The surgical procedure here described aims to prevent premature birth and fetal wastage caused by weakness of the musculature of the cervix uteri. The operation, devised by Shirodkar, consists of the application of a purse string or tourniquet to the cervix. It is indicated only for patients who have a history of repeated unexplained miscarriages during the second trimester and who demonstrate a progressive cervical effacement and dilatation between the 14th and 28th weeks of gestation. It was performed in 40 patients who had had 182 previous pregnancies with 20 premature and only 15 full-term infants surviving. Among the 40 patients after operation, only 8 had unsatisfactory results, for reasons here analyzed, while 32 delivered normal infants, including two sets of twins. Ten deliveries occurred per vaginam after removal of the purse string, and 22 were cesarean.
Taylor ES, Hansen RR. INCOMPETENT OS OF THE CERVIX AS A CAUSE OF FETAL LOSS. JAMA. 1959;171(10):1312–1315. doi:10.1001/jama.1959.03010280036009
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