Expert: Lawrence Jay Rappaport <B>M.D.</B> - 10/18/2005

Question
Hi there,

I thought Shirodkar and Mcdonald are stitching only. TAC is also a stitich but need to be done by an incision at the abdominal while the 2 other procedure is done through the vagina right? the reason why I said the other two procedure has higher risks of infections were because our vagina are more prone to bacteria and we can easily get infections. Just one more question, if you were my dr. which of the three procedures above would you recommend me to go for. Which would be safer and bring the baby to term?Please advise. Thanks.

Karen

Answer
You are correct. Both cerclages are performed through the vagina. The TAC is performed through an abdominal incision as well as through the vagina.There is always a risk for infection whenever dealing with the cervix (in eaither route). I always use the McDonald cerclage because I have had good success with it. It is safe and has a good success rate. There aree failures, however, so I don't want you to think it is foolproof. I do not know your entire history and have not examined you or evaluated your sonogram, so I can't tell you what to do. You will have to carefully discuss it again with your obstetrician and ask for the pros and cons of each procedure. Good Luck.