ABSTRACT
Eighty-two patients with cervical incompetence were managed with MacDonald's cervical cerclage, bed rest, tocolytics and sedatives. 78 of the patients were followed upto termination of pregnancy and their pregnancy data recorded. 69.5% delivered at term. 78.1% were discharged from hospital with live babies. The incidence of operative delivery was encountered. MacDonald's cervical cerclage has a high success rate in a rural setting, well comparable to that in urban settings and prolonged in-patient treatment is not always necessary.
Subject(s)
Suture Techniques/standards , Uterine Cervical Incompetence/surgery , Adolescent , Adult , Bed Rest , Evaluation Studies as Topic , Female , Hospitals, District , Hospitals, Rural , Humans , Hypnotics and Sedatives/therapeutic use , Kenya/epidemiology , Length of Stay/statistics & numerical data , Pregnancy , Pregnancy Outcome , Prognosis , Tocolytic Agents/therapeutic use , Uterine Cervical Incompetence/diagnosis , Uterine Cervical Incompetence/therapyABSTRACT
One hundred and sixty five cases of extra-uterine pregnancy (EP) were managed in Thika District in peri-urban Kenya between January 1985 and June 1988, giving an incidence of 66:10,000 deliveries. 55.8% of the patients were in the age group 23-27 years, and 88.5% were para 0-2. 78.8% of the extra-uterine pregnancies were ruptured at the time of diagnosis. Paracentesis was performed in 126 cases with 13.5% false negatives. There were seven false positive paracentesis. All the false positives had conditions that would probably have required surgical intervention in any case. There were two patients encountered with advanced abdominal pregnancy. Total salpingectomy or salpingo-oophorectomy was performed in 50.9% of the patients--a case could be put forward for more conservative surgery in anticipation of future fertility.
PIP: 165 cases of extrauterine pregnancy (EP) were managed in Thika District in periurban Kenya between January 1985-June 1988, giving an incidence of 66:10,000 deliveries. 55.8% of the patients were 23-27 years of age, and 88.5% were para 0-2. 78.8% of the extrauterine pregnancies were ruptured at the time of diagnosis. Paracentesis was performed in 126 cases with 13.5% false negatives. There were 7 false-positive paracentesis results. All of the false positives had conditions which would probably have required surgical intervention regardless. There were 2 patients who had advanced abdominal pregnancy. Total salpingectomy or salpingo-oophorectomy was performed in 50.9% of the patients; a case could be made for more conservative surgery in anticipation of future fertility.
