Cervical Cerclage is a treatment done for cervical insufficiency or incompetence which may lead to late miscarriage or preterm birth during pregnancy when the cervix starts to shorten or open too early. Cervical Cerclage is recommended to women in order to prevent premature labour. Cervix is basically the lowest part of the uterus which extends into the vagina of the woman. It is a funnel-shaped tissue from where the baby comes out of the uterus and through the vagina during childbirth.
The Cervical Cerclage treatment helps to prevent the early changes in a woman’s cervix. For the woman who has had one or more late miscarriages in the past, it is advisable to undergo the treatment in the first or second trimester of pregnancy. The procedure is done at the surgical centre or at a hospital where the patient can go home on the same day after the procedure.
Doctors advised getting the patient examined routinely to avoid any further complications. The Successful procedure leads to full-term pregnancy with less risk involved. There are various methods for performing Cervical Cerclage, including transvaginal surgery, transabdominal surgery, and Transvaginal Cervico-Isthmic surgery.
Who are eligible candidates for the Cervical Cerclage procedure?
Doctors recommend Cervical Cerclage to women with a high risk of cervical incompetence. If the woman has weakened cervix, doctors may insert a stitch in the cervix. This is done in the 24th week of the pregnancy if the cervix begins to open early or shortens. There are various factors which can make the cervix weaken that includes previous miscarriage or premature delivery.
Why Cervical Cerclage is done?
As the baby grows, the pressure on the cervix may cause the cervix to start to open before the baby is ready to be born. Cervical Cerclage is done when the cervix is weak and there is a possible chance of it getting open. Although Cervical cerclage cannot be performed for those who are dilated more than 4 centimetres, or have ruptured membranes where the foetus has died. A weak cervix can be due to the following factors –
- A ‘LEEP’ Procedure or a previous ‘cone biopsy’
- Due to abortion, chances of the damaged cervix
- Due to second trimester miscarriages or pregnancy loss with painless dilation of the cervix
- If the patient has cervical cerclage during the previous pregnancy
When can a Cervical Cerclage treatment be used?
Cervical Cerclage procedure can be done in the third month i.e. in the 12 to 14 weeks of pregnancy. The procedure can be done at a later stage of the pregnancy as well which is known as emergent cerclage. It is necessary to proceed with the changes such as shortening or opening of the cervix. Future pregnancies might require a cervical cerclage if an emergent cerclage is performed.
What can you expect before the Cervical Cerclage procedure?
Before the procedure begins, an ultrasound image of the womb is done by the doctor to check the baby’s growth and health. The doctor may also check if there is any infection. If there is any injection found, doctors recommend antibiotics and you might need to finish the treatment before the cervical stitch. Doctors may take a sample of amniotic fluids by putting a needle gently through the belly into the uterus or take a swab of the cervical mucus.
How to prepare for the Cervical Cerclage Procedure?
A number of preparatory steps are completed before the actual procedure is performed. That includes –
- Analysis of complete medical history is done and a cervical examination will be conducted to check and assess the cervix.
- Baby’s vital signs and major birth defects are checked by performing an ultrasound of the vagina.
- Amniocentesis can be performed by the doctor. It is a procedure in which small samples of amniotic fluids are retrieved and tested. This is done to identify if the foetus has any chromosomal abnormalities.
- Medications and antibiotics are prescribed by the doctor if the patient has an infection.
- A day prior to the surgery i.e. after midnight, the patient is not allowed to have any food or drink to avoid vomiting and nausea during and after the cerclage treatment.
- Doctors advise the patient to abstain from sexual intercourse, use of douche or tampons 24 hours before the procedure.
- In order to administer fluids and medications, an intravenous catheter is placed.
What is done during the Procedure?
Before the actual start of the procedure, medicines are given to the patient to numb the pain. If the doctor is using regional anesthesia which is also called as an epidural or spinal, with the help of a needle, the doctor will inject the drug into the back of the patient. General anesthesia is usually given to make the patient go to sleep so that they do not feel anything.
The cervical cerclage procedure is either done through the belly (transabdominal) or through the vagina (transvaginal).
- Transabdominal surgery is needed if the patient had a cervical stitch previously and it did not work. For the patient who has a very short cervix, transabdominal surgery is recommended. A small cut is made in the belly by the doctor where the uterus is pulled up to reach the cervix and close it.
