Surgical treatment of incompetent cervix during pregnancy by Saito modification of Shirodkar operation.

The Shirodkar operation for the treatment of cervical incompetency during pregnancy was modified by Motoi Saito of our department and has been adopted since 1974. This paper describes the operative techniques of the procedure and reviews the results of 34 cases treated by the modification during the last 10 years. The rate of success was 76.5% for the post-operative delivery after completing 37 weeks of gestation, and, if the 17.6% of the viable premature births were included, the fetal salvage rate by the procedure was 94.1%. The Saito modification procedure provides easy identification of the cervical cerclage ligature and facilitates the complete removal of the suture before or during labor. The 10-year results suggest that the procedure was as effective as the original Shirodkar operation for the prevention of premature birth and fetal loss due to incompetent cervix during pregnancy.