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Green-top Guideline No. 75 Cervical Cerclage
MP3•Home de episódios
Manage episode 321217131 series 2634049
Conteúdo fornecido por RCOG and Royal College of Obstetricians. Todo o conteúdo do podcast, incluindo episódios, gráficos e descrições de podcast, é carregado e fornecido diretamente por RCOG and Royal College of Obstetricians ou por seu parceiro de plataforma de podcast. Se você acredita que alguém está usando seu trabalho protegido por direitos autorais sem sua permissão, siga o processo descrito aqui https://pt.player.fm/legal.
MP3 Audio Version of Green-top Guideline No. 75, Cervical Cerclage, published February 2022 The purpose of this guideline is to review the literature and provide evidence-based guidance on the use of cerclage in women at risk of preterm birth and second trimester loss. 1. Key recommendations (0:35) 2. Background and scope (03:03) 3. Identification and assessment of evidence (05:35) 4. Definitions (07:30) 5. History-indicated cerclage (11:14) 6. Ultrasound-indicated cerclage (16:54) 6.1. When should an ultrasound-indicated cerclage be offered? (16:58) 6.1.1 Women with a singleton pregnancy and a history of spontaneous second trimester loss or preterm birth (19:45) 6.2. Who should be offered serial sonographic surveillance with a view to ultrasound-indicated cerclage? (24:19) 7. Can cervical cerclage be recommended in any other groups of women considered at increased risk of preterm birth (29:50) 7.1. Multiple pregnancy (30:00) 7.2. Cervical surgery, trauma and uterine abnormalities (35:57) 7.3. Women with raised BMI (43:43) 8. Transabdominal cerclage (45:09) 8.1. When should a transabdominal cerclage be considered? (45:14) 8.2. Should a transabdominal cerclage be performed laparoscopically? (50:06) 8.3. How should women who experience delayed miscarriage or fetal death be cared for? (53:08) 9. Emergency cerclage (55:19) 9.1. When should a rescue cerclage be discussed and considered? (55.22) 9.2. What are the contraindications to cerclage insertion? (1:00:39) 9.3. What information should be given to women before cerclage insertion? (1:01:28) 10. Pre-operative management (1:08:00) 10.1. What investigations should be performed before insertion of cervical cerclage? (1:08:04) 10.2. Should amniocentesis to detect infection be performed before rescue or ultrasound-indicated cerclage? (1:10:53) 10.2.1. Is amnioreduction before emergency cerclage recommended? (1:14:23) 10.2.2. Should a latency period be observed between presentation and insertion of a rescue or ultrasound-indicated cerclage? (1:15:20) 10.2.3. Should routine genital tract screening for infection be carried out before cerclage insertion? (1:16:17) 11. Operative issues (1:17:35) 11.1. Should perioperative tocolysis be used for insertion of cerclage? (1:17:39) 11.2. Should perioperative antibiotics be given? (1:19:11) 11.3. What method of anaesthesia should be employed for the insertion of cerclage? (1:20:31) 11.4. Can cerclage be performed as a day-case procedure? (1:21:53) 11.5. Which technique and material should be used? (1:22:58) 12. Adjuvant management (1:28:53) 12.1. Bed rest (1:28:56) 12.2. Sexual intercourse (1:30:36) 12.3. Is there a role for post-cerclage serial sonographic surveillance of cervical length? (1:31:15) 12.4. Is fetal fibronectin testing useful following insertion of a cervical cerclage? (1:35:07) 12.5. Should women receive supplement progesterone following cerclage? (1:37:38) 12.6. Should women be offered Arabin pessary or progesterone instead of cerclage? (1:40:44) 13. When should the cerclage be removed? (1:44:39) 13.1. Should the cerclage be removed following PPROM? (1:47:30) 14. Recommendations for future research (1:50:28) 15. Suggested audit topics (1:51:25) Closing statement (1:52:05)
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48 episódios
MP3•Home de episódios
Manage episode 321217131 series 2634049
Conteúdo fornecido por RCOG and Royal College of Obstetricians. Todo o conteúdo do podcast, incluindo episódios, gráficos e descrições de podcast, é carregado e fornecido diretamente por RCOG and Royal College of Obstetricians ou por seu parceiro de plataforma de podcast. Se você acredita que alguém está usando seu trabalho protegido por direitos autorais sem sua permissão, siga o processo descrito aqui https://pt.player.fm/legal.
MP3 Audio Version of Green-top Guideline No. 75, Cervical Cerclage, published February 2022 The purpose of this guideline is to review the literature and provide evidence-based guidance on the use of cerclage in women at risk of preterm birth and second trimester loss. 1. Key recommendations (0:35) 2. Background and scope (03:03) 3. Identification and assessment of evidence (05:35) 4. Definitions (07:30) 5. History-indicated cerclage (11:14) 6. Ultrasound-indicated cerclage (16:54) 6.1. When should an ultrasound-indicated cerclage be offered? (16:58) 6.1.1 Women with a singleton pregnancy and a history of spontaneous second trimester loss or preterm birth (19:45) 6.2. Who should be offered serial sonographic surveillance with a view to ultrasound-indicated cerclage? (24:19) 7. Can cervical cerclage be recommended in any other groups of women considered at increased risk of preterm birth (29:50) 7.1. Multiple pregnancy (30:00) 7.2. Cervical surgery, trauma and uterine abnormalities (35:57) 7.3. Women with raised BMI (43:43) 8. Transabdominal cerclage (45:09) 8.1. When should a transabdominal cerclage be considered? (45:14) 8.2. Should a transabdominal cerclage be performed laparoscopically? (50:06) 8.3. How should women who experience delayed miscarriage or fetal death be cared for? (53:08) 9. Emergency cerclage (55:19) 9.1. When should a rescue cerclage be discussed and considered? (55.22) 9.2. What are the contraindications to cerclage insertion? (1:00:39) 9.3. What information should be given to women before cerclage insertion? (1:01:28) 10. Pre-operative management (1:08:00) 10.1. What investigations should be performed before insertion of cervical cerclage? (1:08:04) 10.2. Should amniocentesis to detect infection be performed before rescue or ultrasound-indicated cerclage? (1:10:53) 10.2.1. Is amnioreduction before emergency cerclage recommended? (1:14:23) 10.2.2. Should a latency period be observed between presentation and insertion of a rescue or ultrasound-indicated cerclage? (1:15:20) 10.2.3. Should routine genital tract screening for infection be carried out before cerclage insertion? (1:16:17) 11. Operative issues (1:17:35) 11.1. Should perioperative tocolysis be used for insertion of cerclage? (1:17:39) 11.2. Should perioperative antibiotics be given? (1:19:11) 11.3. What method of anaesthesia should be employed for the insertion of cerclage? (1:20:31) 11.4. Can cerclage be performed as a day-case procedure? (1:21:53) 11.5. Which technique and material should be used? (1:22:58) 12. Adjuvant management (1:28:53) 12.1. Bed rest (1:28:56) 12.2. Sexual intercourse (1:30:36) 12.3. Is there a role for post-cerclage serial sonographic surveillance of cervical length? (1:31:15) 12.4. Is fetal fibronectin testing useful following insertion of a cervical cerclage? (1:35:07) 12.5. Should women receive supplement progesterone following cerclage? (1:37:38) 12.6. Should women be offered Arabin pessary or progesterone instead of cerclage? (1:40:44) 13. When should the cerclage be removed? (1:44:39) 13.1. Should the cerclage be removed following PPROM? (1:47:30) 14. Recommendations for future research (1:50:28) 15. Suggested audit topics (1:51:25) Closing statement (1:52:05)
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