How is Shirodkar cerclage done?
The Shirodkar procedure sometimes involves a permanent stitch around the cervix which will not be removed and therefore a Caesarean section will be necessary to deliver the baby. The Shirodkar technique was first described by V. N. Shirodkar in Bombay in 1955.
What is a Shirodkar procedure?
What is the Shirodkar (high vaginal) cervical suture? It is a suture, or stitch, which is placed around the cervix (neck of the womb) and tied in order to prevent the cervix opening too early in pregnancy.
How do you perform a cervical cerclage?
The speculum is gently opened when inside. This helps to spread the walls of the vagina and allow access to the cervix. A needle will then be used to place stitches around the outside of the cervix and the ends of the sutures will be tied to close the cervix. The procedure usually takes less than 90 minutes.
Is cervical cerclage a surgical procedure?
Cervical cerclage is a surgical procedures in which sutures or synthetic tape is used to reinforce the cervix. The purpose of cervical cerclage is to increase the mechanical strength of the cervix, thereby preventing painless passive dilatation and premature delivery prior to viability.
Which suture is used for cervical cerclage?
Multifilament/braided sutures such as Mersilene tape have been traditionally used for cervical cerclage.
What is a modified Shirodkar cerclage?
The modified Shirodkar technique, adapted from Shirodkar’s original described in 1955 [12], begins with a transverse incision made in the vaginal mucosa of the anterior cervix to allow for upward displacement of the bladder to avoid injury.
What is modified Shirodkar cerclage?
A modified Shirodkar procedure was performed in all women. The modification in the Shirodkar cerclage used in this study was that the knot of the suture and the suture itself were fully embedded under the vaginal mucosa in order to avoid infection.
When is a cervical cerclage inserted?
The best time for the cervical cerclage procedure is in the third month (12-14 weeks) of pregnancy. However, some women may need a cerclage placed later in pregnancy; this is known as an emergent cerclage and is necessary after changes such as opening or shortening of the cervix have already begun.
What are the different types of cerclage?
Glossary Cerclage. The most commonly utilized cerclage is the McDonald cerclage shown at right. Two other types of cerclage are the Shirodkar cerclage which is placed underneath the skin of the cervix, and the abdominal cerclage which is placed around the lower part of the uterus through an abdominal incision.
What material is used for a cerclage?
A cervical cerclage can be performed either with a monofilament or braided suture material; both sutures are routinely used by clinicians [2]. A monofilament suture may be superior at preventing miscarriage, stillbirth and neonatal death through the prevention of early delivery [3].
Is Shirodkar cerclage permanent?
The Shirodkar procedure involves a permanent stitch around the cervix because it will not be removed and therefore a Caesarean section will be necessary to deliver the baby.
Which is better McDonald or Shirodkar?
CONCLUSION: Shirodkar cerclage is associated with improved pregnancy prolongation, lower PTB rates, and better neonatal outcomes compared with McDonald cerclage. A randomized clinical trial to confirm our findings is justified.