WHAT IS CERCLAGE?

Cerclage is a general term used to describe any one of a number of surgical procedures that is intended to either prevent premature opening or to close a prematurely dilated cervix. There are various types of cerclage procedures performed at different times of the pregnancy, which have similar therapeutic objectives in mind. The objective is to prevent premature delivery due to opening or relaxation of the cervical os.

Cerclage placement is often the treatment for cervical incompetence. Cervical incompetence is a phrase used to describe women who have either lost or are at risk of loosing a pregnancy or delivering prematurely due to the inability of the cervix  to remain closed throughout the normal length of the pregnancy.

This practice has developed an extensive experience with a particular type of cerclage procedure called a Shirodkar cerclage. The advantage of this type of suture placement over other forms of cerclage is that the innermost part of the cervical canal will be closed and will remain closed. Other types of cerclage, which close the more outer parts of the cervix can allow for relaxation of the internal portion of the cervix, which in our judgment is an inferior choice when compared to the Shirodkar cerclage.

This practice has performed nearly 900 Shirodkar cerclages. The overall success rate is approximately 85% to 90%. When Shirodkar cerclage is placed at 14 weeks in pregnancy, as a preventative measure, the success rate may exceed 95%. However, later in pregnancy when dilatation of the cervix has already occurred, there is a lower probability of success. Details of the potential advantages of this approach over other forms of cerclage can be provided through consultation with Dr. Potter or members of his staff.

WHO MAY NEED CERCLAGE?

By means of ultrasound, consultation regarding history, or even clinical inspection of the cervix, it is possible to determine patients who may have developed cervical incompetence or who may be at risk of developing cervical incompetence.