Cervical cerclages can be extremely useful to prevent miscarriages or early labor for pregnant women. Although it might sound scary, this procedure is standard treatment for women with an incompetent cervix and rarely has any type of complications. Cervical cerclage is also a highly effective treatment method. Cervical cerclage is a treatment method for an incompetent cervix. Cervical incompetency is usually something that is diagnosed early in pregnancy. However, there are some women who are already at a higher risk for cervix complications and a doctor may preemptively decide to perform a cervical cerclage to avoid potential complications [3].
Some common risk factor for a weak cervix include:. Cervical cerclage is usually performed by the third month of pregnancy , or between weeks [3]. Early detection of the problem is key to preventing further issues later in the pregnancy.
Some women may need a cervical cerclage later in pregnancy due to a sudden problem of the cervix shortening or opening, this is referred to as an emergent cerclage [5].
If a woman ends up needing an emergent cerclage, this is usually a sign that future pregnancies will face the same problem [1]. If the cervix opening is detected too late, cervical cerclage may not be an option because the opening is already too large. In these cases, women may be put on bed rest to reduce the possibility of early labor.
It is always best to discuss with your doctor about the best route to take when overcoming pregnancy complications. Doctors will only suggest a cervical cerclage if they know the benefits outweigh the risks.
A cervical cerclage that is properly performed can protect your baby from miscarriage or any complications presented from being born too early. It can have life-saving results and widely regarded as the best option for an incompetent cervix [1].
In rare cases, there could be some side effects that range from mild to severe. These risks include:. Some side-effects can indicate something has gone wrong with the procedure. Contact your doctor immediately if you experience any of these side-effects after the procedure:. There are a few discussions and procedures you will have to go through before getting the cervical cerclage.
Your doctor will go through your medical history with you and discuss any other pregnancy complications you have experienced in the past. Your doctor will also discuss different pain management options for the procedure, usually recommending some kind of localized or generalized anesthesia.
A physical examination of the cervix and a transvaginal ultrasound will be given prior to the procedure so the specialist can properly see your cervix and decide how to properly sew it. Being nervous or feeling anxiety about the procedure is natural, and it may help to bring up any questions or concerns you have at the initial appointment to ease any stress.
The actual procedure for a cervical cerclage is relatively simple. After giving the anesthesia usually general, spinal, or epidural , the doctor will use a band of strong thread to sew around the cervix and tighten it until it's completely shut. He or she might elevate your uterus to gain better access to your cervix.
Next, your health care provider will use a needle to place tape around the narrow passage connecting the lower part of your uterus to your cervix and tie your cervix closed. Then he or she will set your uterus back into place and close the incision. The procedure also can be done laparoscopically. After cervical cerclage, your health care provider will do an ultrasound to check your baby's well-being. You might experience some spotting, cramps and painful urination for a few days.
Acetaminophen Tylenol, others is recommended for pain or discomfort. If your health care provider used stitches to reposition vaginal tissue affected by incisions in your cervix, you might notice passage of the material in two to three weeks as the stitches dissolve.
If you had history-indicated cervical cerclage, you'll likely be able to go home after you recover from the anesthetic. As a precaution, your health care provider might recommend avoiding sex for a few weeks or more, depending on the reason for the cerclage. If you had cervical cerclage because your cervix had already begun to open or an ultrasound showed that your cervix is short, you might need to remain in the hospital for observation.
As a precaution, your health care provider might recommend limiting physical activity and sex until delivery. Your health care provider will continue to monitor you closely for signs or symptoms of preterm labor. A transvaginal cervical cerclage is typically removed at around week 37 of pregnancy — or at the start of preterm labor. A McDonald cerclage can usually be removed in a health care provider's office without anesthetic, while a Shirodkar cerclage might need to be removed in a hospital or surgery center.
After having a transvaginal cervical cerclage removed, you'll typically be able to resume your usual activities as you wait for labor to begin naturally. If you expect to have a C-section and plan to have children in the future, you might choose to leave a Shirodkar cerclage in place throughout your pregnancy and after the baby is born.
However, it's possible that the cerclage could affect your future fertility. Consult your health care provider about your options. If you had a transabdominal cervical cerclage, you'll need to have another abdominal incision to remove the cerclage. As a result, a C-section is typically recommended. Your baby will be delivered through an incision made above the cerclage. During the C-section, you can choose to have the cerclage removed or leave it in place for future pregnancies.
Research suggests that cervical cerclage reduces the risk of premature birth in women with proven cervical insufficiency. However, the timing of cervical cerclage can also affect the outcome.
Emergency cervical cerclage done in the presence of advanced cervical change and prolapsed membranes has a poorer outcome. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Cervical cerclage Open pop-up dialog box Close. Scott, James R. Cervical Cerclage. What is a cervical cerclage? Why is cervical cerclage used?
What are alternatives to the cervical cerclage procedure? What are the benefits of a cerclage? What should I expect before my cervical cerclage is placed?
Your medical history will be reviewed A thorough exam of your cervix including a transvaginal ultrasound performed by a doctor who specializes in high-risk pregnancies Your doctor will discuss pain control options for the procedure Write down any questions or concerns you may want to discuss with your health care provider What happens during the cervical cerclage procedure?
What can I expect after the procedure? You may stay in the hospital for a few hours or overnight to be monitored for premature contractions or labor. Immediately after the procedure, you may experience light bleeding and mild cramping , which should stop after a few days.
This may be followed by an increased thick vaginal discharge , which may continue for the remainder of the pregnancy. You may receive medication to prevent infection or preterm labor.
For days after the procedure, plan to relax at home; avoid any unnecessary physical activity. Your doctor will discuss with you when would be the appropriate time to resume regular activities. Abstinence from sexual intercourse is often recommended for one week before and at least one week after the procedure. How long is the cerclage stitch left in? What are the risks of having a cerclage placed?
Possible risks could include: Premature contractions Cervical dystocia inability of the cervix to dilate normally in the course of labor Rupture of membranes Cervical infection Cervical laceration if labor happens before the cerclage is removed Some risks associated with general anesthesia include vomiting and nausea Are there signs I should look for after the cerclage is placed that indicate a problem?
It is important to contact your doctor if you experience any of the following symptoms after your cerclage is placed: Contractions or cramping Lower abdominal or back pain that comes and goes like labor pain Vaginal bleeding A fever over F or
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