Interventions for women with premature cervical dilatation and exposed fetal membranes to prevent pregnancy loss and preterm birth – a broad systematic review and meta-analysis. N. Pilarski.
The management of women with premature cervical dilatation and exposed unruptured fetal membranes (CDEM) remains uncertain and controversial. This systematic review aims to summarise all existing evidence for CDEM treatment options.
Patient Perspectives and Preferences on Cerclage and Preterm Birth: A Focus Group Study. Nour Abdulrahman
Opsonisation of vaginal microbiota in women at high-risk of delivering preterm. Belen Gimeno-Molina
There is an association between vaginal microbiota composition and the risk of spontaneous preterm birth (sPTB). Vaginal dominance by Lactobacillus crispatus (Community State Type, CST I) is considered protective, while Lactobacillus spp. depletion (CST IV) confers a higher risk. The mechanisms driving microbial-host immune interactions are poorly understood. Our aim is to determine the role of immunoglobulin recognition (opsonisation) of vaginal microbiota in the context of sPTB.
Cervical Shortening and Spontaneous Preterm Birth are Associated With Cervical Neutrophil Migration and Complement Activation. Belen Gimeno-Molina
Cervical shortening (CxS) during pregnancy and spontaneous preterm birth (sPTB) are associated with depletion of vaginal Lactobacillus species and increased bacterial diversity. However, the mechanisms by which vaginal microbiota mediate host immune inflammatory responses and modulates the risk of CxS and sPTB are unclear. In this study, we investigated the role of the complement system and neutrophils at the cervicovaginal interface in response to vaginal microbiota, CxS and sPTB.
Influence of intra-amniotic infection and inflammation on fetal cortical development in women with preterm labor or preterm prelabor rupture of membranes D. Boada
To evaluate whether fetal cortical brain changes exist in fetuses of mothers admitted for preterm labor (PTL) or preterm prelabor rupture of membranes (PPROM) and if these changes were more pronounced in fetuses exposed to intra-amniotic infection and/or inflammation (IAI).
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A retrospective analysis of cerclage versus cerclage + progesterone in a tertiary unit over a calendar year. Nicole Moriarty
We sought to undertake a retrospective cohort study comparing outcomes of women who had cerclage insertion alone or cervical cerclage and progesterone in combination for women at risk of preterm birth the have been treated with a preventative cerclage, or cerclage and vaginal progesterone.
Baby’s First Passport: co-produced PERIPrem (Perinatal Excellence to Reduce Injury in Premature Birth) passport to the perinatal team in in a tertiary unit in London, UK. Nicole Moriarty
The UK has one of the highest infant mortality rates in Western Europe, mainly secondary to preterm birth. To achieve a 50% reduction in stillbirth, maternal mortality, neonatal mortality and serious brain injury by 2025, the Maternity and Neonatal Safety Improvement Programme (MatNeoSIP) facilitated organisational culture change and established a perinatal team. We introduced the co-produced West of England AHSC PERIPrem (Perinatal Excellence to Reduce Injury in Premature Birth) passport, an evidence-based bundle checklist of 11 interventions, for women at risk of preterm birth (22+0 -34+6 weeks) at a tertiary level hospital in London.
To Explore the Delivery of Optimally Timed Antenatal Corticosteroids for Foetal Lung Maturation in Women Delivering Preterm – Nicole Moriarty
Antenatal corticosteroids (ACS) is an important intervention, improving outcomes and reducing morbidity and mortality in preterm neonates by accelerating lung maturation. Optimal timing is defined as steroid course completed between 24 hours and 7 days prior to delivery. Steroids beyond this range or repeated course of steroids have less impact on neonatal wellbeing. Our aim was to analyse the women who delivered preterm in 2022 in our unit and assess antenatal corticosteroid administration, identifying cohorts of women (by gestation or delivery indication) where we could improve the timing of steroid administration.
PERINATAL OUTCOMES IN WOMEN WITH PRETERM PRELABOUR RUPTURE OF MEMBRANES WHEN ANTIBIOTIC PROPHYLAXIS WAS OPTIMIZED IN WOMEN WITHOUT INTRA-AMNIOTIC INFECTION – Andrea Valenzuela
The aim of this study was to evaluate perinatal outcome when we optimize type and duration of antibiotic prophylaxis according to amniotic fluid information in women with preterm prelabour rupture of membranes (PPROM).
