Cervical cerclage
A cervical cerclage (also shortened to cerclage , French for 'wrap') is a surgical closure of the cervix in obstetrics to prevent premature births .
The procedure is used when the cervix dilates prematurely during pregnancy and the baby may be born prematurely as a result. The procedure consists of pulling a strong thread or tape around the cervix so that the opening is narrowed again. The cerclage is then removed about one to two weeks before the expected due date.
Two different procedures are common:
- In the McDonald's method , an outer purse-string suture is placed around the cervix.
- In the Shirodkar method , an inner, hidden suture is made under the cervical mucosa.
The "prophylactic" cervical cerclage, which was common until the 1970s, has been obsolete since the 1980s, as studies have not shown any prolongation of the duration of pregnancy. Only the therapeutic cervical cerclage is applied if the cervix is opened prematurely.
For some time now, many doctors have been using a cerclage pessary ( Arabin pessary ) instead of the cerclage . This is a ring made of soft rubber that is simply pushed over the cervix. The cerclage pessary can be inserted on an outpatient basis. Anesthesia and a hospital stay are unnecessary.
Individual evidence
- ↑ B. Uhl: OP manual for gynecology and obstetrics: Everything for the operating room and the ward . Georg Thieme Verlag, Stuttgart 2012, ISBN 978-3-13-159382-5 , chap. 11.1, p. 336 ff .
- ^ F. Wolff: Obstetrics . In: J. Baltzer, K. Friese et al. (Eds.): Practice of gynecology and obstetrics: the complete practical knowledge in one volume . Georg Thieme, Stuttgart 2006, ISBN 3-13-144261-1 , chap. 5.5: Pregnancy-related diseases and other disorders , p. 268 ff .
- ↑ M. Kühnert: Obstetric operations . Walter de Gruyter, 2011, ISBN 978-3-11-022871-7 , chap. 1 Therapy of cervical insufficiency , p. 11 .