Journal of International Obstetrics and Gynecology ›› 2016, Vol. 43 ›› Issue (6): 605-608.

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The Past,Present and Future of Cervical Cerclage

LI Tin-chiu,XIAO Yu   

  1. Department of Obstetrics and Gynecology,Chinese University of Hong Kong,Prince of Wales Hospital,Hong Kong 999077,China(LI Tin-chiu);Center of Hysteroscopy Diagnosis and Treatment,Fu Xing Hospital,Capital Medical University,Beijing 100038,China(LI Tin-chiu,XIAO Yu)
  • Received:1900-01-01 Revised:1900-01-01 Published:2016-12-15 Online:2016-12-15
  • Contact: LI Tin-chiu

Abstract: Cervical incompetence, an important cause of mid-trimester loss or preterm birth, is characterized by painless cervical dilation in the absence of uterine contractions or bleeding. Cervical cerclage has been used for many years to treat cervical incompetence. This review will focus on a number of practical issues relating to cervical cerclage, namely, diagnosis,indications,contraindications for cervical cerclage, choosing the surgical approach(vaginal, laparoscopy and laparotomy), deciding when to do it (before or during pregnancy), finding out if the suture has been correctly placed, and considering when to use medical adjuvant therapy such as progesterone and antibiotics and when to removal of cervical suture. Laparoscopic cervical cerclage is becoming increasingly popular especially as a recent report suggested that it is no longer necessary to dissect the bladder away from the lower segment of the uterus in order to insert the cervical cerclage(simplified laparoscopic cervical suture). It means that learning how to perform the procedure is easier, with a shorter learning curve. The finding has far reaching implications and will undoubtedly change clinical practice in the near future.