NEONATAL OUTCOMES IN WOMEN WITH PRETERM PRELABOUR RUPTURE OF MEMBRANES WHEN ANTIBIOTIC PROPHYLAXIS WAS OPTIMIZED ACCORDING TO AMNIOTIC FLUID INFORMATION – Judith Balcells
Identify the incidence and risk factors of early preterm birth (PB <34 weeks) in women with singleton pregnancies with asymptomatic short cervical length (less than 25mm) treated with a cervical pessary. And apply our risk score to another high-risk preterm birth group.
RISK FACTORS OF EARLY PRETERM BIRTH DESPITE CERVICAL PESSARY IN SINGLETONS PREGNANT WOMEN WITH SHORT CERVIX – Maria Goya
Identify the incidence and risk factors of early preterm birth (PB <34 weeks) in women with singleton pregnancies with asymptomatic short cervical length (less than 25mm) treated with a cervical pessary. And apply our risk score to another high-risk preterm birth group.
IMPACT OF 2 YEARS COVID-19 PANDEMIC ON PRETERM BIRTH: EXPERIENCE FROM A LEVEL-1 OBSTETRICS CENTER – Laura Nagel
This monocentric, retrospective study aims to determine if preterm birth (PTB) changed during the pandemic (DTP) compared to a pre-pandemic period (PPP).
Uterine Isthmic Contractions and Their Relationship with Preterm Birth: A Study Protocol – Sara Catalan
Spontaneous preterm birth is the leading cause of perinatal morbidity and mortality; however, predicting it remains challenging. While a short cervical length has long been associated with a high risk of spontaneous preterm birth, and cervical length measurements are usually performed to identify the risk of preterm birth, the dynamic nature of the uterus and cervix is known. Recent studies have shown that approximately 43% of pregnant women experience asymptomatic isthmic contractions during the second trimester. The high frequency of these contractions and their specific imaging pattern suggest they may play a physiological role in maintaining pregnancy.
The primary aim of this study is to explore the correlation between isthmic contractions and latency to delivery. Secondary objectives include assessing the influence of tocolytics on these contractions, comparing the occurrence of isthmic contractions in healthy pregnancies with pregnancies threatened by preterm labour, and investigating the association between specific pregnancy characteristics and isthmic contractions.
High incidence of both spontaneous and indicated preterm birth in women with systemic lupus erythematosus; a systematic review and meta-analysis. – Carolien Abheiden
Preterm birth (PTB) is a frequent complication of pregnancy in women with systemic lupus erythematosus (SLE). The high indicated PTB rate, due to frequent complications in women with SLE like hypertensive disorders of pregnancy and/or fetal growth restriction, is well known. Preventive measures as well as screening for early detection are performed. The risk of spontaneous PTB is less well recognized. The objective of this study is to determine the rate of both spontaneous and indicated PTB in pregnancies of women with SLE.
Multivariate prediction model for preterm delivery and intra-amniotic infection: External validation study – Ester del Barco
Preterm labour (PTL) is a complex syndrome with multiple etiologies, including infection, inflammation, uteroplacental abnormalities, stress, and immunological processes. Identifying pregnant women at high risk of PTL remains challenging, and multivariate prediction models have been developed to improve risk assessment.
The objective was to replicate a multivariable prediction model for preterm delivery within seven days and microbial invasion of the amniotic cavity (MIAC). Additionally, an external validation of the model was performed.
Pentaerythrityltetranitrate (PETN) reduces preterm birth in a cohort of risk pregnancies identified by impaired uterine perfusion – secondary analysis of a randomised trial – Tanja Groten
Study Design: In a multicenter, randomized, double-blind, placebo controlled trial with two parallel groups pregnant women presenting with a mean uterine artery Pulsatility Index >95th percentile at 19+0 to 22+6 weeks of gestation were randomized to Pentalong® 50mg or placebo twice daily. Participants were assigned to high or low risk according to their medical history before randomization was performed block-wise with a fixed block length stratified by center and risk group. The primary efficacy endpoint was the composite outcome of perinatal death or development of fetal growth restriction.
