Major proceduresFree in the app
Cervical cerclage
Suture to support the cervix in women at risk of mid-trimester loss.
Source: RCOG GTG 75 (2022)Indications
| History-indicated | ≥3 previous preterm births and/or 2nd-trimester losses — place at 12–14 weeks. |
|---|---|
| Ultrasound-indicated | Previous preterm birth or 2nd-trimester loss + cervix ≤25 mm before 24 weeks. |
| Rescue | Dilated cervix with exposed membranes — senior decision. |
| Transabdominal | Previous failed vaginal cerclage — ideally before pregnancy; laparoscopic preferred. |
Steps
- Spinal anaesthesia; lithotomy; hold cervix with sponge forceps.
- McDonald: purse-string Mersilene tape at cervicovaginal junction, 4–6 bites, no dissection; tie anteriorly, ends long.
- Shirodkar: push bladder (and rectum) back; suture at level of internal os; bury it.
Remove vaginal cerclage at 36+0–37+0 weeks, in preterm labour, or at planned CS. Transabdominal stitch: birth by CS.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.