Shirodkar cerclage: Obstetrical and neonatal outcomes in a single-center cohort of 55 cases
Autor: | Laurent Mandelbrot, Joy Bloomfield, Cécile Pénager |
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Rok vydání: | 2021 |
Předmět: |
Adult
medicine.medical_specialty Cervical insufficiency medicine.medical_treatment Single Center Cohort Studies 03 medical and health sciences 0302 clinical medicine Pregnancy Uterine malformation medicine Humans Cerclage Cervical Retrospective Studies 030219 obstetrics & reproductive medicine Obstetrics business.industry Vaginal delivery Pregnancy Outcome Obstetrics and Gynecology Gestational age Cervical conization medicine.disease Reproductive Medicine 030220 oncology & carcinogenesis Cohort Gestation Premature Birth Female business |
Zdroj: | Journal of gynecology obstetrics and human reproduction. 50(9) |
ISSN: | 2468-7847 |
Popis: | Background Cervical insufficiency is thought to be responsible for 10% of preterm deliveries. Shirodkar cerclage is among the available techniques ranging from McDonald's to definitive procedures, however the indications for the prevention of preterm births and mid-trimester miscarriages are still poorly delineated. Objective To describe the characteristics, obstetrical and neonatal outcomes of pregnancies with Shirodkar cerclage procedures. Method We performed a descriptive retrospective single-center study, including all patients who had a Shirodkar cerclage between January 1, 2008 and December 31, 2020. The main outcomes measured were delivery at or beyond 24 and 32 weeks of gestations (WG). Results 55 Shirodkar cerclages were performed over the period studied. 7.3% of patients had a uterine malformation, 9% had a history of cervical conization. 74.5% had history of one or more mid-trimester miscarriages. 63.6% had a history of a failed emergency or prophylactic cerclage. The median gestational age (GA) at cerclage placement was 14 WG. There were 4 deliveries before 24 WG, 8 before 32 WG and 16 before 37 WG. Overall neonatal survival was 48/53 (90.6%). The median GA at delivery was 38 weeks (IQR 35–39), with 70.3% of vaginal deliveries. Conclusion Shirodkar cerclage was successful in more than 90% of patients, despite their obstetric history. Shirodkar cerclage may be indicated in the event of prior cerclage failure using the McDonald technique or in order to allow for correct stitch placement in very short cervixes. Its advantage over definitive cerclage is to allow for vaginal delivery. |
Databáze: | OpenAIRE |
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