Summary
Cervical cerclage is a procedure in which sutures are inserted around the cervix in
women suspected to have cervical weakness. This is thought to prevent cervical dilatation
and membrane exposure, thus helping the uterus to retain the pregnancy in women who
are prone to miscarrying, mostly in the mid-trimester. It was first described over
50 years ago by Shirodkar, followed by McDonald. It has been widely practised in different
parts of the world with variable results. This procedure can be performed as either
a planned or an emergency operation depending on the clinical situation. Based on
the indication, the approach could be vaginal or abdominal. Despite having been practised
widely, uncertainty still exists with regard to its indications, patient selection,
effectiveness and adverse effects. Counselling patients of the possible outcome of
the procedure in terms of success needs to be individualised. In this article, we
revisit the basics of this condition, along with the available evidence for its practice.
Keywords
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Further reading
- Elective cervical cerclage for prevention of preterm birth: a systematic review.Acta Obstet Gynaecol Scand. 2003; 82: 398-404
Drakeley AJ, Roberts D, Alfirevic Z. Cervical stitch (cerclage) for preventing pregnancy loss in women. The Cochrane Database of Systematic Reviews 2003, Issue I. Art. No.: CD 003253. doi:10.1002/14651858.CD003253.
- Final report of the MRC/RCOG multicentre randomised Trial of cervical cerclage.Br J Obstet Gynaecol. 1993; 100: 516-523
- Cervical cerclage for prevention of preterm delivery in woman with short cervix: randomised controlled trial.Lancet. 2004; 363: 1849-1853
- Abdominal versus vaginal cerclage after a failed transvaginal cerclage: a systematic review.Am J Obstet Gynecol. 2002; 187: 868-872
- Cervical length at 23 weeks of gestation: prediction of spontaneous preterm delivery.Ultrasound Obstet Gynecol. 1998; 12: 312-317
Article info
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Copyright
© 2006 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