A Novel Technique for Cervical Cerclage Placement at Laparoscopic Pre-Pregnancy Abdominal Cerclage: Operative outcomes and Impact on Preterm Birth – Gillian Corbett
Traditional technique(TT) for suture placement at laparoscopic Total Abdominal Cerclage includes dissection lateral to the lower uterine body creating peritoneal windows to pass suture material. Novel use of EndoCatch™ port closure device (PCD) to pass suture material has been used in our unit in recent years. We examined its operative and subsequent pregnancy outcomes compared to TT for laparoscopic pre-pregnancy TAC(PPLTAC).
THE DIAGNOSTIC PERFORMANCE OF NANOPORE SEQUENCING METHOD IN THE DETECTION OF INTRA-AMNIOTIC INFECTION IN PRETERM LABOR – P. Chaemsaithong
Introduction: Intra-amniotic infection is the leading cause of infection in labor and delivery unit. Clinical standard methods for the detection of intra-amniotic infection are culture or 16S rDNA Sanger sequencing. However, these methods have a long sample-to-result-turnaround time. Nanopore sequencing method is a real-time long read sequencing method with fast speed. The aim of this study is to determine the diagnostic performance of 16S rDNA nanopore sequencing method for the identification of intra-amniotic infection.
Quantitative cervicovaginal fluid fetal fibronectin for the prediction of intra-amniotic inflammation in women with spontaneous preterm labor and intact membranes – P. Chaemsaithong
To determine whether cervicovaginal fluid fetal fibronectin (CVF fFN) can be predictive of the presence of intra-amniotic inflammation in pregnant women presenting with preterm labor with intact membranes and to define appropriate cut-off value.
Embedding the Patient Voice into Preterm Birth Preventative Care: Themes from a Preterm Birth Advisory Council – Gillian Corbett
Spontaneous preterm birth (sPTB) has a deep immediate impact on women but also alters their care and experience in subsequent pregnancies. There is an absence of the pregnant person’s voice in the research surrounding pregnancy at risk of sPTB. Our objective is to address this.
Nanopore Adaptive Sampling Accelerates the Detection of Hard-to-culture Bacteria and Its Antimicrobial Resistance Gene in Silent Intraamniotic Infection – P. Chaemsaithong
Intraamniotic infection can cause preterm birth and serious neonatal complications. Unfortunately, conventional testing methods used to identify bacteria causing intraamniotic infection take days, which inadequate for guiding early and targeted antimicrobial therapy. Here we report the collection of pus sample from the nostrils of a 31-weeks fetus born to a mother with intraamniotic infection.
Pregnancy outcomes following bone marrow transplant +/- total body irradiation: a retrospective data linkage study – Katherine Birchenall
Female childhood cancer survivors have increased risk for preterm birth (PTB), with relatively little known about pregnancy outcomes for women treated with bone marrow transplant (BMT) +/- total body irradiation (TBI), and management is likely variable.
The British Society of Blood and Marrow Transplantation and Cellular Therapies (BSBMTCT) Data Registry holds detailed records for those who have received BMT in the UK since 1974. The British Childhood Cancer Survivor Study (BCCSS) and Teenage and Young Adult Cancer Survivor Study (TYACSS) are large population-based cohort studies of five-year survivors of cancers, linked to Hospital Episode Statistics for England (HES).
We are jointly funded by Action Medical Research/Borne to determine pregnancy outcomes for women who conceive following BMT+/-TBI.
Here, we report on our retrospective data linkage study.
Pregnancy outcomes following bone marrow transplant +/- total body irradiation: a prospective observational study via the UK Obstetric Surveillance System (UKOSS) – Katherine Birchenall
Female childhood cancer survivors have increased risk of preterm birth (PTB), with relatively little known about pregnancy outcomes for those treated with bone marrow transplant (BMT)+/-total body irradiation (TBI), and management is likely variable. The UK Obstetric Surveillance System (UKOSS) was developed to investigate uncommon disorders of pregnancy.
We are jointly funded by Action Medical Research/Borne to determine:
1. The current care offered to women who conceive following BMT +/- TBI;
2. The incidence of adverse pregnancy outcomes for these women.
Here, we report on our UKOSS prospective observational study. Pregnant women with a history of BMT +/- TBI were identified through the UKOSS, between 1/1/2020 and 31/12/2022. UKOSS reporters local to nationwide (UK) consultant-led maternity units submitted data via the UKOSS online data collection system. 42 pregnancies were reported, and we have performed an interim analysis on 33:
• The majority (73%) birthed at term.
