Browsing by Author "Kayambo, Doris"

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    Review of the contemporary use of transvaginal cervical cerclage for the prevention of preterm birth at Tygerberg Hospital
    (Stellenbosch : Stellenbosch University, 2017-12) Kayambo, Doris; Hall, David Raymond; Van der Merwe, J. L.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Obstetrics and Gynaecology.
    ENGLISH SUMMARY: Aim: The main aim of this study was to review the contemporary use of transvaginal cervical cerclage. Methods: This retrospective observational study was done at Tygerberg Academic Hospital (TBH), a secondary and tertiary referral centre in the Western Cape Province. It included all pregnancies in whom a transvaginal cervical cerclage was placed from 1 Jan 2009 to 31 Dec 2014. Cervical cerclage was deemed successful if pregnancy was carried beyond 28 weeks of gestation. Results: 140 transvaginal cerclages were identified for analysis, which consisted of 80 history indicated (HI), 51 ultrasound indicated (UI) and 9 clinical indicated (CI) cerclages. An overall success rate of 74.3% was noted, with individual success rates of 81.3% and 76.5% in the HI and UI groups respectively. All CI cerclages delivered before 28 weeks. The overall live born rate after 24 weeks gestation was 78.6%; 85.0% in the HI group, 76.5% in the UI group and 22.2% in the CI group. The preterm birth (PTB) rate <34 weeks was 42.6% and 33.3% in the HI and UI groups. Cerclage related complications, specifically perioperative rupture of membranes (1.4%), cervical tears (2.1%) and suture displacement (5.0%) were infrequently seen, while preterm rupture of membranes at any gestation was encountered in 22.1% of all cases. Conclusion: Cervical cerclage remains one of the key preventative measures in prevention of PTB especially in high risk populations. Our data highlights the diversity of patients at risk of PTB and the complexities involved in their care. This study sheds light on the need for correct identification of suitable women for cervical cerclage insertion in a developing country setting.