Emergency Cerclage: Outcomes, Patient Selection, and Operative Considerations.
Emergency cerclage refers to a cerclage placed during the second trimester in a woman noted to have painless cervical dilation. Although randomized-controlled trials are limited, observational studies suggest an improvement in neonatal outcomes in selected patients undergoing an emergency cerclage. Labor and chorioamniontis are contraindications for cerclage placement. Advanced dilation (>3 to 4 cm) and a later gestational age (22 to 24 wk) are associated with poorer outcomes. This chapter reviews the indications, outcomes and perioperative management strategies for cerclage placement in this setting.
Vincent Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Mariam
M
Naqvi
William H
WH
Barth
D000649:Amniocentesis; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D023802:Cerclage, Cervical / Q000009:adverse effects / Q000379:methods; D004630:Emergencies; D005260:Female; D006801:Humans; D018579:Patient Selection; D019990:Perioperative Care; D010808:Physical Examination; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D013537:Sutures; D015149:Tocolytic Agents / Q000627:therapeutic use; D014463:Ultrasonography; D002581:Uterine Cervical Incompetence / Q000601:surgery*
D000900:Anti-Bacterial Agents; D015149:Tocolytic Agents