Management of cervical cerclage at term: remove the suture in labor?
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Y. E. Abdelhak
Abstract
Objective: To assess the risks and benefits to patients who carry to term after undergoing a Shirodkar cerclage where the cerclage is not removed until the patient presents in labor.
Methods: A retrospective analysis was conducted examining all patients who underwent a Shirodkar cerclage employing a 5 mm Mersilene band. All the cerclages were placed by a single operator over a twenty five year span, from 1/01/74 till 10/01/98. Only patients who delivered vaginally or were allowed a trial of labor were included. In all cases, the cerclage was removed under regional anesthesia after the patient presented to the hospital in labor.
Results: Ninety six cerclage procedures were performed over that period. Eighty two pregnancies qualified for review. Sixty two patients delivered vaginally (76%). Nine cesareans were indicated for failure to progress in labor (11%) with cervical dystocia possibly implicated in one. There were no cases of ruptured uteri or the development of uterine windows. Of the 82 pregnancies there were five cases (6%) of minor cervical laceration.
Conclusion: Allowing patients to proceed to labor with a Shirodkar cerclage in place, does not increase the risks of cervical dystocia, cervical laceration, or uterine rupture above the reported incidence for these complications in patients in whom the cerclage is removed prophylactically.
Copyright (c)2000 by Walter de Gruyter GmbH & Co. KG
Articles in the same Issue
- Author Index
- Subject Index
- Contents
- Ellis van Creveld syndrome (chondroectodermal dysplasia, MIM 22550) in three siblings from a non-consanguineous mating
- Effect of maternal weight gain on infant birth weight
- Neonatal echocardiograms of macrosomic neonates
- Effects of surfactant treatment on gas-exchange and clinical course in near-term newborns with RDS
- Adolescent pregnancy: positive perinatal outcome at a community hospital
- Prostaglandin induced cortical hyperostosis in neonates with cyanotic heart disease
- Management of cervical cerclage at term: remove the suture in labor?
- Expedited human immunodeficiency virus testing of mothers and new-borns with unknown HIV status at time of labor and delivery
- The pathogenesis of pre-eclampsia: new aspects
- Peripartum hysterectomy
- Wishes and expectations of pregnant women and their partners concerning delivery
- Prevalence and risk factors for prelabor rupture of the membranes (PROM) at or near term in an urban Swedish population
- “Shake hands”; Diagnosing a floppy infant – Myotonic dystrophy and the congenital subtype: a difficult perinatal diagnosis
- Effect of corticosteroids on HELLP syndrome: a case report
Articles in the same Issue
- Author Index
- Subject Index
- Contents
- Ellis van Creveld syndrome (chondroectodermal dysplasia, MIM 22550) in three siblings from a non-consanguineous mating
- Effect of maternal weight gain on infant birth weight
- Neonatal echocardiograms of macrosomic neonates
- Effects of surfactant treatment on gas-exchange and clinical course in near-term newborns with RDS
- Adolescent pregnancy: positive perinatal outcome at a community hospital
- Prostaglandin induced cortical hyperostosis in neonates with cyanotic heart disease
- Management of cervical cerclage at term: remove the suture in labor?
- Expedited human immunodeficiency virus testing of mothers and new-borns with unknown HIV status at time of labor and delivery
- The pathogenesis of pre-eclampsia: new aspects
- Peripartum hysterectomy
- Wishes and expectations of pregnant women and their partners concerning delivery
- Prevalence and risk factors for prelabor rupture of the membranes (PROM) at or near term in an urban Swedish population
- “Shake hands”; Diagnosing a floppy infant – Myotonic dystrophy and the congenital subtype: a difficult perinatal diagnosis
- Effect of corticosteroids on HELLP syndrome: a case report
