Cervical Cerclage
What is cervical cerclage?
Cervical cerclage is a surgical procedure used to keep the cervix closed during 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. 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 Dr. Hardy finds that your cervix is opening too early. An alternative treatment for an incompetent cervix is bed rest that may last for several months.
How do I prepare for the procedure?
This procedure is done in Labor and Delivery. You will be monitored after the procedure for several hours so plan to have someone drive you to and from the appointment.
What happens during the procedure?
You will be given a spinal or epidural anesthetic. Dr. Hardy will then stitch 1 or 2 bands of strong thread around your cervix. He 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. This will be done in Labor and Delivery Antepartum Unit on the 3rd floor of Chesapeake Regional Memorial Hospital. Dr. Hardy may give you medicine to reduce the chance that the procedure will start premature labor.
You will not be able to have sexual intercourse until after your 6 week postpartum appointment. You may also be placed on bedrest for a few weeks or until the end of the pregnancy.
How long is the cerclage thread left in?
The thread is removed when Dr. Hardy decides the baby is mature and safe to deliver. This is generally around the time of the 36th or 37th week of pregnancy. If you have contractions or your bag of water breaks while the thread is still in, call the office right away. If your baby is born by C-section rather than vaginally, the thread may be left in.
What are the benefits of this procedure?
Cervical cerclage may prevent miscarriage or premature delivery caused by cervical incompetence. The procedure is successful in 85% to 90% of cases. A cerclage procedure may need to be done for each of your next pregnancies.
What are the risks?
There are some risks associated with a cerclage and they are:
- risks associated with a spinal or epidural anesthesia
- premature labor
- 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 or could infect the baby or cause premature labor.
If you go into labor with the stitching in your cervix, your contractions may tear open your cervix. It is important that the stitching be removed before or during early labor. It is usually taken out without anesthesia. All of these complications rarely occur.
When should I call the office?
Call the office if you have:
- contractions
- lower abdominal or back pain that comes and goes like labor pains
vaginal bleeding that seems to be more than your provider has told you to
- fever over 100.5°F (38°C)
- chills
- a bad-smelling vaginal discharge
rupture of the membranes (your bag of water breaks)
In some cases these tests find no reason for abnormal AFP results and this would be referred to as a false positive.
