Cervical cerclage

Cervical cerclage is a procedure in which sutures are inserted around the cervix in women suspected to have cervical weakness. This is thought to prevent cervical dilatation and membrane exposure, thus helping the uterus to retain the pregnancy in women who are prone to miscarrying, mostly in the mid-trimester. It was first described over 50 years ago by Shirodkar, followed by McDonald. It has been widely practised in different parts of the world with variable results. This procedure can be performed as either a planned or an emergency operation depending on the clinical situation. Based on the indication, the approach could be vaginal or abdominal. Despite having been practised widely, uncertainty still exists with regard to its indications, patient selection, effectiveness and adverse effects. Counselling patients of the possible outcome of the procedure in terms of success needs to be individualised. In this article, we revisit the basics of this condition, along with the available evidence for its practice.