Cervical cerclage – history and contemporary use
Authors:
P. Černohorská; H. Vitásková; Z. Kokrdová; Z. Hájek; M. Koucký; A. Pařízek
Authors‘ workplace:
Gynekologicko-porodnická klinika VFN a 1. LF UK, Praha, přednosta prof. MUDr. A. Martan, DrSc.
Published in:
Ceska Gynekol 2019; 84(1): 55-60
Category:
Overview
Objective: Contemporary role of cerclage as a preterm birth treatment.
Design: Review article.
Setting: Department of Obstetrics and Gynecology of the First Faculty of Medicine and General Teaching Hospital in Prague.
Methods: Research of existing literature, predominantly foreign journal articles, but also Czech literature and personal experience with the method.
Results: Cerclage is one of the well-known surgical procedures carried out during pregnancy. Its aim is to provide a mechanical support to the cervical canal and to keep the cervix closed. The cervical mucous plug serves as a mechanical barrier between the vagina and the uterine cavity, but it also contains many immune components which protect the fetal compartment from ascendent infections. Application of a cervical stitch can help to retain the mucous plug and thus increases the immunity of the cervical canal. Results of 15 randomised studies (Cochraine Database of Systematic R) suggest that in women with increased risk of preterm birth, cerclage decreases the occurrence of preterm birth relative to the expectant management.
Conclusions: Despite the decreasing numbers of cerclage surgeries, it is still a useful method of preterm birth prevention for a specific group of women. More recently, a progesterone treatment has gained popularity. Its application, however, must begin before the 16th week of pregnancy.
Keywords:
cerclage – cervical insufficiency – cervicometry – Preterm birth
Sources
1. Abbott, D., To, M., Shennan, A. Cervical cerclage: A review of current evidence, Aust N Z J Obstet Gynaecol, 2012, 52(3), p. 220–223.
2. Adams, T., Rafael, T., Kunzier, N., et al. Does cervical cerclage decrease preterm birth in twin pregnancies with a short cervix? AJOG, 2015, 212(1), p. 74–75.
3. Akladios, CY., Sananes, N., Gaudineau, A., et al. Le cerclage cervical. J Gynecol Obstet Biol Reprod, 2015, 44(8), p. 771–775.
4. Al-Azemi, M., Al-Qattan, F., Omu, A., et al. Changing trends in the obstetric indications for cervical cerclage. JOG, 2009, 23(5), p. 507–511.
5. Alfirevic, Z., Stampalija, T., Medley, N. Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy. Cochrane Database of Systematic Reviews, 2017, 6, p. 1–134.
6. Al-Fadhli, R., Tulandi, T. Laparoscopic abdominal cerclage. Obstet Gynecol Clin North Am, 2004, 31(3), p. 497–504.
7. Aoki, S., Ohnuma, E., Kurasawa, K., et al. Emergency cerclage versus expectant management for prolapsed fetal membranes: A retrospective, comparative study. J Obstet Gynaecol Res, 2014, 40(2), p. 381–386.
8. Berghella, V., Ludmir, J., Simonazzi, G., Owen, J. Transvaginal cervical cerklage: evidence for perioperative management strategies. AJOG, 2013, 209(3), p. 181–192.
9. Berghella, V., Rafael, TJ., Szychowski, J., et al. Cerclage for short cervix on ultrasonography in women with singleton gestations and previous preterm birth. Obstet Gynecol, 2011, 117(3), p. 663–671.
10. Berghella, V., Seibel-Seamon, J. Contemporary use of cervical cerclage. Clin Obstet Gynecol, 2007, 50(2), p. 468–477.
11. Conde-Agudelo, A., Romero, R., Nicolaides, K., et al. Vaginal progesterone vs cervical cerclage for the prevention of preterm birth in women with a sonographic short cervix, previous preterm birth, and singleton gestation: a systematic review and indirect comparison metaanalysis. AJOG, 2013, 208(1), p. 42.e1–42.e18
12. Cunningham, F. Williams obstetrics, USA: Mc Graw-Hill Education, 2014, p. 361–363.
13. Dastur, A., Tank, D. Dr Vithal Nagesh Shirodkar and the cervical cerclage. J Obstet Gynaecol India, 2008, 1, p. 22–23.
