COMPARISON OF SUCCESS AND MORBIDITY IN CERVICAL CERCLAGE PROCEDURES

  • 1 January 1980
    • journal article
    • research article
    • Vol. 56  (5) , 543-548
Abstract
A review of 251 cervical cerclage procedures in 205 women over a 7.5 yr period was conducted to compare the success rate and morbidity of the Shirodkar and McDonald techniques. Fetal survival rate was 19% before 139 elective McDonald operations and 20% before 63 elective Shirodkar procedures. Fetal survival was 78% after elective McDonald operations and 87% after elective Shirodkar procedures, a difference that is not significant (P > 0.05). Fetal survival rate was 53% after 30 emergency McDonald and 68% after 19 emergency Shirodkar procedures, a difference not significant. Major postoperative morbidity occurred in 2.0% of the elective cerclage procedures and acute chorioamnionitis accounted for 1/2 the complications (1.2%). Mean blood loss was 30 ml with McDonald operations and 44 ml with Shorodkar procedures; the maximum blood loss of 150 ml occurred in 2 emergency operations. Cervical laceration at parturition occurred more often with Shirodkar (11%) or McDonald (14%) procedures than with the 55,688 other deliveries (2.18%) during the 7.5 yr study period (P < 0.001). Cervical scarring and elective cesarean section (P < 0.025) increased the cesarean section rate to 16% after McDonald procedures and 25% after Shirodkar procedures.