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Cervical cerclage: a ten-year review in a large hospital
Authors:M S Cardwell
Institution:Department of Maternal-Fetal Medicine, Baptist Hospital, Nashville, Tenn. 37236.
Abstract:This retrospective study of 129 pregnancies treated with cervical cerclage was done to analyze differences, if any, in reproductive outcome according to gestational age, race, history of previous successful pregnancy, gravidity, and procedure used (McDonald vs Shirodkar cerclage). Fetal salvage was significantly improved only when cerclage was done before 18 weeks of gestation. Cervical cerclage between 18 and 26 weeks' gestation significantly increased the prematurity rate. Cervical cerclage significantly improved fetal salvage in both the black and white populations but at the expense of increasing the prematurity rate in the former. There was no difference in fetal salvage whether the patient had had a previous successful pregnancy or not, or whether the patient was a primigravida or multigravida. Fetal salvage was significantly improved with both the McDonald and Shirodkar procedures, with no significant differences in the complication, prematurity, or cesarean section rates.
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