Of those admitted to a hospital because of a GI bleed, death occurs in about 7%. Despite treatment, re-bleeding occurs in about 7–16% of those with upper GI bleeding. In those with esophageal varices, bleeding occurs in about 5–15% a year and if they have bled once, there is a higher risk of further bleeding within six weeks. Testing and treating H. pylori if found can prevent re-bleeding in those with peptic ulcers. The benefits versus risks of restarting blood thinners such as aspirin or warfarin and anti-inflammatories such as NSAIDs need to be carefully considered. If aspirin is needed for cardiovascular disease prevention, it is reasonable to restart it within seven days in combination with a PPI for those with nonvariceal upper GI bleeding. Epidemiology
Gastrointestinal bleeding from the upper tract occurs in 50 to 150 per 100,000 adults per year. It is more common than lower gastrointestinal bleeding which is estimated to occur at the rate of 20 to 30 per 100,000 per year. Risk of bleeding is more common in males and increases with age. References
External links
"Gastrointestinal Bleeding". MedlinePlus. U.S. National Library of Medicine.
Cervical effacement or cervical ripening refers to a thinning of the cervix. Background
Cervical effacement is a component of the Bishop score and can be expressed as a percentage.Prior to effacement, the cervix is like a long bottleneck, usually about four centimeters in length. Throughout pregnancy, the cervix is tightly closed and protected by a plug of mucus. When the cervix effaces, the mucus plug is loosened and passes out of the vagina. The mucus may be tinged with blood and the passage of the mucus plug is called bloody show (or simply "show"). As effacement takes place, the cervix then shortens, or effaces, pulling up into the uterus and becoming part of the lower uterine wall. Effacement may be measured in percentages, from zero percent (not effaced at all) to 100 percent, which indicates a paper-thin cervix. Results from a systematic review of the literature found no differences in cesarean delivery nor neonatal outcomes in women with low-risk pregnancies between inpatient or outpatient cervical ripening.Effacement is accompanied by cervical dilation. == References ==