The Experts below are selected from a list of 3312 Experts worldwide ranked by ideXlab platform
Qiaoyun Zhou - One of the best experts on this subject based on the ideXlab platform.
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Cervical Cerclage in twin pregnancy
Best Practice & Research in Clinical Obstetrics & Gynaecology, 2019Co-Authors: Xiaowu Huang, Sotirios H Saravelos, Tinchiu Li, Rui Huang, Ruonan Xu, Qiaoyun ZhouAbstract:Abstract Cervical Cerclage in women with twin pregnancy is not routinely indicated but appears to be beneficial in subjects with a history of preterm birth or very short cervix or dilated cervix. There is a paucity of literature data regarding transabdominal or laparoscopic Cervical Cerclage (LCC) in twin pregnancy. It is uncertain whether LCC is more effective than transvaginal Cerclage. Our own experience of 24 cases of LCC in twin pregnancy showed encouraging results. Further, well-planned studies are required to answer whether, when, and how Cervical Cerclage should be performed in women with twin pregnancy.
Xiaowu Huang - One of the best experts on this subject based on the ideXlab platform.
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Cervical Cerclage in twin pregnancy
Best Practice & Research in Clinical Obstetrics & Gynaecology, 2019Co-Authors: Xiaowu Huang, Sotirios H Saravelos, Tinchiu Li, Rui Huang, Ruonan Xu, Qiaoyun ZhouAbstract:Abstract Cervical Cerclage in women with twin pregnancy is not routinely indicated but appears to be beneficial in subjects with a history of preterm birth or very short cervix or dilated cervix. There is a paucity of literature data regarding transabdominal or laparoscopic Cervical Cerclage (LCC) in twin pregnancy. It is uncertain whether LCC is more effective than transvaginal Cerclage. Our own experience of 24 cases of LCC in twin pregnancy showed encouraging results. Further, well-planned studies are required to answer whether, when, and how Cervical Cerclage should be performed in women with twin pregnancy.
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simplified laparoscopic Cervical Cerclage after failure of vaginal suture technique and results of a consecutive series of 100 cases
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2016Co-Authors: Xiaowu Huang, Tinchiu Li, Dongmei Song, Yuting ZhaoAbstract:Abstract Objective To evaluate the efficacy of simplified laparoscopic Cervical Cerclage (SLCC) in the prevention of miscarriage and preterm delivery in women with Cervical incompetence who failed to have a live birth following a vaginal Cervical Cerclage in a previous pregnancy. Study design From Dec 2010 to January 2015, a consecutive cases of 100 subjects with Cervical incompetence but who failed to have a live birth following a vaginal Cervical Cerclage in a previous pregnancy underwent SLCC. Surgical outcome parameters (estimated total blood loss, operation time, complications) were recorded, the outcome of any subsequent pregnancy was evaluated. Results Among the 100 cases of SLCC, the mean ± SD (range) surgical time was 26 ± 4.7 (20–40) min. After the operation, 82 women conceived, 3 of them conceived twice. There were altogether 85 pregnancies, including 12 early miscarriages and one case of ectopic pregnancy. Among the 55 pregnancies which progressed beyond the first trimester and in whom the final outcome was confirmed, the live birth rate was 53/55 (96.4%). The mean gestational age at delivery of this group of women was 37.5 ± 1.8 weeks. Conclusions The simplified laparoscopic Cervical Cerclage is a simple, safe, and effective procedure for the treatment of Cervical incompetence which had previously failed to benefit from vaginal Cervical Cerclage.
Andrew Shennan - One of the best experts on this subject based on the ideXlab platform.
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Cervical Cerclage: an established intervention with neglected potential?
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2014Co-Authors: Lisa Story, Andrew ShennanAbstract:Abstract Cervical Cerclage is a common obstetric procedure, performed in an attempt to reduce the likelihood of late miscarriage and preterm delivery. Many questions still remain unanswered, however, regarding its efficacy and the populations most likely to benefit. Existing studies often use endpoints such as preterm delivery, but associations between preterm birth and more long-term health effects such as neurodevelopmental sequelae are well reported. Such endpoints have often not been addressed in many of the studies to date. This article reviews and appraises the literature and evidence regarding Cervical Cerclage as well as addressing the questions that, as yet, remain unanswered.
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Cervical Cerclage a review of current evidence
Australian & New Zealand Journal of Obstetrics & Gynaecology, 2012Co-Authors: D Abbott, Meekai To, Andrew ShennanAbstract:: Cervical Cerclage is commonly used in the management of women considered to be at high risk of second-trimester loss and spontaneous preterm birth. Insertion is dictated by factors such as multiple pregnancy, uterine anomalies, a history of Cervical trauma through destructive procedures or forced dilatation, and Cervical shortening seen on transvaginal ultrasound examination. However, its use and efficacy in these different groups is highly controversial as there is contradiction in the results of individual studies and meta-analyses. This review examines the contemporary evidence on Cervical Cerclage and its current role in obstetrics.
