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Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse

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Cervical cerclage and preterm PROM.

Maria A Giraldo-Isaza¹, Vincenzo Berghella

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology,Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Clinical Obstetrics and Gynecology

|April 22, 2011

Summary

This summary is machine-generated.

Immediate removal of cerclage after preterm premature rupture of membranes (PPROM) is generally preferred. While retention may prolong pregnancy, it increases risks of maternal infection and neonatal sepsis.

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Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine

Background:

Preterm premature rupture of membranes (PPROM) complicates 38% of pregnancies with cerclage.
Clinical management of cerclage following PPROM remains controversial.

Purpose of the Study:

To review existing literature on cerclage retention versus removal after PPROM.
To provide evidence-based management recommendations for this clinical scenario.

Main Methods:

Literature review of studies addressing cerclage management post-PPROM.
Analysis of outcomes associated with cerclage retention and removal.

Main Results:

Cerclage retention beyond 24 hours post-PPROM can extend pregnancy duration (>48 hours).
However, retention significantly increases maternal chorioamnionitis and neonatal sepsis-related mortality.
Immediate cerclage removal is typically the preferred approach.

Conclusions:

Immediate removal of cerclage following PPROM is generally recommended to mitigate maternal and neonatal complications.
Consideration of steroids for fetal maturity is advised for gestations between 24 and 33 6/7 weeks prior to cerclage removal.