSULTS: pas wh rat sn i
| ube and toni

‘on ional id noi,hx
vow ota, cto
inh wetognti HoTenig
(vet
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| Cretind| week
Chan ac nd ti ain i 2 ots (ve)

(WO) alow panic nd ee raft in oth Undeflor vatlaeasrtt wdank

4pes, Pino eam cannonvas (net)

cad 70 opis (19, nd gui aa at Tre l0 l0 amnacertsis
fom, ho eon ore ani ean ct be
en (rt)
nial orp i. Tren Fellonup aniocetess

‘it fanatic wm ly ed ss) permed
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(nore nO ter 169 wal pois
Lại Lal
Tr ua cured 32 yds (G8) wth a

‘ale atin wo vd ais, The naan

tial vy ral asic ge ang won
orned womb fabs anon xe wo dak

(14 881 da P=

teen lh!, thự tttltf8, einai toa

aloo aan ais rasa

isp ni lm

(lune oh aa enti er

‘Troatmant success el)
(deine as reson ofira. amnioic efechonnaomr cmkvneray b2:i4 woeenks)

44% 120 of patents with naan lneconannaton

hata Ant ira fie Am] iC 208

ŸII#ilJ spontaneous petrm bith by cra Jnsse Long! evluton of crcl length and shear wae elastography n women wth
length and shearnave lastoraphy inthfiest
trimoef psregtnarncy PL Bg, 0, Spontaneous pret beh

Cu FeyDy yt 0, ey Dui agp LNguyen-Hoang"P Chaamsathong VK. Chang. FengJ Fung! H, Ova,M
Juv on A Yo a UG Pn WO KC Chong’ 1. Leung. Poon

+ Salton beh © Sivpotn rm bth
1 Sagi grr keh
«Sign. prelsem bh

lún lý eds 1 a2 es Wwe 0s sh

Cu oh NT mk 108) Mates) Math

SVE Mol Shp 0ì nh) hf
SVE MM <1 pwn a0
II WM 1U HỮ AỤI-NM
SWE Me «9h pore II Hel U4) THe
wud ee
SWE Ma 2 pl OO IMAI) /M ỊR-I
1) S502) AM 164-0
SEM 2h pcre 65 AMA

IWiIWIIYWWI (0LlE1 9£ (MU AM) ¿ 2:‹-›:7: (,›

Conical crlage for shot con at 24 o 26 weeks o gestation;

systematic review and mela ana landonaceoodled als
Using individu panel dala

i ul MO, a LenPDdp,o Neds MD, Sa Mi, M+

yun Bol, MO Vion Bag, MD» Show au

Pah Mh 4,00» 0 pt apa» so nn

Data rom the 4 eigbe randomized controled tals were induded, A otal of 131 singletons prasnted al 2440/7 to 2648/7

weeks of gestation and wer further analyzed here were no data on palans with acerlage a 274017 weeks’ gestation or
ltr (those nuded, 68 (604%) were inthe cela grup and (406%) were inthe no cerlage group The ae of

preter bth <7 weeks getaton was simlrbetwean patents who ware randomged othe crag group and hoe who
Were randomaedothe no crag OU (27V.6 898.%5%; eller, 0.78; 95% conidenoe nev 0.728),

Secondary outcomes including preterm bith <4, <3, and <26wooks' ostatn, gosttionl age at delvey img inna

{rom randomization to deliver, preterm prelabo upure of membranes, and adverse neonallouloomes such a ow

bithwegh, very low ithwegh, and perinatal death were smlar between the 2 groups

DAtuan:

+ mbcelditan dé dp dung phong ng

+ mc bat đều

PRAIPRO balance POFR camtagonits TAR antagonats

w k , he rn ⁄ i) ' lu Ow

NI»

— +

Cyfokine-suppresshe NFB inhibitors

tlillunmluJdut|_ „ Mi4 0ÚU ,
KH rn

`. ———

ghe: \ Pelyphenols

primary Polstity | ————

(lu elds and pd ÂU

\4ftbf1 IL1!t40t metabolites

Itiidlt 6 MW

kin Sos

‘Se Rev

Inman and Peter ith A Sse Revie

Ata rt dA Matai)

Cellte fetal DNA and spontapnreeteormubsith First Trimester Circulating

SaaRvan Boeck! Donald} Daido’, Jane E Noman! and Sah Sok erg Biomarker Predictive of

SubsequentPretermDelvery and

Cervical Shortening

‘c Heat oiP e i,

Aid Adega Grete BaniMakcy
tei?

Metabolic Dynamics and Preictioonf Gestational 4..... "

Age and Time tDo elvery iPn regnant Women " J—— tí

in Ling Maa H Rana rn Pi Klan hy! Sng Cv Has Rb!” ‘aldaton Coho
2 js „
‘en Sy tet Th Ue Sat’ Nr, La HC Bt Ft
Haya Me Sa Mat ty

Clrvicdl microRNA expression and spontaneous

preterm bith

M0, oD omaha ict

Women with preter birth havea
distinct cervicovaginal metabolome

Jey Ghar, DO, MS ml ABaste, MD, MSE Any, Brown, PD,

Laur Angi, BA Mich A, loi,MD

Thong digp

+ DoCTCthudnqgu dé sing loc SN

*Ap dung phong neta dyatrthaéy n i SA higu qua hon cf ao tt
can

' injtthngibnud Gl cindug cn dodn sm va kg sinh

tet tru

+CTyCeu tuftlitg th dur nh gist 12 tan

+ Cn thém che biomarkdyerdosdn

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