• 24% had a first trimester miscarriage.
• 6% birthed <37 weeks’ gestation.
• Regarding mode of birth: 40% had an unassisted vaginal birth, 18% an emergency Caesarean section (CS); 12% an assisted vaginal birth; 9% an elective CS; and for 21% birth details are awaited.
We will present the findings from our full dataset at the time of Conference, including analysis regarding type of cancer treatment and pregnancy outcomes, and frequency of antenatal interventions such as cervical cerclage. These findings will enable improved information provision, both at the time of cancer treatment and during preconception counselling, and optimisation of antenatal care for women with history of BMT+/-TBI.
Non-genetic risk factors for preterm birth: an umbrella review of systematic reviews and meta-analyses. Job Klumper
In this umbrella review, we summarized systematic evidence on risk factors for preterm birth. We assessed the presence of statistical biases and identified associations with robust evidence.
UK-wide clinician survey to investigate current care offered to women who conceive having previously received a bone marrow transplant +/- total body irradiation – Katherine Birchenall
Female childhood cancer survivors have increased risk of preterm birth (PTB), with relatively little known about pregnancy outcomes for those treated with bone marrow transplant (BMT) +/- total body irradiation (TBI), and management is likely variable. Preconception counselling and early referral to PTB prevention clinics (PTBPC) may improve outcomes.
We are jointly funded by Action Medical Research/Borne to determine:
1. Current care offered to women who conceive following BMT +/- TBI.
2. Incidence of adverse pregnancy outcomes for these women.
Here we report on our national clinician survey.
Novel technology for the prevention of spontaneous preterm birth – David Shashar
Existing solutions for preventing spontaneous preterm birth (sPTB) are unsatisfactory. Therefore, rates have not changed for decades. We have developed a novel and non-surgical device for the prevention of sPTB called Lioness.
Lioness is an elastic, smartly structured silicone ring, anchored around the uterine cervix at the site of the Shirodkar cerclage. It is designed to reduce the load off the cervix and keep it elongated despite pressure and premature contractions. Lioness is placed in the clinic, through the speculum, with intended application tools in a procedure taking only a few minutes. Placement is between 12 and 18 weeks of gestation, and removal is conducted at term. The Lioness has a self-release safety mechanism allowing it to detach in active labor.
Interventions for women with premature cervical dilatation and exposed fetal membranes to prevent pregnancy loss and preterm birth – a broad systematic review and meta-analysis – N. Pilarski
The management of women with premature cervical dilatation and exposed unruptured fetal membranes (CDEM) remains uncertain and controversial. This systematic review aims to summarise all existing evidence for CDEM treatment options.
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Prediction of chorioamnionitis using Volatile Organic Compounds in exhaled breath. – Sanne Claassen
To predict chorioamnionitis using Volatile Organic Compounds (VOC)
A week in the life of the QUiPP app, a preterm birth prediction tool – Helena Watson
QUiPP is a validated preterm birth (PTB) decision-making aid that utilises individual risk factors , cervical length measurements and/or quantitative fetal fibronectin (fFN). We analysed app usage over seven-days, explored trends in usage and potential future research questions.
The contribution of infections in women with a threatened preterm birth, a review. – Giovanni Bel
Numerous studies have shown an association between infection and an increased risk of preterm birth (PTB). However, the contribution of these specific etiologies to threatened PTB is not known. Our aim was to examine the prevalence of infections in women with a threatened PTB.
What causes the increased preterm birth rate in women treated for Asherman’s Syndrome? Tilan Banning
The incidence of preterm birth in women diagnosed and treated for Asherman’s Syndrome (AS) increased, why is not known. This first-of-its-kind study examines the increased preterm birth rate by analysing the risk factors for preterm birth and the characteristics of AS and its treatment in patients with AS after transcervical adhesiolysis (TCA).
Detection of preterm birth by maternal urinary volatile organic compound analysis: a prospective cohort study – Emma Ronde
Prediction of preterm birth is currently not feasible, resulting in maternal and fetal overexposure to prenatal corticosteroids. Novel biomarkers seem to hold potential for predictive applicability, including non-invasive volatile organic compounds. In this study, we aimed to assess the potential of urinary volatile organic compound (VOC) profiles in the identification of pregnant women at risk for preterm birth.
