title: Labor outcomes after Shirodkar cerclage.
abstract: OBJECTIVE
  To describe labor outcomes in women who had a Shirodkar cerclage placed during pregnancy and removed before labor.
  
  
  METHODS
  A review was conducted of 69 patients with a singleton pregnancy and a Shirodkar cervical cerclage placed before 24 weeks' gestation. Indications for cerclage were history indicated, ultrasound indicated or physical examination indicated.
  
  
  RESULTS
  The mean time from cerclage removal to delivery was 9.4 +/- 8.8 days. The overall cesarean delivery rate was 18.8%, with the majority (9 of 13) being for fetal indications. Two (2.9%) patients had a uterine rupture of an unscarred uterus and 2 (2.9%) patients had an umbilical cord prolapse. Four (5.8%) patients had a cervical laceration requiring repair.
  
  
  CONCLUSIONS
  Patients with a Shirodkar cerclage placed and removed during the index pregnancy appear to have a higher than expected rate of cesarean delivery for fetal indications and complications associated with significant neonatal morbidity including uterine rupture and cord prolapse.
authors.affiliation: Maternal Fetal Medicine Associates, PLLC, 70 East 90th Street, New York, NY 10128, USA. nfox@mfmnyc.com
authors.forename: Nathan S
authors.initials: NS
authors.lastname: Fox
authors.forename: Andrei
authors.initials: A
authors.lastname: Rebarber
authors.forename: Samuel
authors.initials: S
authors.lastname: Bender
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Saltzman
mesh_terms: D000328:Adult; D023802:Cerclage, Cervical / Q000009:adverse effects / Q000295:instrumentation*; D015331:Cohort Studies; D036861:Delivery, Obstetric; D020878:Device Removal; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D011247:Pregnancy; D012189:Retrospective Studies; D013537:Sutures / Q000009:adverse effects; D013997:Time Factors; D002581:Uterine Cervical Incompetence / Q000601:surgery*