Cervical Cerclage: Types, Placement Techniques, and Postoperative Monitoring

Overview

Cervical cerclage is a surgical procedure performed to prevent preterm birth by reinforcing the cervix in pregnancies at risk of cervical insufficiency.

Types of Cervical Cerclage

• Transvaginal Cerclage: The most common approach, placed around the cervix through the vagina.
• Transabdominal Cerclage: Used when vaginal cerclage is not effective, placed via abdominal surgery.
• Emergency Cerclage: Performed when cervical dilation has already begun but intervention is needed.

Placement Techniques

Different suturing techniques are used depending on the type of cerclage:

• McDonald Technique: A simple, purse-string suture around the cervix.
• Shirodkar Technique: A more invasive approach with permanent sutures placed deeper into cervical tissue.

Postoperative Monitoring

Following cerclage placement, regular follow-ups are necessary to monitor cervical integrity. Key aspects include:

• Ultrasound assessments
• Observation for signs of infection
• Monitoring for contractions and preterm labor symptoms