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What are the main claims of the paper and how important are they?
Author claimed and reported about importance of measuring cervical length for predecting preterm birth.
yes measurement of cervical lenght is one of important paramaters that reflects preterm birth.
Authors also studied correlation between cervical macrophases and pre term birth but could not find significant correlation.
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Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.
No, not novel.
1.Sotiriadis, A.et al. (2010): Transvaginal cervical length measurement for prediction of preterm birth in women with threatened preterm labor: a meta-analysis. Ultrasound Obstet Gynecol. 35(1):54-64
2.Grimes-Dennis, J. and Berghella, V. (2007): Cervical length and prediction of preterm delivery. Curr Opin Obstet Gynecol. 19(2):191-5
3.Crane, J.M. and Hutchens, D. (2008): Transvaginal sonographic measurement of cervical length to predict preterm birth in asymptomatic women at increased risk: a systematic review. Ultrasound Obstet Gynecol. 31(5):579-87
4.Iams, J.D. et al.(1996): The Length of the Cervix and the Risk of Spontaneous Premature Delivery. N Engl J Med ; 334:567-573
5.Berghella, V. et al. (2003) : Does transvaginal sonographic measurement of cervical length before 14 weeks predict preterm delivery in high-risk pregnancies? Ultrasound Obstet Gynecol, 21:140-144
6.Heath V.C.F.et al. (1998): Cervical length at 23 weeks of gestation: prediction of spontaneous preterm delivery. Ultrasound Obstet Gynecol, 12:312-317
7.Gonzalez, J.M.et al (2011): Complement activation triggers metalloproteinases release inducing cervical remodeling and preterm birth in mice. Am J Pathol., 179(2):838-49
8.An Online Chapter at https://iame.com/online/cervical_length/content.php
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Are the claims properly placed in the context of the previous literature?
Yes
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Do the results support the claims? If not, what other evidence is required?
Yes
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If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?
NA
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Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?
Methodology must have been described under the heading (i) experimental design (ii) Variables/Parameters studied (Cervicle Length, Vascular index, vascular flow index, macrophase count etc.) (iii) Statistical methods and tests of significance applied for studying if the differences in values of parameters studied are significant or non-significant
Original observed datas with their Mean+ S.E.values of variables/parameters studied must have been presented as annexure.
In addition it's ingenuine and unfair to compell the reader for reading previously published articles for knowing methodology and experimental design of recent article.
In my opinion Author should revise his article in this context for refining and making this publication a complete article.
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Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?
In my opinion Total Leucocyte counts among Preterm birth patients and control group must have been studied and compared for arriving at a definite conclusion about importance of cervical immunity for predicting preterm birth
Review of available literature on this topic reveals that cervical length is one among important parameters for predicting preterm birth. Available literature and previously published articles atates that :-
Most patients who deliver preterm will have a cervical length < 25 mm between 16 and 22 weeks' gestation (Berghella V et al., 2003).
A cervical length < 25 mm rarely occurs before 14 weeks' gestation . Since the lower uterine segment may not have developed, a short cervix is difficult to identify at < 14 weeks' gestation. There is a gradually progressive shortening of cervical length after 30 weeks' gestation (Heath et al., 1998).
For patients at highest risk for preterm delivery (prior 24 week delivery, 2nd trimester losses), an initial examination at 15 to 16 weeks should be considered. For patients at a lower risk (cone biopsy, uterine malformations), a first exam could be obtained during the 18 to 20 weeks anatomy scan.
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Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?
No
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Other Comments:
It's suggested to revise the paper wherein methodology must have been written in this article rathern than refering to read previously published articles of author for knowing the methodology.
Data obtained must have been presented in an annexure
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Competing interests:
None
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Invited by the author to review this article? :
No -
Have you previously published on this or a similar topic?:
No
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References:
None -
Experience and credentials in the specific area of science:
Obst. and Gynae. is my subject of specialization, I keep my knowledge about advances in obstetrics and Gynecology.
- How to cite: Sharma S .Review on Article Cervical Immunobiology in Women at Risk of Preterm Labour [Review of the article 'Cervical Immunobiology in Women at Risk of Preterm Labour ' by Othman M].WebmedCentral 2013;4(5):WMCRW002733
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What are the main claims of the paper and how important are they?
This is a combination of the authors two previous articles on 3D for cervical anatomy and cervical immunology where based on their previous analysis of 106 preterm labour women and finding that women who had a low macrophage count
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Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.
No-recently even concept of leukocytes challenged and role of complement highlihted 1)Chandiramani M,Seed PT,Orsi NM,Ekbote UV,Bennett PR,ShennanAH,Tribe RM.Limited relationship between cervico=vaginalfluid cytokine profiles and cervical shortening in women at high risk of spontaneous preterm birth.PLoS One 2012;7(12)e52412.
