Cervical cerclage success rate

Cervical cerclage is a pregnancy preservation measure for women who are prone to miscarriage. Through this operation, the occurrence of threatened abortion can be effectively prevented, and women with certain fertility defects can have a normal pregnancy and ensure the survival rate of the child. There are certain contraindications and indications for cervical cerclage. Here is some information about cervical cerclage.

1. Introduction to cervical cerclage

Since Shirodkar in 1955 and MacDonald in 1957 described the clinical application of cervical cerclage, these two cervical cerclages, especially MacDonald, have become the most commonly used surgical methods for preventing mid-term pregnancy loss and premature birth in clinical practice for cervical insufficiency. Studies have shown that it has a certain preventive effect in high-risk groups, and high-risk groups generally refer to those who have a history of 3 or more mid-term pregnancy losses or premature births or those with a shortened cervix. The purpose of cervical cerclage is to repair and establish the normal morphology and function of the internal cervical os so that the pregnancy can be maintained to full term or the fetus can survive. The surgery is usually performed between 14 and 18 weeks of pregnancy.

2. Indications

1. Habitual miscarriage and premature birth caused by cervical insufficiency. Surgery can prolong pregnancy and improve newborn survival rate.

2. Placenta previa: Cervical cerclage can prevent the extension of the lower uterine segment and the dilation of the cervical opening, making it less likely for the placenta to be dislocated and detached from the uterine wall.

3. Twin or multiple pregnancy: Twin or multiple pregnancy is one of the main causes of premature rupture of membranes and premature birth due to excessive uterine expansion. The use of cervical cerclage can prolong the gestational age and significantly improve the fetal survival rate in multiple pregnancies.

3. Contraindications

1. Vaginal bleeding, uterine contraction and rupture of fetal membranes are contraindications for surgery.

2. Fetal malformation, placental abruption, amnionitis, etc.

4. Timing of surgery

For non-pregnant women, surgery should be performed 3-7 days after the menstruation ends.

Surgical options during pregnancy.

1. Cervical insufficiency: For those with a history of habitual miscarriage or premature birth, and those who have been diagnosed with cervical insufficiency before pregnancy, cerclage is usually performed at 16 to 20 weeks of pregnancy, or one week in advance of the previous miscarriage.

2. Painless vaginal bleeding usually occurs between 25 and 34 weeks of pregnancy. Ultrasound examination confirms that it is central placenta previa, and cervical cerclage can be considered.