J Gynecol Obstet Biol Reprod (Paris)
Pôle Femme-Mère-Enfant, service de gynécologie obstétrique, groupe hospitalier Sud-Réunion, CHU de la Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion; CEPOI, centre d'étude périnatale de l'Océan indien, CHU de la Réunion, 97448 Saint-Pierre, Réunion; UFR santé, université de la Réunion, 97490 Saint-Denis, Réunion. Electronic address:
Published: September 2016
Unlabelled: Cervical incompetency is one of the direct causes of neonatal morbidity and mortality; a unique and efficient treatment of which is cervical cerclage. The objective of this study was the evaluation of physicians' practice patterns concerning cerclage in Reunion Island, in order to reinforce the management and information of patients at risk. The indications and complications of cerclages effectuated in 2010 and 2011 were compared to the literature.
Material And Methods: In this retrospective study, all the medical records of cerclage realized in Reunion Island during two years were collected and analyzed, specifically data concerning patients' cerclage, the complications, and the outcome of the pregnancy.
Results: We listed 200 cerclages, which were predominantly prophylactic cerclages (75.5%) and represented 0.71% of all births. A total of 71% of the indications of cerclage in Reunion Island did not take into account the recommendations of the literature. Analysis revealed the frequent use of prophylactic cerclage and subsequently reflected the insufficient use of therapeutic cerclage. In those cases, the rate of premature delivery was indeed lower (P=0.003), as well as the rate of chorioamniotitis (P=0.003).
Conclusion: Cerclage is an efficient treatment to extend the length of the pregnancy. Nevertheless, it is important to comply with the recommendations given by the literature, by spotting the patients at risk of premature delivery, and recommend cerclage only in case of real cervical incompetency, for the sake of improving their management and reducing the rate of complications.
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http://dx.doi.org/10.1016/j.jgyn.2015.10.003 | DOI Listing |
Bull Cancer
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Unité U9192, université de Montpellier, 34960 Montpellier, France; CHU de Montpellier, 34090 Montpellier, France.
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Service de gynécologie-obstétrique, centre hospitalier universitaire Sud-Réunion, BP350, 97448 Saint-Pierre cedex, France; Centre d'études périnatales Océan Indien, centre hospitalier universitaire Sud-Réunion, BP350, 97448 Saint-Pierre cedex, France; Unité de formation et de recherche santé de La Réunion, faculté de médecine, 97490 Saint Denis, France.
Introduction: In Réunion Island, the standardized mortality rate for cervical cancer is 4.8/100,000 women, while it is 2.2/100,000 in France.
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In 2013, all populations of the precious wood genera (Fabaceae) and (Ebenaceae) from Madagascar were placed on CITES Appendix II in an effort to combat unsustainable and illicit over-exploitation and illegal exportation for the international market. The accompanying Action Plan adopted by CITES identified several information and capacity gaps, which undermine the sustainable and equitable management of these valuable resources. These gaps include the lack of practical, reliable tools to identify species along the entire value chain, from standing trees to cut wood and finished products.
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