14. Ehsanipoor, RM., Seligman, NS., Saccone, G., et al. Physical examination-indicated cerclage. Obstet Gynecol, 2015, 126(1) p. 125–135.
15. Eskander, MA., Sobande, AA., Damole, IO., Bahar, AM. Emergency cervical cerclage: does the gestational age make a difference? Saudi Med J, 2004, 25, p. 1028–1031.
16. Hájek, Z. Porodnictví, Praha: Grada, 2014, s. 467–470.
17. Huml, K., Kantor, L., Procházková, M., et al. Laparoskopická abdominální cerkláž u pacientek s habituálním potrácením – kazuistika. Čes Gynek, 2016, 81(1), s. 58–62.
18. Kacerovský, M., Kokrdová, Z., Koucký, M., et al. Spontální předčasný porod. Doporučený postup. Čes Gynek, 2017, 82, s. 160–165.
19. Macnaughton, MC., Chalmers, IG., Dubowitz, V., et al. Final report of the Medical Research Council/Royal College of Obstetricians and Gynaecologists Multicentre Randomised Trial of Cervical Cerclage. BJOG, 1993, 100(6), p. 516–523.
20. Novy, MJ., Ducsay, CA., Stanczyk, FZ. Plasma concentrations of prostaglandin F2 alpha and prostaglandin E2 metabolites after transabdominal and transvaginal cervical cerclage. AJOG, 1987, 156, p. 1543–1552.
21. Pařízek, A. Kritické stavy v porodnictví. Kamenice: Mother-care-centrum publishing, 2012, s. 66–70.
22. Practice, B. Cerclage for the management of cervical insufficiency. Obstet Gynec, 2014, 132, p. 372–379.
23. Practice, B. Use of prophylactic antibiotics in labor and delivery. Obstet Gynec, 2011, 117, p. 1472–1483.
24. Purandara, CN., Patel, M., Balsarkar, G. Indian contribution to Obstetrics & Gynecology. J Obstet Gynaecol India, 2011, 61(6), p. 624–625.
25. Rafael, TJ, Berghella, V., Alfirevic, Z. Cervical stitch (cerclage) for preventing preterm birth in multiple pregnancy. Cochrane Database of Systematic Reviews, 2014, 9. p. Art. No.: CD009166.
26. Romero, R., Chaemsaithong, P., Chaiyasit, N., et al. CXCL10 and IL-6: Markers of two different forms of intraamniotic inflammation in preterm labor. Am J Reprod Immunol, 2017, 78, p. 1–17.
27. Scibetta, JJ., Sanko, SR., Phipps, WR. Laparoscopic transabdominal cervicoisthmic cerclage. Fertil Steril, 1998, 69(1), p. 161–163.
28. Shiber, LD., Lang, T., Pasic, R. First trimester laparoscopic cerclage. J Minim Invasive Gynecol, 2015, 22(5), p. 715–716.
29. Simcox, R., Shennan, A. Cervical cerclage: A review. Int J Surg, 2007, 5(3), p. 205–209.
30. Smith, J., DeFranco, E. Tocolytics used as adjuctive therapy at the time of cerclage placement: a systematic review. J Perinatol, 2015, 35(8), p. 561–565.
31. Sperling, JD., Dahlke, JD., Gonzalez, JM. Cerclage use. Obstet Gynecol Surv, 2017, 72(4), p. 235–241.
32. Suhaag, A., Berghella, V. Cervical cerclage. Clin Obstet Gynecol, 2014, 57(3), p. 557–567.
33. Umstad, MP., Quinn, MA., Ades, A. Transabdominal cervical cerclage. Aust N Z J Obstet Gynaecol, 2010, 50(5), p. 460–464.
34. Zaveri, V., Aghajafari, F., Amankwah, K., et al. Abdominal versus vaginal cerclage after a failed transvaginal cerclage: A systematic review. AJOG, 2002, 187(4), p. 868–872.
Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Czech Gynaecology
2019 Issue 1
Most read in this issue
- Endometriosis in pregnancy – diagnostics and management
- Diagnostics and modern trends in therapy of postpartum depression
- Cervical cerclage – history and contemporary use
- Uterine microbiome and endometrial receptivity