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95279356_9065726_AbstractVOC1
95279356_9065727_AbstractVOCtable3
Maternal exposure to betamethasone in pregnancy: a population pharmacokinetic study – Emma Ronde
In order to determine the possibilities of individualized ACS the current study was performed. The aim was to develop a population pharmacokinetic model for the corticosteroid betamethasone and to determine individual differences and co-variates that affect the maternal betamethasone exposure after intramuscular administration of the standard treatment.
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95279110_9065634_AbstractPE1
95279110_9065635_AbstractPE2
Preterm Birth and High Intelligence: a Systematic Review and Meta-Analysis – Yaela Schrijver
Preterm born children (PTB) are often studied for their lower cognitive abilities, whereas high performing children are part of the complete spectrum as well. We studied the prevalence of high intelligence amongst preterm children, compared to their term-born (TB) peers.
Additional risk of preterm birth in women of advanced age conceive after IVF/ICSI treatment – results of a Mid-German register analysis – Ekkehard Schleussner
Advanced maternal age (AMA; > 40 years) is an increasing trend and related to preterm birth (PTB) and various pregnancy complications [1]. AMA is also associated with increasing need of artificial reproductive therapy (ART). PTB is more common in pregnancies conceived by ART as compared with those conceived naturally [2]. Up to now, the combination of both risk factors is a less researched and discussed issue. Thus, the aim of this study was to quantify the risk of PTB < 37 weeks in pregnancies subsequently to ART, in women > 40 years or in combination of both, compared to women spontaneously conceived.
PREDICTION OF EARLY-ONSET NEONATAL SEPSIS (EONS) IN PREGNANT WOMEN WITH PRETERM PREMATURE RUPTURE OF MEMBRANES (PPROM) BY VAGINAL MICROBIOME ANALYSIS – THE PEONS TRIAL – Ekkehard Schleussner
The risk for preterm neonates to develop an early-onset neonatal sepsis (EONS) after preterm premature rupture of membranes (PPROM) is not less than 14-22 %. Established diagnostic tools are currently unable to provide a rapid and accurate prediction of EONS after PPROM or poor neonatal outcome related to EONS. Hence, there is an unmet need to identify this high-risk group as early as possible. A shift in maternal vaginal microbiota composition may be potentially predictive in a high-risk subgroup of neonates developing EONS after PPROM. There is an urgent need to evaluate this potential diagnostic tool in daily clinical practice to improve early prediction and diagnosis of EONS.
Transmission of Ureaplasma after PPROM with consecutive EONS and lethal neonatal outcome – a case report – Ekkehard Schleussner
A primiparous pregnant woman was admitted to the university hospital in the 27+0 week of gestation due to preterm premature rupture of membranes (PPROM). Conventional vaginal microbiological culture at admission reported no pathological colonization. Therefore, management decision was based on national guidelines, including antenatal corticoids, tocolytic and calculated antibiotic therapy. The pregnancy could be prolonged to 28+0 week. Unstoppable efforts of preterm labor with suspicious diagnosis of amniotic infection syndrome necessitated delivery by emergency cesarean section. The preterm infant underwent immediate NICU maximal therapy because of an early-onset neonatal sepsis. Despite successful therapy, the infant developed a therapy refractory pulmonary insufficiency with consecutive right heart failure, resulting in death on the 36th day of life.
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History of full-dilated c-section in patients with cervical cerclage. L. Pratcorona
To study in our population of women with cerclage the prevalence of a history of full-dilated c-section according to the indication for cerclage, comparing it with other risk factors for cervical insufficiency.
Onset of fetal brain sparing impact on neonatal outcome in growth restricted infants born before 32 weeks of gestation – an effect which might be ameliorated by the NO-donor PETN – Tanja Groten
Preterm birth and fetal growth restriction are the main determinants of perinatal mortality. In the absence of therapeutic interventions observation of fetal growth and fetoplacental perfusion to determine when to deliver is established. Fetal circulatory redistribution “brain sparing” represent a sign of fetal hypoxia and has been implemented in management algorithms. In the absence of any other option we offered treatment with the NO-donor pentaerithrityltetranitrate (PETN), which has been shown to improve fetoplacental flow, to high-risk patients. The aim of this study was to evaluate the pregnancy related determinants on immediate neonatal outcome in a cohort of growth restricted infants born before completed 32 weeks.
