Cerclage placement
From WikiAnesthesia
Revision as of 15:49, 8 January 2025 by Kelvin Kweku Ampem-Darko (talk | contribs) (I filled in the first few sections of the procedure.)
Cerclage placement
| Anesthesia type | |
|---|---|
| Airway | |
| Lines and access | |
| Monitors | |
| Primary anesthetic considerations | |
| Preoperative | |
| Intraoperative | |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Cervical cerclage placement is a procedure where the cervix is sewn closed with stitches to prevent premature labor.
Overview
Indications[1][2]
Surgical procedure[3][4]
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Airway | Evaluate for Mallampati score, upper Bite Lip test, checking for lose or chipped dentition and overall keeping in mind that the airway tends to be edematous and friable in gravid patients. |
| Neurologic | Complete a standard neurological exam, asking detailed questions about chronicity of lower back pain, any history of sciatica, spine surgery, and/or extremity weakness, numbness or tingling. |
| Cardiovascular | Obtain a brief history of the patients cardiovascular tolerance before and during pregnancy and auscultate to rule out murmurs. |
| Pulmonary | Obtain a detailed history on pulmonary diseases such as asthma, recent URI, or cough. No other special considerations beyond being aware of the standard pulmonary changes that occur in pregnancy. |
| Gastrointestinal | Confirm if the patient is on medication for GERD and verify NPO status. |
| Hematologic | Obtain a brief history on any history coagulopathy since neuraxial is a consideration for this procedure. |
| Other |
Labs and studies
Patient preparation and premedication
Regional and neuraxial techniques
Intraoperative management
Monitoring and access
Induction and airway management
Positioning
Maintenance and surgical considerations
Emergence
Postoperative management
Disposition
Pain management
Potential complications
Procedure variants
| Variant 1 | Variant 2 | |
|---|---|---|
| Unique considerations | ||
| Indications | ||
| Position | ||
| Surgical time | ||
| EBL | ||
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |
References
- ↑ Klemm, P., Vayssière, C., & Marret, H. (2020). Cervical cerclage in prevention of preterm birth: A critical review of indications and efficacy. European Journal of Obstetrics & Gynecology and Reproductive Biology, 249, 31-37.
- ↑ Lyndon, A., Smith, R. S., & McIntire, D. D. (2021). Cervical cerclage: Indications, techniques, and outcomes. American Journal of Obstetrics and Gynecology, 224(4), 455-463.
- ↑ Coomarasamy, A., Small, R., & Cacciatore, S. (2017). Cervical cerclage for preventing preterm birth in women with a short cervix. Cochrane Database of Systematic Reviews, 2017(7)
- ↑ Klemm, P., Vayssière, C., & Marret, H. (2020). Cervical cerclage in prevention of preterm birth: A critical review of indications and efficacy. European Journal of Obstetrics & Gynecology and Reproductive Biology, 249, 31-37.