Labor outcomes after Shirodkar cerclage.

ABSTRACT

OBJECTIVE: To describe labor outcomes in women who had a Shirodkar cerclage placed during pregnancy and removed before labor. METHODS: A review was conducted of 69 patients with a singleton pregnancy and a Shirodkar cervical cerclage placed before 24 weeks' gestation. Indications for cerclage were history indicated, ultrasound indicated or physical examination indicated. RESULTS: The mean time from cerclage removal to delivery was 9.4 +/- 8.8 days. The overall cesarean delivery rate was 18.8%, with the majority (9 of 13) being for fetal indications. Two (2.9%) patients had a uterine rupture of an unscarred uterus and 2 (2.9%) patients had an umbilical cord prolapse. Four (5.8%) patients had a cervical laceration requiring repair. CONCLUSION: Patients with a Shirodkar cerclage placed and removed during the index pregnancy appear to have a higher than expected rate of cesarean delivery for fetal indications and complications associated with significant neonatal morbidity including uterine rupture and cord prolapse.