title: [Cervical cerclage in Reunion island: Evaluation of physicians' practice patterns].
abstract: 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.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Pôle Femme-Mère-Enfant, service de gynécologie obstétrique, groupe hospitalier Sud-Réunion, CHU de la Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion.
authors.forename: P L
authors.initials: PL
authors.lastname: Tran
authors.affiliation: Pôle Femme-Mère-Enfant, service de gynécologie obstétrique, groupe hospitalier Sud-Réunion, CHU de la Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion.
authors.forename: G
authors.initials: G
authors.lastname: Payet
authors.affiliation: Pôle Femme-Mère-Enfant, service de gynécologie obstétrique, groupe hospitalier Sud-Réunion, CHU de la Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion.
authors.forename: G
authors.initials: G
authors.lastname: Barau
authors.affiliation: 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: malik.boukerrou@chu-reunion.fr.
authors.forename: M
authors.initials: M
authors.lastname: Boukerrou
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D023802:Cerclage, Cervical / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D012189:Retrospective Studies; D017508:Reunion / Q000453:epidemiology; D002581:Uterine Cervical Incompetence / Q000453:epidemiology* / Q000601:surgery; D055815:Young Adult
keywords: Accouchement prématuré; Cerclage; Cerclage du col; Cervical incompetency; Fausse couche tardive; Incompétence cervicale; Late miscarriage; Preterm delivery; Recommandations; Recommendations