Prophylactic Cervical Cerclage in Cases Following Cervical Conization at a Japanese Perinatal Center.

The objective of this study was to re-examine the effect of cerclage on the possible factors associated with preterm delivery in women who had cervical conization. This was a retrospective cohort study comparing the obstetric outcomes of women with or without prophylactic cervical cerclage in pregnancy following a prior conization and managed at our institute between 2004 and 2023. In this study, there were 75% of pregnant women with a history of cervical conization. In 13 women of these (17%), prophylactic cervical cerclage was performed at 12-17 weeks' gestation. The incidence of preterm delivery was 15 (9/62) and 31% (4/13, p = 0.38) in cases with and without cervical cerclage, respectively. The prevalence of histological chorioamnionitis (CAM) in cases of preterm delivery following cervical cerclage was 100%. Prophylactic cervical cerclage in the cases following conization did not contribute to the prevention of preterm delivery associated with the development of CAM.

Prevalence of rubella antibodies: comparison between women with pregnancy induced by infertility treatments and those with spontaneous pregnancy.

Widespread rubella epidemics have sometimes occurred in Japan. We compared the prevalence of rubella antibodies in women who had conceived after infertility treatments and in those who had conceived spontaneously. We reviewed the obstetric records of nulliparous Japanese women who had conceived after infertility treatments and whose babies had been born at the Japanese Red Cross Katsushika Maternity Hospital from 2014 to 2018. No significant differences in the rates of women with rubella antibody titers < 8 or < 32 emerged between those who had been treated and those who had not (titer < 8: 4.1 vs. 3.4%, p = 0.58; titer < 32: 17.3 vs. 15.3%, p = 0.45, respectively). It is necessary to thoroughly implement pre-conception care concerning the risk of congenital rubella infection for women undergoing infertility treatments, especially in Japanese obstetric clinics.

Outcomes of 'one-day trial of vaginal delivery of twins' at 36-37 weeks' gestation in Japan.

OBJECTIVE: The lack of obstetricians in Japan has prevented the implementation of a 24-hour delivery monitoring system for high-risk deliveries such as twin vaginal delivery at many obstetric facilities. To examine the outcomes of a 1-day trial of the vaginal delivery of twins at 36-37 weeks' gestation. METHODS: We induced the vaginal delivery of twins at 36-37 weeks' gestation of 256 women who provided consent between January 2007 and December 2016 using the following protocol: 1) administration of 0.5 mg oral prostaglandin E2 every 1 hour (maximum: 1.5 mg) in the morning; 2) intravenous administration of oxytocin and amniotomy in the afternoon; and 3) selection of caesarean delivery when vaginal delivery was not expected by evening. We examined their perinatal outcomes in a chart review. RESULTS: The completion rates of vaginal delivery in total, nulliparous, and multiparous women were 79%, 72%, and 84%, respectively. There were no cases of neonatal asphyxia. The total incidence of neonatal respiratory disorders was 2.1%, but there were no cases of persistent pulmonary hypertension. The total incidence of postpartum hemorrhage requiring transfusion was 2.7%. CONCLUSION: The 1-day planned vaginal delivery of twins at 36-37 weeks' gestation appears valid and safe, and our findings suggest that it can be an option for the delivery of twins.

Cardiotocography findings of early-stage chronic fetomaternal hemorrhage after the presentation of reduced fetal movement.

In the current case of fetomaternal hemorrhage with reduced fetal movements, the findings of cardiotocography (CTG) seemed to be indicating reassuring fetal status; however, a late deceleration and sinusoidal heart rate (SHR)-like findings were observed following a weak uterine contraction. Altogether, this case indicates that the presence of reduced fetal movements may precede the appearance of SHR patterns on CTG in cases of chronic fetomaternal hemorrhage.