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The efficacy of cervical cerclage
1Mount Hope Women's Hospital, Trinidad.
The West Indian Medical Journal
|March 1, 1990
Summary
Cervical cerclage significantly increases perinatal survival rates in pregnancy. While techniques and suture materials showed comparable effectiveness, early cerclage placement before 14 weeks was linked to spontaneous abortions.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Cervical insufficiency is a leading cause of pregnancy loss.
- Cervical cerclage is a surgical procedure to prevent premature birth.
Purpose of the Study:
- To evaluate the effectiveness and safety of cervical cerclage in managing pregnancies at risk for preterm birth.
- To compare different cerclage techniques and suture materials.
Main Methods:
- Retrospective analysis of 187 pregnancies involving cervical cerclage.
- Comparison of McDonald and Shirodkar cerclage techniques.
- Evaluation of Mersilene and black silk suture materials.
Main Results:
- A three-fold increase in crude perinatal survival rate was observed with cervical cerclage.
- McDonald and Shirodkar techniques yielded similar outcomes.
- Mersilene and black silk demonstrated comparable efficacy.
- Early cerclage (<14 weeks) was associated with a higher rate of spontaneous abortions.
- Post-procedure morbidity was low, with minimal need for abdominal delivery.
Conclusions:
- Cervical cerclage is a justified procedure for selected high-risk pregnancies.
- Timing of cerclage placement is critical to optimize outcomes.
- Further research into optimal cerclage protocols is warranted.
