Shirodkar procedure following failed cervical cerclage: Guidelines on the management of cervical incompetence

G. B. Candiani, M. Gargiulo, M. Candiani, M. Passafaro

Research output: Contribution to journalArticle


With the aim of evaluating if Shirodkar cerclage is appropriate for patients at high risk of cervical incompetence, we performed a retrospective analysis of the results obtained with this procedure performed over an 8- year period by a single surgeon in 65 women in whom previous cerclage(s) had proved unsuccessful. The women were divided into three groups according to indication for cerclage as follows: (I) 31 women considered at high risk of cervical incompetence based on their obstetric history or altered cervical conditions, 16 of whom had had two or three cerclages without success, (II) 9 women with prolapse of the amniotic sac who required emergency Wurm-Hefner cerclage, and (III) 25 women with a history of conservative operations on the uterus who underwent a prophylactic Shirodkar cerclage (experimental management). The pregnancy outcome was not known in 7 cases. A full-term pregnancy (≤37 weeks of gestation) was achieved in 44 women, and premature delivery (34-36 weeks) occurred in 7 and very premature delivery (24-26 weeks) in 2, for a total of 51 viable fetuses. The live birth rate was 88%. In conclusion, Shirodkar cerclage is useful in real cervical incompetence even in women who have already undergone repeated cerclages.

Original languageEnglish
Pages (from-to)117-124
Number of pages8
JournalJournal of Gynecologic Surgery
Issue number3
Publication statusPublished - 1997

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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