This time everything went smoothly, but because my cervix was weak, I had a cervical cerclage
- a stitch to hold it and keep it closed.
Although these cervical injuries are more common in term deliveries, alternative risk factors associated with cervical injuries are cervical cerclage
, induction of labour, young maternal age, vacuum-assisted vaginal delivery, prostaglandin use and precipitate labour.
Review of the literature shows the facts that the pyometra after ovum retrieval, uterine rupture following successful tubal blastocyst transfer after laparoscopic cervical cerclage
and placenta accreta causing uterine rupture in the second trimester of pregnancy after IVF resulted in hysterectomy.
The routinely practised vaginal cerclage procedure is not effective enough in preventing these miscarriages compared to our new method of laparoscopic cervical cerclage
Various reports have suggested safety of such management particularly with Methotrexate, (6) embolization of Uterine vessels, (7, 8) or Shirodkar cervical cerclage
, (9) followed by dilatation and curettage.
The role of cervical cerclage
in pregnancy outcome in women with uterine anomaly.
Since our study took place prior to these new ACOG recommendations, we had been routinely recording ultrasound (US) parameters including cervical length in an US database to identify patients who were candidates for the only intervention at the time, cervical cerclage
Furthermore, vaginal progesterone has been shown to be a safe and beneficial intervention for women with no known risk factors who are diagnosed with a shortened cervical length (< 2 cm), and cervical cerclage
has been suggested to reduce the risk of preterm birth for women with a history of prior preterm birth who also have a shortened cervical length.
5), vaginal bleeding, history of surgical procedure on the cervix, cervical cerclage
, autoimmune disease, sexual intercourse or use of products that can affect vaginal pH over the past 24 hours, major congenital fetal anomalies that were diagnosed in the previous ultrasound exam or screening tests for the first and second trimester of pregnancy.
In these circumstances, in the absence of labor or intra-amniotic infection, a "rescue" cervical cerclage
may be considered as a last resort (see page 34 for more on cerclage).
Under expert obstetrician Bryan Beattie, at UHW, she underwent a cervical cerclage
at 14 weeks, which, basically, ties a stitch in the cervix to prevent it opening too early.
was employed in all the patients, although ultrasound investigation was not employed in 65.