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Indian Journal of Obstetrics and Gynecology

Volume  8, Issue 2, April – June 2020, Pages 37-44
 

Original Article

Foetal Salvage by Modified McDonal’s Method

Madhubala Chauhan, Mona Nagar, Rekha Garasiya

1Professor and Head, 2Resident, 3Senior Resident, Department of Obstetrics and Gynecology, Ravindra Nath Tagore Medical College, Udaipur, Rajasthan 313001, India.

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DOI: http://dx.doi.org/10.21088/ijog.2321.1636.8220.6

Abstract

Background: Cervical cerclage is the main stay of surgical treatment for cervical insufficiency and is reasonable in the following situations. Cerclage can be accomplished either transvaginally or transabdominally. Aim: To evaluate the effectiveness of cervical cerclage by modified McDonald’s method in form of better perinatal, foetal and maternal outcome. Materials and Methods: This is a prospective cohort study conducted on 100 ANC pregnant women with history of previous spontaneous preterm birth, previous 2nd trimester abortion, previous early and late recurrent foetal loss and women with short cervix in pregnancy at PDZH, Udaipur. Result: Mean age 25.94±3.69 years, mean gravida 2.71 ± 1.27, mean gestational age at time of cervical cerclage 18.1 ± 3.76 weeks. Mean good APGAR among
93 live births was 94% babies between 7–10. Among 3 neonatal death all babies were <2.5 kg (p < 0.05). Maximum patient reach at term who had cervical cerclage between 14–18 week i.e. 49% (p < 0.05). In short cervix cases total foetal salvage by modified McDonald’s method is 84.61%, abortion 7.69%, NICU admission 23.07% and neonatal death is 7.69%. Conclusion: Cervical cerclage is a simple procedure, require little surgical expertise but has very good results. Advantage of our method over McDonald’s method is that it is simpler procedure having less stitches on cervix so that less chances of haemorrhage, at the time of surgery or postsurgery. Round body prolene suture does less trauma to cervix and less chances of infection to genital tract in comparison to
braided silk suture.
 


Keywords : Cervical cerclage; McDonald’s method; Prolene suture.
Corresponding Author : Mona Nagar