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Is Cerclage height associated with preterm delivery in women undergoing ultrasound-indicated Cervical Cerclage?
Archives of Disease in Childhood-fetal and Neonatal Edition, 2012Co-Authors: Susan Chatfield, Lynne Sykes, D Abbott, Andrew Shennan, Rachael Simcox, Joanna R. Cook, M. Chandiramani, Bryony Jones, J Loudon, Pb BennettAbstract:Objective To determine whether the level of an ultrasound (USS) indicated Cervical Cerclage is a factor in the subsequent risk of preterm delivery. Study Design and Results A retrospective cohort study of women with a singleton pregnancy undergoing USS-indicated Cerclage in two UK tertiary referral centres between 2001–2011. Demographic data, Cervical dimensions (length, suture distance from external/internal os) and obstetric outcomes were obtained. In 131 women undergoing USS-indicated Cerclage, the preterm birth rate at The cohort was divided according to Cerclage height from the external os or suture height as percentage of total Cervical length, at first USS after suture insertion and the RR of preterm delivery at 34 and 37 weeks calculated (Table 1). Conclusion It has been thought, historically, that the closer a Cervical Cerclage is to the internal os the more effective it will be, but this has never been proven. This is the largest reported cohort of USS-indicated Cervical Cerclage and shows that the higher a Cervical Cerclage is placed the lower the subsequent risk of preterm delivery. When placing a Cervical Cerclage every effort should be made to place it as high as possible.
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Cervical Cerclage in the prevention of preterm birth
Best Practice & Research in Clinical Obstetrics & Gynaecology, 2007Co-Authors: Rachael Simcox, Andrew ShennanAbstract:Cervical Cerclage has been used in the management of Cervical insufficiency for several decades, yet the indications are uncertain and benefits marginal. It remains a controversial intervention. The diagnosis of Cervical insufficiency is traditionally based on a history of recurrent second trimester miscarriages, or very preterm delivery whereby the cervix is unable to retain the pregnancy until term. Cervical Cerclage has been the subject of many observational and randomised controlled trials. This article reviews the literature regarding the effectiveness of elective or emergency transvaginal Cerclage and transabdominal Cerclage.
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Cervical Cerclage a review
International Journal of Surgery, 2007Co-Authors: Rachael Simcox, Andrew ShennanAbstract:Abstract Cervical Cerclage is a common prophylactic intervention that has been used in the management of second trimester loss for several decades, yet it remains one of the more controversial surgical interventions in obstetrics. The diagnosis of Cervical insufficiency is notoriously difficult to make, and is usually a retrospective one based on a history of recurrent second trimester loss (or early preterm delivery) following painless Cervical dilatation in the absence of contractions, bleeding, or other causes of recurrent pregnancy loss. This article reviews the current literature regarding the efficacy of transvaginal Cerclage (in both an elective and emergency setting), therapeutic Cerclage (whereby a suture is inserted on the basis of ultrasound evidence of Cervical shortening) and transabdominal Cerclage.
Tinchiu Li - One of the best experts on this subject based on the ideXlab platform.
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Cervical Cerclage in twin pregnancy
Best Practice & Research in Clinical Obstetrics & Gynaecology, 2019Co-Authors: Xiaowu Huang, Sotirios H Saravelos, Tinchiu Li, Rui Huang, Ruonan Xu, Qiaoyun ZhouAbstract:Abstract Cervical Cerclage in women with twin pregnancy is not routinely indicated but appears to be beneficial in subjects with a history of preterm birth or very short cervix or dilated cervix. There is a paucity of literature data regarding transabdominal or laparoscopic Cervical Cerclage (LCC) in twin pregnancy. It is uncertain whether LCC is more effective than transvaginal Cerclage. Our own experience of 24 cases of LCC in twin pregnancy showed encouraging results. Further, well-planned studies are required to answer whether, when, and how Cervical Cerclage should be performed in women with twin pregnancy.
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simplified laparoscopic Cervical Cerclage after failure of vaginal suture technique and results of a consecutive series of 100 cases
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2016Co-Authors: Xiaowu Huang, Tinchiu Li, Dongmei Song, Yuting ZhaoAbstract:Abstract Objective To evaluate the efficacy of simplified laparoscopic Cervical Cerclage (SLCC) in the prevention of miscarriage and preterm delivery in women with Cervical incompetence who failed to have a live birth following a vaginal Cervical Cerclage in a previous pregnancy. Study design From Dec 2010 to January 2015, a consecutive cases of 100 subjects with Cervical incompetence but who failed to have a live birth following a vaginal Cervical Cerclage in a previous pregnancy underwent SLCC. Surgical outcome parameters (estimated total blood loss, operation time, complications) were recorded, the outcome of any subsequent pregnancy was evaluated. Results Among the 100 cases of SLCC, the mean ± SD (range) surgical time was 26 ± 4.7 (20–40) min. After the operation, 82 women conceived, 3 of them conceived twice. There were altogether 85 pregnancies, including 12 early miscarriages and one case of ectopic pregnancy. Among the 55 pregnancies which progressed beyond the first trimester and in whom the final outcome was confirmed, the live birth rate was 53/55 (96.4%). The mean gestational age at delivery of this group of women was 37.5 ± 1.8 weeks. Conclusions The simplified laparoscopic Cervical Cerclage is a simple, safe, and effective procedure for the treatment of Cervical incompetence which had previously failed to benefit from vaginal Cervical Cerclage.
