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Emergency versus Elective Cervical Cerclage: An Audit of Our First Two Years of Service
- Source :
- BioMed Research International, BioMed Research International, Vol 2018 (2018)
- Publication Year :
- 2018
- Publisher :
- Hindawi Limited, 2018.
-
Abstract
- One of the biggest obstetric challenges is the diagnosis and management of a short cervix as cervical length has an inverse relationship with risk of preterm birth. A cervical cerclage is a surgical procedure to reduce the risk of preterm birth and can be placed in an elective or emergency setting. This is a retrospective review of cervical cerclages inserted at an outer metropolitan hospital from February 2014 to May 2017. Since the introduction of the service, a total of 43 patients were identified as requiring a cervical cerclage. Four of these patients were transferred to tertiary hospitals. Of the 39 cerclages inserted, 26 were elective and 13 were emergency, placed at a mean gestation of 15.6 and 19.6 weeks. In total, there were 35 live births, 2 stillbirths, and 2 neonatal deaths. The maternal demographics (age, gravidity, parity, and preterm risk factors) were not statistically significant between the two groups. The mean pregnancy prolongation and birthweight was greater in the elective than the emergency group (21.4 versus 14.1 weeks; 3148.2 versus 2447.2 grams). There was no obvious pattern with which patients received antibiotics pre-, intra-, or postoperatively or received a vaginal swab. This audit identified the need for improvements to guidelines to standardise the use of antibiotics and progesterone in women with a cervical cerclage.
- Subjects :
- Adult
Emergency Medical Services
medicine.medical_specialty
Article Subject
medicine.medical_treatment
lcsh:Medicine
Audit
General Biochemistry, Genetics and Molecular Biology
03 medical and health sciences
0302 clinical medicine
Pregnancy
medicine
Emergency medical services
Humans
Cervical cerclage
030212 general & internal medicine
Cerclage, Cervical
Medical Audit
030219 obstetrics & reproductive medicine
General Immunology and Microbiology
business.industry
Obstetrics
lcsh:R
Pregnancy Outcome
General Medicine
medicine.disease
Clinical trial
Short cervix
Elective Surgical Procedures
Premature Birth
Gestation
Female
Guideline Adherence
Elective Surgical Procedure
business
Research Article
Subjects
Details
- ISSN :
- 23146141 and 23146133
- Volume :
- 2018
- Database :
- OpenAIRE
- Journal :
- BioMed Research International
- Accession number :
- edsair.doi.dedup.....b044b86565ab536918a4f902c2cc201d