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Cervical incompetence
s------l CORRESFONDENCE
Cervicel incompetence
and 2.90 per cent, respectively. Of’ could t.he definitions of major complications may vary
To the Editors: I read with interest the letter from Dr. Goodstein and your comments in the AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, January 15, 1978,with regard to the term “cervical incompetence” and its impact on the psychological health of an insecure woman. Many years ago, when practicing in Europe, I was faced with a similar problem in a patient who had been told by his cardiologist that he had “mitral incompetence.” Might I suggest that it is not the terms that are at fault so much as those who use them without proffering adequate explanation? Wena Hy& Williams, M.B., Ch.B. Stu&nt Health Services Medical Ofice UniversiQ of Win&or Windsor 1 I, Ontario, Canada
Fteeponee to the letter by Dr. Hodari (AM. J. &SlEl. GYNECOL.130: 505,1978) To the Editors: Although Dr. Hodari responded adequately in his reply to my letter, his data stiI1 do not convince me that second-trimester abortion performed by dilatation and evacuation is safer than when performed by transabdominal amniocentesis followed by intra-amniotic instillation of hypertonic saline, prostaglandin, or another agent. At menstrual weeks 15, 16, and 17 major complications occur at rates of 0.96. 1.38, and 3.75 per cent, respectively. and total complications occur at rates of 1.66, 2.08, and 4.12 per cent, according to the amplified data presented by Dr. Hodari in his response to my letter. The absence of complications at 18 or more menstrual weeks may be attributed to the expertise of the operator(s), since perhaps the potentially more hazardous abortions were performed by those more adept, or may perhaps be attributed to the small number, relatively speaking, of cases performed. According to the Joint Program for the Study of Abortion (JPSA) as reported in Centerfor Disease Control Abortion Surveillance 1975, issued in April, 1977, the major complication rates for dilatation and evacuation, intra-amniotic hypertonic saline, and intra-amniotic prostaglandin FZa abortion techniques were 0.69, I .81,
Obstetric prectices To iI7e b1ditor.j. In January of 1978, the obstetrical Division of St. Paul Hospital in Dallas, Texas, undertook to update some of the time-honored practices. Our plan was to 703
Cervicel incompetence
and 2.90 per cent, respectively. Of’ could t.he definitions of major complications may vary
To the Editors: I read with interest the letter from Dr. Goodstein and your comments in the AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, January 15, 1978,with regard to the term “cervical incompetence” and its impact on the psychological health of an insecure woman. Many years ago, when practicing in Europe, I was faced with a similar problem in a patient who had been told by his cardiologist that he had “mitral incompetence.” Might I suggest that it is not the terms that are at fault so much as those who use them without proffering adequate explanation? Wena Hy& Williams, M.B., Ch.B. Stu&nt Health Services Medical Ofice UniversiQ of Win&or Windsor 1 I, Ontario, Canada
Fteeponee to the letter by Dr. Hodari (AM. J. &SlEl. GYNECOL.130: 505,1978) To the Editors: Although Dr. Hodari responded adequately in his reply to my letter, his data stiI1 do not convince me that second-trimester abortion performed by dilatation and evacuation is safer than when performed by transabdominal amniocentesis followed by intra-amniotic instillation of hypertonic saline, prostaglandin, or another agent. At menstrual weeks 15, 16, and 17 major complications occur at rates of 0.96. 1.38, and 3.75 per cent, respectively. and total complications occur at rates of 1.66, 2.08, and 4.12 per cent, according to the amplified data presented by Dr. Hodari in his response to my letter. The absence of complications at 18 or more menstrual weeks may be attributed to the expertise of the operator(s), since perhaps the potentially more hazardous abortions were performed by those more adept, or may perhaps be attributed to the small number, relatively speaking, of cases performed. According to the Joint Program for the Study of Abortion (JPSA) as reported in Centerfor Disease Control Abortion Surveillance 1975, issued in April, 1977, the major complication rates for dilatation and evacuation, intra-amniotic hypertonic saline, and intra-amniotic prostaglandin FZa abortion techniques were 0.69, I .81,
Obstetric prectices To iI7e b1ditor.j. In January of 1978, the obstetrical Division of St. Paul Hospital in Dallas, Texas, undertook to update some of the time-honored practices. Our plan was to 703