BACKGROUND Several observational studies have claimed high success rates for cerclage in women with cervical insufficiency. A recent Cochrane review found no conclusive evidence of benefit, although significant heterogeneity was present for some of the important clinical outcomes. OBJECTIVES We undertook an individual patient data (IPD) meta-analysis to examine effect of cerclage on neonatal ...

OBJECTIVE To investigate the therapeutic effect and safety of cerclage placed in pregnancy via laparoscopy (CPL) in the first trimesteror in non-pregnant phase (CNL). METHODS A total of 134 cervical insufficiency patients who were treated with cervical cerclage were included. All the patients were divided into 3 groups. CPL group: 43 cases were treated with cerclage placed in pregnancy via la...

Introduction: Transabdominal cerclage (TAC) is a procedure for cervical insufficiency in women in whom transvaginal cerclage cannot be performed. In recent years, laparoscopic transabdominal cerclage has gained favor by eliminating the need for laparotomy and reducing surgical morbidity. Case Description: We present a case of laparoscopic removal of a TAC in a 27-year-old woman with uterus dide...

Background: The traditional surgical treatment for cervical insufficiency is vaginal placement of a cervical cerclage. However, in a small number of cases a vaginal approach is not possible. A transabdominal approach can become an option for these patients. Laparoscopic cervical cerclage is associated with good pregnancy outcomes but comes at the cost of a higher risk of serious surgical compli...

OBJECTIVE The objective of this study was to describe pregnancy outcomes, including cervical insufficiency and preterm birth, in the subsequent pregnancy following an intrapartum cervical laceration. STUDY DESIGN Retrospective cohort of women with their first two consecutive singleton pregnancies carried to ≥ 20(0/7) weeks' gestation within a tertiary health care system from 2002 to 2012. Cer...

The doctrine of informed consent requires that a patient understand the medical procedure being proposed, that consent be voluntary, and that the patient be competent to give consent. Because of declining cognitive functioning, elderly patients are at significant risk of becoming incompetent and, therefore, unable in the eyes of the law to give informed consent. Advance directives allow compete...

Background: Objective of current study was to evaluate cervical length by transabdominal and transvaginal ultrasonography at 14-24 weeks of gestation in asymptomatic women for predicting women at risk of preterm delivery and to find out the one method which is more accurate of the two. Methods: Fifty one women were enrolled in this prospective study. Women with cervical incompetence, multiple g...

BACKGROUND The evidence on the effect of sleep deprivation on the cognitive and motor skills of physicians in training is sparse and conflicting, and the evidence is nonexistent on surgeons in practice. Work-hour limitations based on these data have contributed to challenges in the quality of surgical education under the apprentice model, and as a result there is an increasing focus on competen...