Significant improvement of waiting time in maternity triage through midwife’s vs doctor’s preterm birth risk assessment – Laurence Frei
To improve the waiting time for patients presenting to maternity triage with threatened preterm (< 37 weeks’ gestation) labour (TPTL) and/or suspicion of preterm premature rupture of membranes (PPROM).
Until April 2021, in our Maternity Department, the assessment of women presenting to maternity triage with symptoms of TPTL and/or PPROM was traditionally undertaken by a doctor. They would perform a speculum examination to assess the cervical dilatation and perform a quantitative fetal fibronectin test (qfFN) – to assess the risk of going into preterm labour – and/or an actim prom swab – to assess for PPROM. However, since the doctors covering the maternity triage are also covering delivery suite, patients in triage often had to wait for a long time until a doctor review could take place. These delays are known to create anxiety for pregnant women and impair the capacity of triage midwives to care for other women.
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95268580_9063575_Tables
Cervical Pessary to Prevent Preterm Birth and Poor Neonatal Outcome: An Integrity Meta-Analysis of Randomized Controlled Trials Focusing on Adherence to the European Medical Device Regulation – Ioannis Kyvernitakis
Findings from randomized controlled trials (RCTs) on cervical pessary treatment to prevent spontaneous preterm birth (sPTB) are inconsistent. We hypothesized that adherence to the European Medical Device Regulation (MDR) and instructions for use (IFUs) are prerequisite for a successful therapy and vice versa, their non-adherence contributes to its failure.
SPRUCE: Is the vaginal microbiome and metabolome associated with spontaneous preterm birth (sPTB) in multiple pregnancies? Joanna Gent
Multiple pregnancies account for 20% of all preterm births (PTB) despite representing only 3% of live births. Unlike singleton pregnancies, a global lack of evidence exists for clinically useful screening tools and interventions for PTB in twins.
Whilst the pathophysiology of sPTB remains poorly understood, microbial invasion into the uterine cavity by microorganisms from the lower genital tract occurs in up to 40% of sPTB’s. The vaginal microbial composition is therefore suggested to play a significant role in increasing a woman’s susceptibility to sPTB along with complex host interactions mediated by immune and genetic factors. Unfortunately, this avenue has yet to be explored in multiple pregnancies.
This study will assess the vaginal microbiome in multiple pregnancies compared to low and high-risk singleton pregnancies and evaluate associations between the vaginal microbiome, vaginal metabolome and sPTB.
Tocolysis – A Germany-wide Survey on the current Practice after Dissemination of the German Guideline – Patrick Stelzl
To investigate the adherence of German perinatal care centers (PNCs) to the national guideline we compared data from a nation-wide survey on the practice of initial tocolysis, maintenance tocolysis, tocolysis in preterm premature rupture of membranes (PPROM) and in the perioperative setting of cervical cerclage, and bedrest during and after tocolysis with recommendations from the current German Guideline 015/025 „Prevention and Treatment of Preterm Birth“.
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95253598_9059938_Table_2_Bed_Rest_EPBSC_P-Stelzl
95253598_9059937_Table_1_Maintenance_Tocolysis_P-Stelzl_ESPBC
Is the risk of still and preterm birth affected by the timing of symptomatic SARS-CoV-2 infection during pregnancy? Antonella Iannaccone
A SARS-CoV-2 infection during pregnancy increases the risk for preterm birth (PTB). This study analyzed the association between the timing of symptomatic SARS-CoV-2 infection during pregnancy with PTB and stillbirth risk.
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95252919_9059736_table
Pregnancy and neonatal outcomes in ultrasound-indicated cerclage: a retrospective study María Pastor Lorca
To evaluate maternal and neonatal outcomes of women with ultrasound-indicated cerclage (UiC) compared to history (HiC) and physical examination-indicated cerclage (PhiC).
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95241302_9056715_Tables__1
95241302_9056716_Tables_2
Two different antenatal antibiotic prophylaxis in preterm prelabour rupture of membranes: delivery and maternal outcomes – Ana Contreras
To evaluate maternal and delivery outcomes after optimizing the type and duration of antibiotics based on the results of the amniocentesis performed to determine intra-amniotic infection at admission.
