Cervical cerclage is a method of suturing and keeping the cervix closed during pregnancy. It prevents premature birth due to a weak cervix. If the cervix weakens, the doctor may prescribe a cerclage procedure to keep the fetus healthy until delivery. Stay with us to learn more about cervical cerclage, its types, purpose, and risks in pregnancy.
Cervical Cerclage Definition
Cervical cerclage is a surgical intervention that consists of stitching around the cervix (uterine cervix). The purpose of the sutures is to prevent the cervix from shortening and dilating, thus reducing the risk of premature birth. The effectiveness and safety of performing this procedure in multiple pregnancies is still a matter of debate.
Cervical Cerclage Definition
For pregnant women who have a weak and loose cervix, a gynecologist prescribes this procedure, which helps the fetus to be preserved until the time of delivery. As a consequence, the doctor puts one or more stitches in the opening of the cervix to keep it closed during pregnancy. The cervix is the lower part of the uterus or the opening. As an example, the uterus is a bag, and the cerclage can be similar to straps that keep a bag closed.
In this method, which is usually performed between 14 and 18 weeks of pregnancy, the cervix is closed using stitches. In emergencies, cerclage may be performed at week 25 or even later.
Cervical Cerclage Types
There are several types of cervical cerclage procedures, each customized to specific medical needs and conditions. The major types of cerclages include:
McDonald Cerclage
McDonald cerclage is the most common type and closes the cervix with a sac-shaped suture pattern and is performed using a permanent suture.
Shirodkar Cerclage
The method is permanent and is used in women who are not able to do the McDonald cerclage method. With Shirodkar cerclage operation, the cervix is stitched from the inside. The stitch is placed around the cervix (neck of the womb).
Transabdominal Cerclage
In this method, the upper part of the cervix is stitched, and these stitches are not to be opened until delivery. Transabdominal cerclage is considered a permanent method. This cerclage is recommended when the previous two methods are not possible.
Emergency Cerclage
To close the cervix is in an emergency when the cervix is too open, and there is a possibility of miscarriage at any moment. This condition is called rescue stitch.
Cervical Cerclage Types
Cervical Cerclage Purpose
Here are some of the purposes of cervical cerclage:
- Strengthening the cervix and preventing its premature opening in women who have a weak cervix.
- Cervical cerclage for prevention in women with structural abnormalities of the cervix.
- Preventing and reducing the possibility of premature birth: If you have symptoms of premature birth, you should see a doctor.
Prevention method in women who have a history of frequent miscarriage. First, the reasons for frequent abortions should be investigated.
Who Can Have Cervical Cerclage?
Naturally, this operation cannot be prescribed for all people. Cerclage is only performed during particular conditions based on a diagnosis from the physician.
Which group of Individuals is Cervical Cerclage not Suitable for?
It will not be necessary to perform cervical cerclage if the length of the cervix is less than or equal to 25 mm before the 24th week of pregnancy and the patient does not have a history of premature singleton delivery. Even if the cervix begins to dilate very early, it is not a suitable option for cerclage if the patient has the following conditions:
- Infection in the uterus
- premature birth
- Vaginal bleeding
How Long is Cervical Cerclage Surgery?
This procedure is usually very short-term and will not take much of your time. Usually, this surgery takes about an hour.
Cervical Cerclage Surgery
Preparation for Cervical cerclage Surgery
First, you should see your obstetrician and gynecologist and get detailed information about the cerclage process, its pros and cons, and the post-procedure. After examining and reviewing the patient’s records, the doctor prescribes tests such as blood tests, ultrasound, and other diagnostic tests to assess the mother’s health.
Cervical Cerclage Procedure
Cervical cerclage is performed using one of McDonald, Shirodkar, or abdominal methods. Depending on the condition of the patient, after examining the health status of the mother and the baby, one of the methods of local, spinal, or epidural anesthesia is chosen to anesthetize the patient.
In some cases, the cervix is also numbed using local anesthetics. Even in mothers who have specific problems, the use of anesthesia is possible. After preparing the patient, the doctor inserts a speculum into the vagina to keep it open and then performs surgery using one of the McDonald or Shirodkar methods. The methods of performing these two types of surgery are different from each other, but the results are the same.
If using the above methods is not possible or fails, the gynecologist connects the cervix to the upper parts by making an incision on the patient’s abdomen. In the transabdominal cerclage method, due to the complete closure of the cervix, delivery must be performed by the cesarean section.
The price of Cervical Cerclage Surgery
The price of cerclage depends on various factors, including the central geographic location where the operation is performed, the equipment used, and the expertise and skill of the doctor. To know the price of cerclage, you can contact your desired clinic or health center.
Price of Cervical Cerclage Surgery
Benefits of Cervical Cerclage
The benefits of cerclage are as follows:
- Prevent premature birth due to weak cervix
- Birth of a healthy baby
- Prevention of unwanted abortion
- Remaining of the fetus in the mother’s womb during normal time
Cervical Cerclage Risks
During the first 24 hours after the operation, the patient may face complications such as rupture of the cervix, bleeding, damage or trauma to the cervix, rupture of the water sac and premature birth, fever, and severe infection of the mother. Other complications of this procedure include:
- Infection
- Heavy and prolonged bleeding
- Swelling, pain, warmth, and redness in the cervical area
- Increased pressure in the cervix and increased risk of uterine failure
Recovery and Care After Cervical Cerclage
After the cervical cerclage procedure, having complete rest is of key importance. Be cautious about your doctor’s orders, take absolute rest with no heavy activities, and avoid long walks seriously. If the doctor has prescribed anti-inflammatory drugs and antibiotics, be sure to take them on time and accurately.
How to Sleep after Cervical Cerclage
How to sleep after cerclage is important in that a position should be chosen that puts the least pressure on the area. The best sleeping position after cervical cerclage is to sleep on the left side for the first few days.
Cervical Cerclage Recovery
Final Word
Cervical cerclage is a surgical procedure that is performed to prevent premature birth and miscarriage during pregnancy. The cervix is sutured. In this procedure, the gynecologist sews around the cervix to increase the strength of the uterus and prevent the early opening of the uterus and premature delivery that results in unwanted abortion.
This medical operation is prescribed for women who have a history of frequent miscarriages and suffer from uterine weakness. This procedure is usually performed in the first months of pregnancy and depends on the conditions before or after the 20th week of pregnancy. Before deciding on a cervical cerclage, it is better to consult with a good obstetrician and check its advantages and disadvantages in detail.