- Transvaginal surgery is one of the common ways to do cervical cerclage treatment. Doctors need to hold the vagina open in order to reach the cervix using a tool called a speculum. The cervix is then stitched close by the doctor.
What a patient can expect after procedure?
The patient might be required to stay hospitalized for a few hours or maybe overnight. The patient is monitored for premature labor or contraction. Once the procedure is done, the patient might experience mild cramping or light bleeding, which will stop after a few days. He/she may also experience increased thick vaginal discharge for a few days. Doctor will recommend medicines to prevent preterm labor or infection. It is advised to avoid unnecessary physical activity and to relax at home for 2 to 3 days after the procedure. Your doctor may recommend to abstain from sexual intercourse at least one week prior and a week after the procedure is done.
Cervical Cerclage Aftercare
After the surgery, it is important for the patient to recover well while the doctor can keep you under observation. Medications, reduced or no physical activities, no sexual activities are some of the aftercare measures advised by the doctors.
Benefits of Cervical Cerclage
Cervical Cerclage is usually successful in about 85 to 90 percent of the cases.
- It helps to prevent premature labor or miscarriages caused due to cervical incompetence.
- Reduction in preterm birth
Risks of having a Cervical Cerclage procedure
Even though Cervical Cerclage is a safe procedure, there are few potential complications that might arise during or after the surgery. Some of the risks associated with cervical cerclage treatment are–
- Injury to the bladder or cervix
- Displacement of the cervix
- Premature labor
- Early breaking of the water
- Injection of the cervix and amniotic sac (chorioamnionitis)
- Cervical rupture that might occur if the stitch is not removed before labor.
- Premature rupture of membranes and cervical dystocia with failure to dilate that can require Cesarean section
It is recommended to consult the doctor if any bleeding or fluid leak is observed by the patient. The doctor might decide to take the stitches out early or not based on this condition.
When is Cervical Cerclage not recommended?
Cervical Cerclage is usually not recommended if you have the following –
- Bleeding in the vagina
- Preterm Labor
- Uterus infection
- The Amniotic sac through the cervix has bulged
- If the amniotic sac also called a bag of waters gets broke or leaked before 37 weeks of pregnancy.
Cervical Cerclage is only recommended for women pregnant with only one child.
When to contact doctor?
It is highly recommended to consult your doctor if you experience below symptoms after the cervical cerclage is placed.
- A fever or chills over 100 F
- Vomiting or nausea
- Bleeding in the vagina
- Back pain or lower abdominal pain
- Cramping and contractions
- Leaking or water breakage
- Foul smell during vaginal discharge
Apollo Cradle Jayanagar is a well-known hospital that handles cases of Cervical Cerclage. The doctors, nurses, and technicians are well trained and highly experienced. Apollo Cradle is one of the most trusted maternity hospitals in India for both the mother and child care.
Why Choose Apollo Cradle Jayanagar?
Apollo Cradle offers the most advanced maternity treatment to its patients with the highest quality care by top doctors and gynecologists in the country. Various medical specialties are available that includes Laparoscopy, Gynaecology, Fertility, Fetal Medicine and NICU, Pediatrics, and Neonatology. All these wards are supported by highly qualified pregnancy specialists.
Facilities offered at Apollo Cradle Jayanagar includes –
- Specialized Labor and delivery rooms for the patients
- No prize difference for normal delivery and Caesarean section (Maternity surgery)
- Highly trained Gynecologists, nurses, and technicians
- Surgical ICU and Level III NICU
- Ventilator equipped ambulances
- 24×7 pharmacy available
- Offers a range of maternity packages
- Ultrasound imaging with state-of-the-art facility
- Apollo Experts available for consultations
The doctors at Apollo Cradle always encourage patients for a normal and healthy delivery. The experienced gynaecologists ensure that the patient gets the best maternity experience even if there is any high-risk involved in the pregnancy to conceive via normal delivery. It is the choice mother to decide for the maternity surgery or for a normal delivery while the doctors at Apollo Cradle helps the patient to take the right decision for the pregnancy. With 36 years of legacy in clinical excellence, Apollo Cradle serves with the best treatment ensuring safety for both mother and the child.