Delayed Interval Delivery of the Second Twin: Neonatal and maternal outcomes. Judit Hidalgo
To evaluate neonatal and maternal outcomes of the remaining fetus after delayed interval delivery (DID) in twin pregnancies
Outpatient management of preterm prelabor rupture of membranes below 34 weeks: maternal and neonatal outcomes – Silvia Ferrero
To evaluate the maternal, fetal and neonatal outcomes of pregnant women complicated with preterm prelabor rupture of membranes (PPROM) eligible for outpatient care.
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95229404_9054076_TABLES_Outpatient_ESPBC_2023_Outpatient
Impact of a new aspiration technique-based device for assessment of cervical stiffness in pregnant women with symptoms of preterm labour: preliminary results of a prospective study. Dario Colacurci
A major challenge in the management of women presenting with symptoms of Preterm Labor (PTL) is to identify true PTL: over 50% of the women with threatened PTL do not deliver prematurely and are unnecessarily hospitalized and treated, with less than 10% of those women give birth within 7 days of presentation.
Cervical stiffness (CS) may play a significant role at maintaining pregnancy. We measure CS with the Pregnolia System, to determine whether it can improve distinguishing between threatened and true PTL.
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Preliminary Results of the CerclAge REgisterstudie Deutschland (CARE Studie): a multicenter, prospektive study for women with emergency or secondary cerclage by cervial insufficiency – Katrina Kraft
Background: Limited preventive and therapeutic interventions are available for women with cervical insufficiency. This epidemiologic registry study for women following secondary or emergency cerclage is intended to assess the indication for cerclage and implementation of the German guideline recommendations (first publication February 2020).
Synbiotics in patients at risk for spontaneous preterm birth: a study protocol for a multi-centre, randomised controlled trial (PRIORI)- Katrien Nulens
Prematurity remains one of the main causes of neonatal morbidity and mortality. Approximately two thirds is secondary to preterm labour, preterm prelabour rupture of membranes (PPROM) or cervical insufficiency. Etiologically, the vaginal microbiome plays an important role in spontaneous preterm birth (sPTB). Vaginal dysbiosis and bacterial vaginosis are well-known risk factors for ascending lower genital tract infections and sPTB, while a Lactobacillus crispatus dominant vaginal microbiome is associated with term deliveries. Synbiotics may help to achieve and/or maintain a normal, Lactobacillus-dominant vaginal microbiome.
Pregnancy outcomes in women attending preterm birth prevention services in the UK: a cohort study – Katherine Mountain
In the United Kingdom 8% of women experience preterm birth (PTB), and it is recommended that women at risk are cared for in specialist services, yet the outcomes of women in these services according to risk factor has not been widely reported. The study objective is to evaluate pregnancy outcomes of women at high risk of PTB being cared for by a specialist PTB prevention service.
Fetal growth impairment in a cohort of pregnancies complicated by spontaneous preterm labor or preterm prelabor rupture of membranes. C Rueda
The aim of this study was to explore differences in fetal growth in a cohort of pregnancies complicated by spontaneous preterm labor (sPTL) or preterm prelabor rupture of membranes (PPROM) as compared to uncomplicated pregnancies.
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95059702_9014015_Table_1
Influence of intra-amniotic infection and inflammation on the fetal corpus callosum in women with preterm labor or preterm prelabor rupture of membranes. C Murillo
To evaluate if fetal corpus callosum changes exist in fetuses of mothers admitted for preterm labor (PTL) or preterm prelabor rupture of membranes (PPROM) and the influence of intra-amniotic infection and/or inflammation (IAI).
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95054753_9012512_TABLE_1_COS_CALLOS
95054753_9012513_Table_2_COS_CALLOS
Prenatal origin of cardiovascular remodeling and dysfunction in preterm labor and premature rupture of membranes: impact of intra-amniotic infection and/or inflammation – C Murillo
To evaluate fetal cardiac morphology and function in fetuses of mothers admitted for preterm labor (PTL) or preterm prelabor rupture of membranes (PPROM) and the association with intra-amniotic infection and/or inflammation (IAI).
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95051546_9011782_TABLE_1_cardio_ESPBC
95051546_9011783_TABLE_2_cardio
Cervicovaginal biomarkers in women treated with vaginal progesterone for short cervix in the mid trimester – Penelope Sheehan
To investigate the effect of vaginal progesterone treatment on cervicovaginal fluid biomarker proteins in women with a short cervix in the midtrimester.
