title: [Threatened late miscarriage. French guidelines].
abstract: OBJECTIVE
  To define guidelines for the management of women diagnosed with threatened late miscarriage (TLM).
  
  
  METHODS
  A systematic review of the literature was performed using Pubmed and the Cochrane library databases and the guidelines from main international societies.
  
  
  RESULTS
  Management of women diagnosed with threatened LM requires a complete history-taking searching for a previous history of LM and/or of premature delivery (Grade B). Speculum examination is required to diagnose membrane prolapse (Grade B) and vaginal ultrasound scan is recommended to measure the cervical length (Grade B). Finally, initial management should allow to rule out chorioamniotitis (Grade B). Vaginal progesterone therapy (90-200mg daily) is recommended for women diagnosed with a sole shortened cervix (<25mm) in mid-pregnancy (Grade A). Cerclage is only recommended in women with both history of previous premature delivery and/or previous LM and shortened cervical length diagnosed before 24 weeks of gestation (Grade A). Finally, cervical cerclage (Mc Donald technique) associated with systematic tocolytic therapy (indometacine) and antibiotics are to be recommended in women diagnosed with TLM with dilated cervical os eventually associated with membrane prolapse (GradeC).
authors.affiliation: Service de gynécologie-obstétrique, Aix-Marseille université (AMU), hôpital Nord, assistance publique des hôpitaux de Marseille (APHM), chemin des Bourrely, 13915 Marseille cedex 20, France; Centre de cancérologie de Marseille, Inserm, U1068, Aix-Marseille université (AMU), UM 105, CNRS, UMR7258, 13000 Marseille, France. Electronic address: xcarco@free.fr.
authors.forename: X
authors.initials: X
authors.lastname: Carcopino
authors.affiliation: Service de gynécologie-obstétrique, Aix-Marseille université (AMU), hôpital Nord, assistance publique des hôpitaux de Marseille (APHM), chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: K
authors.initials: K
authors.lastname: Barde
authors.affiliation: Service de gynécologie-obstétrique, Aix-Marseille université (AMU), hôpital Nord, assistance publique des hôpitaux de Marseille (APHM), chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: M
authors.initials: M
authors.lastname: Petrovic
authors.affiliation: Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen cedex 9, France.
authors.forename: G
authors.initials: G
authors.lastname: Beucher
authors.affiliation: Service de gynécologie-obstétrique, hôpital Bicêtre, GHU Sud, AP-HP, 78, rue du Général-Leclerc, 94276 Le Kremlin-Bicêtre, France; Faculté de médecine, université Paris Sud, 94276 Le Kremlin-Bicêtre, France.
authors.forename: P
authors.initials: P
authors.lastname: Capmas
authors.affiliation: Service de gynécologie-obstétrique, CHI Poissy, Saint-Germain-en-Laye, 10, rue du Champ-Gaillard, 78300 Poissy, France; EA 7285 risques cliniques et sécurité en santé des femmes, université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France.
authors.forename: C
authors.initials: C
authors.lastname: Huchon
authors.affiliation: Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
authors.forename: X
authors.initials: X
authors.lastname: Deffieux
authors.affiliation: Service de gynécologie-obstétrique, Aix-Marseille université (AMU), hôpital Nord, assistance publique des hôpitaux de Marseille (APHM), chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: C
authors.initials: C
authors.lastname: d'Ercole
authors.affiliation: Service de gynécologie-obstétrique, Aix-Marseille université (AMU), hôpital Nord, assistance publique des hôpitaux de Marseille (APHM), chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: F
authors.initials: F
authors.lastname: Bretelle
mesh_terms: D000022:Abortion, Spontaneous / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D005602:France; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second
keywords: Antibiothérapie; Antibiotics; Bacterial vaginosis; Cerclage; Cervical length; Fausse couche tardive; Late miscarriage; Longueur cervicale; Membrane prolapse; Progesterone therapy; Progestérone; Protrusion des membranes; Vaginose bactérienne