Recent Management of Cervical incompetence.

Lee, Keun Young

Review

Korean Journal of Obstetrics & Gynecology 2005;48(5):1093-1105.
Published online May 1, 2005.

Recent Management of Cervical incompetence.

Keun Young Lee

Department of Obstetrics and Gynecology, Hallym University College of Medicine, Seoul, Korea. mfmlee@hallym.ac.kr

Abstract

Treatment of incompetent cervix has traditionally been surgical correction of presumed physical deficit in tissue strength with an encircling or cerclage suture, placed electively between 12 and 15 weeks or urgently in the second trimester. Despite the prolonged controversy about the role of cerclage, a randomized trial of cerclage versus bed rest or no therapy in women with atypical history of incompetent cervix has not been concluded. Until conclusive information is available, clinicians challenged to make the best management decision or each patient based on her history and cervical examination. Women with either a typical history of recurrent midtrimester delivery in the absence of another diagnosis or with atypical history accompanied by significant cervical effacement should be offered treatment with cerclage accompanied by an acknowledgement that it's efficacy is unproven. A cerclage operation may be considered during pregnancy in four clinical setting which is elective cerclage, urgent cerclage, emergency cerclage, transabdominal cerclage.

Key Words: Cervical incompetence, Elective cerclage, Urgent cerclage, Emergency cerclage, Transabdominal cerclage, Management