Caesarean section (CS) is one of the most common major operations performed around the world, yet operative rates vary considerably. This review will address the variation in caesarean section rates worldwide and changes in these rates over time. In addition we shall try to assess possible explanations for the differences and whether such differences are reflected in outcome.
The National Health Service Cervical Screening Programme has issued quality standards for the colposcopy service nationally. One standard is that for women who undergo treatment at their first colposcopy clinic visit, 90% should have proven cervical intra-epithelial neoplasia (CIN) on histology. We have assessed data from a teaching hospital colposcopy clinic over a 9-year period to assess the criteria that should be satisfied in order to achieve this target. We propose that only those women with severe dyskaryosis on the referral smear and a colposcopic appearance of CIN 2 or 3, or those in whom the colposcopic appearance suggests CIN 3 with any grade of dyskaryosis undergo treatment at their first visit.
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