Critical Care Obstetrics and Gynecology

Elective Cerclage Followed By Rescue Cervical Resuture: A Case Study

Cervical cerclage is a term given to various surgical procedures that involve placing sutures, wires or tape on the cervix as an attempt to mechanically increase the tensile strength of it. Hence, reducing the complications of cervical incompetence. Several adverse events can occur in pregnancy due to cervical incompetence like fetal loss, prolapse of the fetal membranes into the vagina and Intraamniotic infection. Cervical incompetence is the inability of the uterine cervix to retain a pregnancy in the second trimester in the absence of clinical contractions, labour, or both. The efficacy of cerclage in managing and preventing complications of cervical incompetence, versus conservative management is controversial. This case report discusses the management of a 40-year-old female, G3P0A2, who presented at 23+3 weeks of gestation, on a cervical cerclage, complaining of mild PV spotting. When examined it was found that her cervical os was 3 cm-4 cm dilated and the amniotic membrane bulging through the external os, without any fetal parts. The patient did not have any abdominal pain. She was taken for a rescue cervical resuture. Postoperatively she was managed with complete bed rest, prophylactic clexane and IV antibiotics.

Author(s):

 Fatema Al Hubaishi*, Saeeda Albalooshi and Bina Suresh

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