2)Romero R,Yeo L,Miranda J,Hadssan SS,Conde AgudeloA,Chaiworaponqsa T.A blueprint for the prevention of preterm birth:vaginal progesteronein women with short cervix.J Perinat Med 2013;41:27-44.
3)Parry S,Simhan H,Elovitz M,Iams J.Universal maternal cervical length screening during the second trimester :pros and cons of a strategy to identify women at risk of spontaneous labour.Am J Obstet Gynecol 2012;207:101-106.
4)DeFranco EA,Lewis DF, Odibo AOImproving the screening accutacy for preterm labor:is the combination of fetal fibronectin and cervical length in symptomatic patients a useful predictor of preterm birth?Asystematic review.Am J Obstet Gynecol 2013;208:233:e1-6.
5)Gorowiec MR,Catalano RD,Norman JE,Denison FC,Jabbour HN.Prokineticin1 induces inflammatory response in human myometrium:a potential role in initiating term and preterm parturition.Am J Path 2011 ;179:2709-2719.
6)Catalano RD,Lammagan TR,Gorowiec M,Denison FC,Norman E,Jabbour HN.Prokineticins:novel mediators of inflammatoryans contractile pathways at parturition.Mol Hum Reprod 2010;16:311-319.
7)Woidacki KJensen F,Zenclussen AC.Mast cells as novel mediators of reproductive processes.Front Immunol 2013;4:29-39.
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Are the claims properly placed in the context of the previous literature?
Yes and need is to conduct future studies although numbers are very small in contrast to the 106 cases in their previous study for drawing some meaningful conclusions in that study but this is much better than just presenting the study of anatomical data or cervical leukocyte data individually and it makes it more meaningful and the study having been conducted very early in pregnancy may be responsible for the low macrophage detection at later part of second trimester to give any meaning to study.
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Do the results support the claims? If not, what other evidence is required?
The author has already combined the data of the 3D study and the power doppler and FACS and flow cytometry for cervical leukocytes which they have used for the first time to dwtermine cervical leukocutes rather than the manuam method and to make this more meaningful the study should be reptoduced in a later part of 2nd tromester and have a higher number of cases of preterm labour to put any meaning to their worksince no statistical association was founmd either with the number of macrophages being lower in preterm group or the PD findings although cevical length was small but no corelation with cervical volume found.
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If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?
NA
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Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?
No, it doesnt offer any therapeoutic benefits or any new results of significance
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Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?
Recently lot of advances have come regarding role of prokineticin signalling as the mediator of lopopolysaccharide/infection signalling from an ascending infection and how TLR4 receptors may be playing a part in uterus and how intervention in this signalling may help in preventing the NFKB signalling and activation of COX enzyme induction pathway and secondly recently woidavckis group have rekindled interest in role of mast cells as possibly having a role in preterm labour and Girardi's group has shown that it is the complement activation which is essential in preterm labour perse and not mere leukocytes as compared to term pregnancy -with different pathways hence the aurhor should also consider incorporating progestrone in his study considering the good work he has been doing and the availible technologies and get a meaningful outcome from a greater number of patients
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Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?
NA
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Other Comments:
NA
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Competing interests:
None
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Invited by the author to review this article? :
No -
Have you previously published on this or a similar topic?:
No
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References:
None -
Experience and credentials in the specific area of science:
I have been practicing obstetrics since 1984 although now i practice only high risk obstetrics of my infertility patients who conceived at my centre only although i have kept, myself updated with advances in world literature.
- How to cite: Kaur K K.Review on Cervical Immunobiology in Women at Risk of Preterm Labour[Review of the article 'Cervical Immunobiology in Women at Risk of Preterm Labour ' by Othman M].WebmedCentral 2013;4(4):WMCRW002703
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Author claims that ascending infection is a leading cause of Preterm labour via finding the subtype of leucocyte and it is very important ... also author claim that the cervical length and volume are important predictors of preterm labour though the cervical volume was not a good predictor
No
1. Grimes-Dennis, J. and Berghella, V. (2007): Cervical length and prediction of preterm delivery. Curr Opin Obstet Gynecol. 19(2):191-5
2. many chapters in text books of obstetrics
Yes
Yes to some extent
No. not a double blinded RCT
Though the methodology is good but it is NOT the standard method of conducting a study NOR publishing in a standard protocol
Sytematic study supporting the sono study with MRI may be thought of
No. Needs systematic protocol and double blinded RCT
Good initiative and worth appreciating the study
None
No
No
None
A study of vaginal prochieve(progesterone) for prevention of preterm labour in short cervix was carried out in my department ... everyday witnessing diagnosing and managing the cases of preterm labour in our high risk and critical care obstetrical unit