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Importance of cervical cerclage to maintain successful pregnancy

17 June 2020

Cervical insufficiency (also known as incompetent cervix) occurs when the cervical tissue is too weak to maintain an otherwise healthy pregnancy. It is a rare condition, occurring in only 1-2% of all pregnancies and usually within the first 24 weeks.

Importance of cervical cerclage to maintain successful pregnancy

The rate of cervical insufficiency and preterm birth related to a short cervix is twice as likely to occur in black women when compared to white and Hispanic cultures.

Cervical cerclage is a treatment where a stitch is placed around the cervix when it begins to shorten and open too early. It is usually done between 12 and 14 weeks of pregnancy, although occasionally it may be done at later stages in pregnancy when there is evidence that the mother’s cervix has started to dilate prematurely.

Studies show that the application of cervical cerclage in pregnant women with previous preterm delivery reduces the preterm delivery rate at a reasonable cost with no additional risk to the mother and the fetus. The overall success rate of cervical cerclage was found to be 80% in the age of less than 30 years.1

In a review of cervical cerclage procedures carried out to compare the success rate and morbidity of the McDonalds and Shirodkar techniques, it was established that before elective procedures were introduced the fetal survival rate in McDonalds operations was 19%, rising to 78% after introduction. A similarly positive result was witnessed with the Shirodkar technique, which saw a 67% increase in fetal survival rate after the introduction of elective procedures.2

Source: Blausen Medical Communications 

Limbs & Things is proud to offer a new Cervical Cerclage training module for the PROMPT Flex range. This model allows for learners to build confidence as well as obtain and maintain competence by practicing the procedure safely, without the risk of causing harm to a pregnant woman or fetus.  

Two leading obstetric experts, Dr. Graham Tydeman, Consultant Obstetrician & Inventor, NHS Fife, and Professor Andrew Shennan OBE, Consultant Obstetrician and Director of the Clinical Trials Unit in the Women’s Academic Health Centre, partnered with the Limbs & Things development team to create a  realistic training solution for cervical cerclage.

Dr. Tydeman and Prof. Shennan OBE, use the PROMPT Flex Birthing Simulator for teaching and training, and have rigorously tested the module to ensure it meets the standards needed to teach and maintain the skill of cervical cerclage. The cost-effective design facilitates training in the most common cervical cerclage technique, the McDonalds technique, whilst learners also have the option to use the versatile module for elective and emergency procedures.

‘It’s great that the cervix travels down the vagina but that traction is needed to keep it in place, that’s very realistic. As is the restricted space to perform the procedure. It makes placing the cerclage high up the cervix challenging, just as it is in life.’

For more information on the Cervical Cerclage module and how it can be used in conjunction with other modules of PROMPT Flex Range in a well-rounded classroom setting contact our team.

 

References:
1: Success Rate of Cervical Cerclage in Preventing Preterm Labor/Journal of Pregnancy and Child Health
2: Comparison of success and morbidity in cervical cerclage procedures/Europe PMC