Cervical Cerclage: Anesthetic Management

Cerclage, or surgical reinforcement of the cervix, is primarily used to prevent preterm birth in patients with cervical insufficiency. Cerclage is most often performed transvaginally, either the McDonald or the more invasive Shirdokar (Antiseptic 1955;52:299), though transabdomianl cerclage can be performed if there is insufficient cervical tissue for transvaginal cerclage or if prior transvaginal cerclage has failed. The major risk for cerclage is rupture of fetal membranes. Cerclage can be placed primarily (prophylactically) before pregnancy or before observed cervical change, secondarily (when cervical changes are noted), or emergently (often for exposed fetal membranes).
 

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