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Am J Perinatol 2000; 17(8): 437-440
DOI: 10.1055/s-2000-13451
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

MODIFICATIONS TO THE MODIFIED SHIRODKAR OPERATION

Kiyoshi Uchide, Hirohisa Ueno, Hiroshi Sumitani, Hiroiku Ueno, Masaki Inoue
  • Department of Obstetrics & Gynecology, School of Medicine, Kanazawa University, Kanazawa, Japan
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Publication History

Publication Date:
31 December 2000 (online)

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ABSTRACT

In cases of cervical incompetence, the Shirodkar procedure is occasionally necessary when the McDonald procedure cannot be used due to poor cervical anatomic conditions. We have further facilitated a modified Shirodkar procedure with some modifications. A transverse incision over the anterior lip of the cervix is made and the bladder is separated from the cervix. One end of an atraumatic forceps is introduced deeply into the space between the bladder and the cervix, and the other end is pushed against the posterior fornix to grasp paracervical tissues, so that a needle is easily passed through at the tip of the forceps. The knot is placed anteriorly and a silk thread is passed around the tape in the posterior fornix to facilitate removal of the tape. This procedure resulted in no complications and greatly facilitated removal of the tape, resulting in a cervical cerclage which was comparatively easily carried out.

KEYWORD

Cervical incompetence - modified Shirodkar operation - removal of Shirodkar tape

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