| Emergency cervical cerclage: predictors of success. | |
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MedLine Citation:
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PMID: 19883267 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To document predictors of success of emergency cervical cerclage. METHODS: This is a retrospective cohort study of 8 years at a university hospital. Emergency cerclage was defined as when the membranes were at or beyond the external os and was only performed where evidence of infection or labour were absent. Outcomes used were interval between cerclage and delivery, gestation at delivery; a 'good outcome' was defined as delivery after 32 weeks and healthy at discharge. Predictive factors for a successful pregnancy outcome were analysed using odds ratios (OR) with 95% confidence intervals. RESULTS: Forty-five emergency cerclages were performed, including 11 twin pregnancies. Twenty-one (47%) had a 'good outcome', including two twin pregnancies; 20 (44%) pregnancies reached 36 weeks. In 79.2% of 'poor outcomes' chorioamnionitis was found. Prolapsed membranes, advanced cervical dilatation, maternal symptoms and equivocal markers of infection were associated with a poor outcome, but not consistently enough to dictate management. CONCLUSIONS: Given the poor natural history of an open external os, emergency cerclage appears beneficial. That this might apply to twin pregnancies has implications for their management. Although success is indeed partly predictable, it can still be achieved even when there is advanced dilatation, prolapse, bleeding or discomfort. |
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Authors:
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Manish Gupta; Kate Emary; Lawrence Impey |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians Volume: 23 ISSN: 1476-4954 ISO Abbreviation: J. Matern. Fetal. Neonatal. Med. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-14 Completed Date: 2010-09-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101136916 Medline TA: J Matern Fetal Neonatal Med Country: England |
Other Details:
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Languages: eng Pagination: 670-4 Citation Subset: IM |
Affiliation:
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Oxford Fetal Medicine Unit, The John Radcliffe Hospital, Oxford, UK. dr_m_gupta@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abortion, Spontaneous
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diagnosis,
prevention & control*,
therapy Adult Birth Weight Cerclage, Cervical / methods* Cohort Studies Emergency Medical Services* / methods Female Gestational Age Humans Infant, Newborn Pregnancy Pregnancy Outcome Pregnancy, Multiple / physiology Prognosis Retrospective Studies Term Birth / physiology Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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