| 000 | 04112cam a2200217 4500 | ||
|---|---|---|---|
| 001 | NMDX6610 | ||
| 008 | 120401t2008 xxu||||| |||| 00| 0 eng d | ||
| 022 | _a09320067 | ||
| 100 | _aSteel, A. | ||
| 240 | _aArchives of Gynecology and Obstetrics | ||
| 245 | _aIs there still a role for emergency cerclage in the developed world? An experience from a London district hospital | ||
| 260 | _c2008 | ||
| 500 | _aNMUH Staff Publications | ||
| 500 | _a277 | ||
| 520 | _a<p style="margin: 0px 0px 0.5em; line-height: 17.999801635742188px;"><span style="font-size: 8pt;"><strong>INTRODUCTION</strong>: Cervical incompetence appears to have a greater prevalence in the developing&nbsp;<span class="highlight">world</span>, which possibly extends to multi-ethnic communities in the UK.&nbsp;<span class="highlight">Emergency</span>&nbsp;<span class="highlight">cerclage</span>&nbsp;has been found to have a relative degree of success in patients detected on ultrasound or presenting clinically. Our study aimed to look at the&nbsp;<span class="highlight">emergency</span>&nbsp;<span class="highlight">cerclage</span>&nbsp;outcome in the multi-ethnic population of our&nbsp;<span class="highlight">district</span>&nbsp;<span class="highlight">hospital</span>.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">METHODS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">Sixty-two cases of cervical&nbsp;<span class="highlight">cerclage</span>&nbsp;were reviewed retrospectively from 2000 to 2006 with 16 cases being emergencies. Maternal history, presentation, operation details and outcome were recorded.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">RESULTS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">Of the 16&nbsp;<span class="highlight">emergency</span>&nbsp;cases, 8 were successful (delivery over 24 weeks gestation), 7 failed and 1 had not yet delivered. The failure rate was found to be significantly higher in the black African women (P = 0.04). Diagnosis by ultrasound as opposed to clinical presentation was associated with a better outcome (P = 0.03). The most significant determinant of outcome was the presence of coliforms on presentation, all of which failed (P = 0.007).</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">CONCLUSION:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">In this small sample of patients requiring&nbsp;<span class="highlight">emergency</span>&nbsp;<span class="highlight">cerclage</span>, findings are suggestive of a poor outcome in black African women, which may be related to previous obstetric history. Similarly the presence of infection especially coliforms is also associated with poor prognosis, while ultrasound diagnosis of dilating cervix rather than clinical diagnosis had a better outcome. Early screening for infection, use of prophylactic antibiotics and sonographic monitoring are likely to improve the success rate of&nbsp;<span class="highlight">emergency</span>&nbsp;cervical&nbsp;<span class="highlight">cerclage</span>.</span></p> | ||
| 700 | _aYoong, W. | ||
| 700 | _aOkolo, S. | ||
| 700 | _aFakokunde, A. | ||
| 856 | _uwww.ncbi.nlm.nih.gov/pubmed/17653737 | ||
| 856 | _uhttp://link.springer.com/article/10.1007%2Fs00404-007-0422-5 | ||
| 999 |
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