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  • Title: [Indication for and benefit of 574 cerclages performed at the Medical University of Hannover (1987-1985)].
    Author: Böhmer S, Degenhardt F, Oester-Barkey S, Schneider J.
    Journal: Z Geburtshilfe Perinatol; 1990; 194(4):158-65. PubMed ID: 2396466.
    Abstract:
    574 cervical ligations according to the method of Shirodkar had been performed at the Department of Obstetrics and Gynecology during the years 1978 to 1985. In all cases the "Cervix Set" of Braun-Dexon was used. Compared to the number of 11,397 deliveries in this period, there is a frequency of cerclage operations of about 5%. The average age of the patients had been 29.2 years. Most of the operations had been carried out between the 17th and the 20th and between the 25th and the 30th week of gestation, 20.6% and 34.9%, respectively. 512 women delivered in our hospital, the records of these patients could be evaluated further. 185 women had been primiparae, 225 secundiparae and 102 pluriparae. In a retrospective study the singleton pregnancies (n = 481) had been grouped due to the indication for cerclage: group "obstetric history", group "dilated internal os", group "dilated external cervical os plus decreased cervical length", group "visible fetal membranes" and group "premature contractions plus threatened preterm delivery". Twin and triplet pregnancies (n = 31) had been evaluated separately. Only 48.8% of the multiparae patients had already delivered a viable child, while after cervical ligation 93.9% of the children survived beyond the perinatal phase. Before the 37th week of gestation delivery occurred in only 19.3% of the cases. According to maturity stage of the newborn and to the time period between removal of the cervical ligature and delivery we judged the effectiveness and the necessity of Shirodkar operation in the different patient groups. The results could demonstrate the high importance of this treatment especially in patients with "visible fetal membranes".(ABSTRACT TRUNCATED AT 250 WORDS)
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