Surgery to Close the Cervix (Cervical Cerclage)
What is cervical cerclage?
Cervical cerclage is a surgical procedure used to keep the cervix closed during pregnancy. Cervical cerclage is also called the stitch to keep your cervix closed in pregnancy. The cervix is the lowest part of the uterus and extends into the vagina. During normal pregnancy it remains closed until the third trimester.
When is it used?
Cervical cerclage is used to prevent a miscarriage or premature delivery if you have an incompetent cervix. An incompetent cervix is a cervix that opens without labor too early in a pregnancy, causing the baby to be born before it is due. Stitching around the cervix helps keep it closed as the baby grows. The procedure may be used if you have a history of miscarriages during the second trimester of pregnancy.
If you have a history of second-trimester miscarriages, a cerclage may be done at the beginning of your second trimester. Otherwise, it may be done at the time your healthcare provider finds that your cervix is opening too early (as long as you are not yet having contractions).
Additional treatments for an incompetent cervix include bed rest that may last for several months and not having sexual intercourse. These other treatments alone are not very effective.
How do I prepare for the procedure?
Follow instructions provided by your healthcare provider. If you are to receive a general anesthetic, eat a light meal such as soup or salad the night before the procedure. Do not eat or drink anything after midnight before the procedure. Do not even drink coffee, tea, or water.
What happens during the procedure?
You will be given a general, spinal, or epidural anesthetic. Your healthcare provider will then stitch 1 or 2 bands of strong suture thread around your cervix. He or she will tighten the thread to hold the cervix firmly closed.
What happens after the procedure?
- You may stay in the hospital for several hours or overnight so that you can be monitored for premature contractions or labor.
- Your healthcare provider may give you medicine to reduce the chance that the procedure will start premature labor.
- Ask your provider if and when you can have sexual intercourse again during the pregnancy.
How long is the cerclage thread left in?
The thread is removed when your provider decides the baby is mature and safe to deliver. This is generally around the time of the 37th week of pregnancy. If you have contractions or your bag of water breaks while the thread is still in, call your provider right away.
If your baby is born by C-section rather than vaginally, the thread is usually removed after the C-section is done. Sometimes the thread is left in.
What are the benefits of this procedure?
Cervical cerclage prevents miscarriage or premature delivery caused by cervical incompetence. The procedure is successful in 85 to 90% of cases. You may need cervical cerclage again for each of your next pregnancies.
What are the risks?
- There are some risks associated with each kind of anesthesia. Discuss the risks of anesthesia with your healthcare provider.
- The procedure may cause premature labor.
- It may cause the bag of water to rupture.
- The cervix may become infected. An infection may cause fever, chills, cramping, or a bad-smelling vaginal discharge. An infection could infect the baby or cause premature labor.
- If you go into labor with the stitch in your cervix, your contractions may tear open your cervix. It is important that the stitch be removed before or during early labor. It is usually taken out without anesthesia.
- The procedure could damage the bladder or the rectum.
All of these complications rarely occur.
When should I call my healthcare provider?
Call your provider if you have any of the following symptoms:
- contractions
- lower abdominal or back pain that comes and goes like labor pains
- vaginal bleeding that seems to be more than your healthcare provider has told you to expect
- a fever over 100.5°F (38°C)
- chills
- a bad-smelling vaginal discharge
- rupture of the membranes (your bag of water breaks)
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Published by RelayHealth.
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