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  • Title: [Cervical cerclage with buried prosthetic band: technique, indications and results in a series of 28 pregnancies].
    Author: Gervaise A, Senat MV, Audibert F, Frydman R, Fernandez H.
    Journal: J Gynecol Obstet Biol Reprod (Paris); 2000 Oct; 29(6):579-87. PubMed ID: 11084465.
    Abstract:
    OBJECTIVES: We performed a retrospective study to evaluate the results of a new approach to cervical cerclage using a prosthetic band. MATERIALS AND METHODS: 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. RESULTS: 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.
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