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Role of aquaporin 5 in the regulation of pregnant uterus contraction – Eszter Ducza
The aquaporin (AQP) channels play an important role during pregnancy. Our aims were to (1) examine the role of AQP5 in the length of the gestational period in rats, (2) investigate the effect of a tocolytic agent on the AQP5 level in the late pregnant rat uterus, moreover to (3) determine the AQP5 expressions in human myometrium and plasma.
Trends in preterm birth in HIV-infected women in Switzerland over the last four decades – a multicentric, prospective, cohort study. Marina Lumbreras Areta
HIV infection and its management during pregnancy have been associated with an increased risk of preterm birth (PTB). Since management has drastically changed over time, we aimed to evaluate changes in PTB rates over the past four decades among women living with HIV (WLWH) in Switzerland.
Comparative pharmacokinetic study of levocetirizine in pregnant and non-pregnant rats – Anita Sztojkov-Ivanov
Physiological changes during pregnancy may alter the pharmacokinetics and pharmacodynamics of medications. High doses of some antihistamine drugs before delivery can induce uterine contractions due to oxytocin-like effects which can lead to premature birth. The effects of pregnancy on the pharmacokinetics of antihistamines are poorly understood. The aim of the study is to examine the gestation induced alteration in pharmacokinetic parameters and the fetal disposition of an antihistamine drug levocetirizine.
How can we improve implementation of the Preterm Birth Surveillance Pathway in England? Naomi Carlisle
In 2019 Saving Babies Lives Care Bundle Version 2 stated all women in England at risk of preterm birth should have care within a preterm birth surveillance clinic. This is the first-time national guidance has formally mentioned preterm clinics.
This study wanted to understand how the preterm birth pathway is successfully (and unsuccessfully) implemented across England.
TRANSFER: ThReatened preterm birth, Assessment for in utero transfer; 22+0-23+6 weeks’ gestation – Melanie Griffin
Between 22+0-23+6 weeks’ gestation:
1. Identify women presenting with threatened preterm birth.
2. Determine number of women presenting outside an obstetric unit with Level 3 NICU.
3. Determine number of women requiring in-utero transfer.
4. Determine number of women who deliver in a unit without Level 3 NICU.
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94790044_8950673_TRANSFER_additional_data_analysis
94790044_8950672_TRANSFER_results_flow_diagram
Methodological challenges in the development and validation of a prognostic prediction model for time-to-birth in patients admitted for threatened preterm birth at a tertiary care centre Isabelle Dehaene
The goal of this study was to illustrate the development and validation of a preterm birth prognostic prediction model for symptomatic patients admitted at a gestational age between 24 and 34 weeks’ gestation at a tertiary care centre. We aimed to highlight the importance of adequately handling loss-to-follow up and not restricting analyses to complete cases or cases selected on outcome.
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94768369_8946893_Abstract_ESPBC_2023_Prediction_model
Neonatal magnesium levels are safe after maternal MgSO4 administration: a comparison between unexposed preterm neonates and neonates exposed for fetal neuroprotection or maternal eclampsia prevention – Isabelle Dehaene
To objective was to compare neonatal magnesemia in the first 15 days of neonatal life between three groups: a control group not exposed to MgSO4, a neuroprotection group, and an eclampsia prevention group, and to explore its associations with child outcomes.
Overly optimistic prediction results on imbalanced data – Isabelle Dehaene
Information extracted from electrohysterogram (EHG) recordings could potentially prove to be an interesting addition to estimate the risk of preterm birth. Recently, a large number of studies have reported near-perfect results to distinguish between term and preterm EHG recordings using a public resource, called the Term/Preterm Electrohysterogram database (TPEHGDB). The objective of this work is to bring to light a methodological flaw resulting in overly optimistic results: applying over-sampling before partitioning the data into a mutually exclusive training and testing set.
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94768148_8946863_Oversampling
The Implementation of a Clinical Phenotyping Tool for Spontaneous Preterm Birth and PPROM in a Prospective Cohort Study – Angharad Care
The role of transabdominal cerclage for the prevention of recurrent spontaneous preterm birth following full dilatation caesarean section – Hannah Rosen O’Sullivan
Physical activity during hospitalization on the antepartum service and delivery gestational age – Tracy Manuck
Time Interval between Administration of Antenatal Corticosteroids and Delivery – A Shot in the Dark? Maggy O’Brien
History of full-dilated c-section in patients with cervical cerclage. L. Pratcorona
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