Cervical cerclage, also known as a cervical stitch, is a treatment for cervical weakness, when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth. In women with a prior spontaneous preterm birth and who are pregnant with one baby, and have shortening of the cervical length less than 25 mm, a cerclage prevents a preterm birth and reduces death and illness in the baby.[1]
The treatment consists of a strong suture sewn into and around the cervix early in the pregnancy, usually between weeks 12 to 14, and then removed towards the end of the pregnancy when the greatest risk of miscarriage has passed. The procedure is performed under local anaesthesia, usually by way of a spinal block. It is typically performed on an outpatient basis by an obstetrician-gynecologist. Usually the treatment is done in the first or second trimester of pregnancy, for a woman who has had one or more late miscarriages in the past.[2] The word "cerclage" means encircling, hooping or banding in French.[3]
The success rate for cervical cerclage is approximately 80–90% for elective cerclages, and 40–60% for emergency cerclages. A cerclage is considered successful if labor and delivery is delayed to at least 37 weeks (full term). After the cerclage has been placed, the patient will be observed for at least several hours (sometimes overnight) to ensure that she does not go into premature labor. The patient will then be allowed to return home, but will be instructed to remain in bed or avoid physical activity (including sexual intercourse) for two to three days, or up to two weeks. Follow-up appointments will usually take place so that her doctor can monitor the cervix and stitch and watch for signs of premature labor.[citation needed]
For women who are pregnant with one baby (a singleton pregnancy) and at risk for a preterm birth, when cerclage is compared with no treatment, there is a reduction in preterm birth and there may be a reduction in the number of babies who die (perinatal mortality)[2] There is no evidence that cerclage is effective in a multiple gestation pregnancy for preventing preterm births and reducing perinatal deaths or neonatal morbidity.[4] Various studies have been undertaken to investigate whether cervical cerclage is more effective when combined with other treatments, such as antibiotics or vaginal pessary, but the evidence remains uncertain.[5]
^Berghella V, Rafael TJ, Szychowski JM, Rust OA, Owen J (March 2011). "Cerclage for short cervix on ultrasonography in women with singleton gestations and previous preterm birth: a meta-analysis". Obstetrics and Gynecology. 117 (3): 663–671. doi:10.1097/aog.0b013e31820ca847. PMID 21446209. S2CID 7509348.
^ abAlfirevic Z, Stampalija T, Medley N (June 2017). "Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy". The Cochrane Database of Systematic Reviews. 2017 (6): CD008991. doi:10.1002/14651858.CD008991.pub3. PMC 6481522. PMID 28586127.
^Stedman T (1987). Webster's New World/Stedman's Concise Medical Dictionary (1 ed.). Baltimore: Williams & Wilkins. p. 130. ISBN 0139481427.
^Rafael TJ, Berghella V, Alfirevic Z (September 2014). "Cervical stitch (cerclage) for preventing preterm birth in multiple pregnancy". The Cochrane Database of Systematic Reviews. 9 (9): CD009166. doi:10.1002/14651858.CD009166.pub2. PMC 10629495. PMID 25208049.
^Eleje GU, Eke AC, Ikechebelu JI, Ezebialu IU, Okam PC, Ilika CP (September 2020). "Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton pregnancies". The Cochrane Database of Systematic Reviews. 2020 (9): CD012871. doi:10.1002/14651858.CD012871.pub2. PMC 8094629. PMID 32970845.
Cervicalcerclage, also known as a cervical stitch, is a treatment for cervical weakness, when the cervix starts to shorten and open too early during...
cervix shortens. Preterm cervical shortening is linked to preterm birth and can be detected by ultrasonography. Cervicalcerclage is a surgical intervention...
and innovator. His most widely known contribution is Cervicalcerclage the "Shirodkar cerclage". His other contributions include operations for prolapse...
treatment is cervicalcerclage or stitch when a suture is stitched around the opening of the cervix around 12–14 weeks into the pregnancy. A cervical pessary...
months, but also tells her that the condition is easily treatable with cervicalcerclage, a stitch inserted into the womb after a woman has been pregnant for...
acknowledged in works dealing with the subject.[better source needed] Cervicalcerclage – was first described by V. N. Shirodkar in Bombay in 1955. Horn antenna...
pregnancy such as resection of the rudimentary horn and prophylactic cervicalcerclage decidedly improve obstetrical outcomes, current practice suggests...
hold body tissues together after an injury or surgery Cervicalcerclage, also known as a cervical stitch Husband stitch, a purported historical surgical...
contaminated, through invasive procedures like amniocentesis and cervicalcerclage, or contamination of bacteria in the vaginal canal. Infants can contribute...
these women, if the transvaginal ultrasound cervical length shortens to <25 mm at < 24 weeks, cervicalcerclage may be offered. In the 2013 study the guideline...
sutures are kept in place with the help of hemostatic artery forceps. Cervicalcerclage Alec M. Ansons; Helen Davis (30 April 2008). Diagnosis and Management...
Tratamento da Insuficiência Cervical Uterina pela Circlagem" (A Contribution for the Treatment of Uterine Cervical Insufficiency by Cerclage). Endrizzi was a pioneer...
Gynecologists (Feb 2014). "ACOG Practice Bulletin No.142: Cerclage for the management of cervical insufficiency". Obstetrics and Gynecology. 123 (2 Pt 1):...
Rafael, TJ; Berghella, V; Alfirevic, Z (10 September 2014). "Cervical stitch (cerclage) for preventing preterm birth in multiple pregnancy". The Cochrane...
Gynecologists (February 2014). "ACOG Practice Bulletin No.142: Cerclage for the management of cervical insufficiency". Obstetrics and Gynecology. 123 (2 Pt 1):...
other type of nail. A lateral incision over the trochanter is made and a cerclage wire is placed around the fracture for reduction. Once reduction has been...
(June 2017). Cochrane Pregnancy and Childbirth Group (ed.). "Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy". The Cochrane...
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