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Cervical cerclage: twenty years' experience.

W A Peters, S Thiagarajah, G M Harbert

    Southern Medical Journal
    |August 1, 1979
    PubMed
    Summary
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    Early diagnosis of incompetent cervix significantly improves fetal salvage rates. Prompt cerclage before symptom onset maximizes pregnancy outcomes, while delayed intervention reduces success and increases risks.

    Area of Science:

    • Obstetrics and Gynecology
    • Maternal-Fetal Medicine

    Background:

    • Incompetent cervix is a condition affecting pregnancy.
    • Cervical cerclage is a treatment option.

    Purpose of the Study:

    • To evaluate the effectiveness of cervical cerclage for treating incompetent cervix.
    • To determine factors influencing fetal salvage rates.

    Main Methods:

    • Retrospective review of 40 pregnancies in 32 patients over 20 years.
    • Analysis of fetal salvage based on timing of diagnosis and cerclage placement.
    • Comparison of Shirodkar and McDonald procedures.
    • Assessment of complications associated with cerclage.

    Main Results:

    • Diagnosis before symptoms yielded 92% fetal salvage, with 68% reaching 36 weeks.

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  • Symptomatic diagnosis before cerclage reduced fetal salvage to 40%.
  • Factors like membrane bulging, >3cm dilation, and >26 weeks gestation decreased salvage.
  • No significant difference between Shirodkar and McDonald procedures.
  • Major complications included uterine rupture and acute chorioamnionitis.

    • Conclusions:

    • Early diagnosis and cerclage are crucial for successful fetal salvage in incompetent cervix.
    • Treatment is contraindicated with history alone or lack of close follow-up due to complication risks.