Loading

Specialties Calculators

Specialties Calculators

Loading

Twitter

Disclaimer

Gas Cookbook is a quick-reference for healthcare professionals. Recipes are example plans and calculators reproduce published formulas; check every dose against the BNF and your local protocols and adapt to the patient in front of you. Our liability is limited as set out in the Terms; nothing excludes liability that cannot be excluded by law. Read the full disclaimer.

About

FAQs
Contribute
Privacy Policy
Terms & Conditions
Disclaimer

Helpful Links

Specialties
Calculators
Sign In

© 2026 Healthcare Design Studio Ltd. All rights reserved.

Healthcare Design Studio Ltd is registered in England and Wales, company no. 16672830.

Specialties Calculators Cookbook Sign In

Loading

Gas Cookbook | Cervical Cerclage

Cervical Cerclage

Cervical Cerclage

Regional · 30–60 min

Indications

History-indicated (12-14 weeks)
Ultrasound-indicated (14-24 weeks)
Rescue with membranes at or through the os (up to 26-28 weeks)

Preparation

Aspiration prophylaxis from 18-20 weeks or if symptomatic: Omeprazole40mg PO
Left lateral tilt from 20 weeks

Aim for T10 - S4 block

NeuraxialSpinal

Prilocaine2% hyperbaric, 2.5 ml (50mg) + Fentanyl15mcg

Surgical block 60-90 minutes.

Positioning

PositionLithotomy(Left lateral tilt from 20 weeks)

Haemodynamics

PhenylephrineIf required
NIBP 2-3 min cycles until the block settles

Anti-emetics

Cyclizine50mg first line in first trimester
Ondansetron4mg

Analgesia

Paracetamol1g, QDS
Dihydrocodeine30mg, QDS PRN

Elective at 36-37 weeks, earlier for labour, ruptured membranes or infection
McDonald - often no anaesthetic, or Entonox in delivery suite
Shirodkar or a buried suture - spinal, same doses as insertion
Already labouring with a working epidural - top up and remove

Details

Specialty: Obstetrics
Author: Gas Cookbook
Procedure: Spinal
Updated: Oct 2026

Example plan written by a clinician, not medical advice. Check every dose against the BNF and your local protocols and adapt to the patient in front of you. You remain responsible for every clinical decision. Disclaimer

Related

Perianal Abscess I&DGeneral Surgery · GA · LMA · Volatile · 30 min
Elective LSCS (Single Shot Spinal)Obstetrics · Regional · Spinal · 1 h
Elective LSCS (Combined Spinal Epidural)Obstetrics · Regional · Combined Spinal Epidural · 1 h