Emergency versus Elective Cervical Cerclage: An Audit of Our First Two Years of Service.

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  • Additional Information
    • Source:
      Publisher: Hindawi Pub. Co Country of Publication: United States NLM ID: 101600173 Publication Model: eCollection Cited Medium: Internet ISSN: 2314-6141 (Electronic) NLM ISO Abbreviation: Biomed Res Int Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York, NY : Hindawi Pub. Co.
    • Subject Terms:
      Cerclage, Cervical* ; Elective Surgical Procedures* ; Emergency Medical Services* ; Medical Audit* ; Pregnancy Outcome*; Premature Birth/*prevention & control; Adult ; Female ; Guideline Adherence ; Humans ; Pregnancy
    • 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.
    • References:
      Clin Obstet Gynecol. 2016 Jun;59(2):237-40. (PMID: 27015229)
      J Matern Fetal Neonatal Med. 2009 Mar;22(3):269-73. (PMID: 19330713)
      Clin Obstet Gynecol. 2014 Sep;57(3):557-67. (PMID: 24979354)
      Am J Obstet Gynecol. 2017 May;216(5):434-442. (PMID: 27890647)
      J Obstet Gynaecol Can. 2017 Dec;39(12):1192-1202. (PMID: 29197486)
      Ultrasound Obstet Gynecol. 2016 Sep;48(3):308-17. (PMID: 27444208)
      J Matern Fetal Neonatal Med. 2018 Jan;31(2):135-140. (PMID: 28064548)
      J Obstet Gynaecol Can. 2013 Dec;35(12):1115-1127. (PMID: 24405880)
      Am J Obstet Gynecol. 2018 Feb;218(2):161-180. (PMID: 29157866)
      N Engl J Med. 1996 Feb 29;334(9):567-72. (PMID: 8569824)
      Cochrane Database Syst Rev. 2017 Jun 06;6:CD008991. (PMID: 28586127)
      Australas J Ultrasound Med. 2015 Feb;18(1):19-26. (PMID: 28191237)
      Obstet Gynecol Int. 2013;2013:528158. (PMID: 23606847)
    • Publication Date:
      Date Created: 20181027 Date Completed: 20190130 Latest Revision: 20190130
    • Publication Date:
      20240829
    • Accession Number:
      PMC6186325
    • Accession Number:
      10.1155/2018/2065232
    • Accession Number:
      30363980