It was reported via journal article: "title: emergency cervical circlage for cervical incompetence." authors: m.Ratnavale and k.Arumugam.Citation: journal of obstetrics and gynaecology.1997; 17(1): 49-50.Doi: 10.1080/01443619750114095 a total of 12 patients underwent emergency cervical cerclage for inevitable middle trimester abortion due to cervical incompetence at the university hospital, kuala lumpur from march 1989 to june 1992.Six patients underwent cerclage as described by mcdonald and 6 patients had a minor modification of the shirodkar method.In both methods, mersilene tape (ethicon) was used.During the modified shirodkar method, a needle carrying the mersilene tape was threaded around the cervix, commencing at the anterior incision.It was tunnelled below the cervical mucosa towards the right, coming out at the posterior incision.The process was repeated on the other side to complete the cerclage commencing anteriorly, towards the left and coming out through the posterior incision.The knot was tied posteriorly with the inflated foley catheter balloon in situ.This ensures that the knot is not excessively tight.Reported post-operative complications included evidence of infection (n-8) which required routine and prophylactic antibiotic therapy.The authors confirmed that cervical cerclage is technically possible despite the dilatation of the cervical os.The authors recommended the use of emergency cervical cerclage in the management of cervical incompetence during the middle trimester for patients who present with some dilatation of the cervix.
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