Cervical cerclage with buried prosthetic band: technique, indications and results in a series of 28 pregnancies
Gervaise, A.; Senat, M.V.; Audibert, F.; Frydman, R.; Fernandez, H.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction 29(6): 579-587
2000
ISSN/ISBN: 0368-2315 PMID: 11084465 Document Number: 519065
We performed a retrospective study to evaluate the results of a new approach to cervical cerclage using a prosthetic band. Twenty-four patients were recruited over an 8-year period between 1991 and 1999. All had a history of at least two late abortions and/or preterm delivery and a failed attempt with McDonald or Hervet cerclage. We used a cervical cerclage technique with prosthetic band inspired from the Shirodkar technique but which has been simplified and quite easy to reproduce. The technique consists in placing a prosthetic band around the internal os under the vaginal mucosa at the vesicovaginal reflection level. Outcome of pregnancy before and after inserting the prosthetic band was compared. Outcome of 28 pregnancies after cerclage were assessed (4 patients had two successive pregnancies with the same cerclage left in place). 82% of the children were liveborn after cerclage versus 21.7% before cerclage. 53.3% of the patients delivered at term after cerclage versus 2.8% before cerclage. We had 7.1% late miscarriages after cerclasge versus 65.2% before. There were no surgical complications. 22 of the 23 liveborn children were delivered by cesarean section. Conclusion. These results show that the cervical prosthesis is a solution of these patients with an obstetric history of cervical incompetence with failure of classical techniques.