Alex Ades - One of the best experts on this subject based on the ideXlab platform.
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transabdominal Cervical Cerclage laparoscopy versus laparotomy
Journal of Minimally Invasive Gynecology, 2015Co-Authors: Kim C Dobromilsky, Alex Ades, King T Cheung, Mark P UmstadAbstract:Abstract Study Objective To evaluate the obstetric outcome, surgical morbidity, and pre-abdominal Cerclage characteristics of women undergoing transabdominal Cerclage (TAC) via laparotomy or laparoscopy. Design Prospective cohort study (Canadian Task Force classification II-2). Setting University hospital. Patients and Intervention Between 2007 and 2014, 51 patients underwent laparoscopic abdominal Cervical Cerclage to treat Cervical incompetence. These women were compared with a historical cohort of 18 patients who underwent the same procedure via laparotomy between 1995 and 2011. All of the women had a diagnosis of Cervical incompetence based on previous obstetric history and/or a short or absent cervix. Measurements and Main Results The fetal survival rate postCerclage was 100% in the laparotomy group (n = 30 pregnancies) and 98% in the laparoscopy group (n = 54 pregnancies). There were no perioperative pregnancy losses in either group. The median gestation age was 36.9 weeks (range: 35.0–37.3) in the laparotomy group and 37.0 weeks (range: 34.7–38.0) in the laparoscopy group. Complications were recorded in 4 (22%) cases from the laparotomy group and 1 (2%) of the laparoscopies; however, the types of complications might not be comparable between groups. There were no conversions to laparotomy in the laparoscopy group. Pre-TAC median gestational age in the laparotomy group was 24.0 weeks (range: 20.0–25.1) with 19 (57.6%) previous pregnancies occurring after transvaginal Cervical Cerclage placement. The corresponding laparoscopy pre-TAC median gestational age was 22.0 weeks (range 19.0–34.0) with 40 (40%) previous pregnancies having a transvaginal Cerclage. Before the TAC, women in the laparotomy group had lost 25 babies, and 63 babies were lost in the laparoscopy group. After TAC, these numbers were 0 and 1. Conclusions Our findings show that transabdominal Cervical Cerclage placed laparoscopically appears to be as effective as TAC placed via laparotomy. Neither approach was associated with serious or long-term complications. Because of this finding, the approach depends on the surgical experience and expertise of the unit in conjunction with discussion with the patient.
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transabdominal Cervical Cerclage
Australian & New Zealand Journal of Obstetrics & Gynaecology, 2010Co-Authors: Mark P Umstad, Michael A Quinn, Alex AdesAbstract:Background: Transabdominal Cervical Cerclage has been performed via laparotomy for over four decades. A laparoscopicapproach has recently been developed and offers the potential for lower morbidity.Aims: The experience of one operator with transabdominal Cervical Cerclage via laparotomy is reviewed to establish abaseline with which to compare results from the laparoscopic approach.Methods: Transabdominal Cervical Cerclage was performed with Mersilene tape. The pregnancy outcome prior totransabdominal Cervical Cerclage was compared with the outcomes after its insertion.Results: Prior to transabdominal Cervical Cerclage, there were 58 pregnancies of which 18 ended with a first trimesterpregnancy loss. Twenty-eight of the 36 pregnancies delivering between 13- and 26-week gestation resulted in a pregnancyloss. Three of the four children delivered after 26-week gestation survived. Following transabdominal Cervical Cerclage,there were no first trimester pregnancy losses. Of the 23 pregnancies after transabdominal Cerclage, one was terminatedat 18-week gestation for spina bifida and the remaining 22 babies were delivered at a mean gestation of 36.2 weeks.Maternal morbidity was limited to a single wound infection. Respiratory distress was the only significant neonatalmorbidity with all babies recovering completely.Conclusions: Transabdominal Cervical Cerclage via laparotomy is a safe and successful method of treating women whoneed a Cervical Cerclage but are unable to have a vaginal suture. A baseline has been established with which to comparethe results from laparoscopic transabdominal Cervical Cerclage in the future.Key words : Cervical incompetence, cervico-isthmi c Cerclage, transabdominal Cerclage.