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Updated: Jun 21, 2026
Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Labor outcomes after Shirodkar cerclage
Nathan S Fox1, Andrei Rebarber, Samuel Bender
1Maternal Fetal Medicine Associates, PLLC, 70 East 90th Street, New York, NY 10128, USA. nfox@mfmnyc.com
Objective:
To describe labor outcomes in women who had a Shirodkar cerclage placed during pregnancy and removed before labor.
Methods:
A review was conducted of 69 patients with a singleton pregnancy and a Shirodkar cervical cerclage placed before 24 weeks' gestation. Indications for cerclage were history indicated, ultrasound indicated or physical examination indicated.
Results:
The mean time from cerclage removal to delivery was 9.4 +/- 8.8 days. The overall cesarean delivery rate was 18.8%, with the majority (9 of 13) being for fetal indications. Two (2.9%) patients had a uterine rupture of an unscarred uterus and 2 (2.9%) patients had an umbilical cord prolapse. Four (5.8%) patients had a cervical laceration requiring repair.
Conclusion:
Patients with a Shirodkar cerclage placed and removed during the index pregnancy appear to have a higher than expected rate of cesarean delivery for fetal indications and complications associated with significant neonatal morbidity including uterine rupture and cord prolapse.
