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Cervical Cerclage is the closing of the cervix - the lower part of the uterus that opens to the vagina - via stitching. This surgery is performed during pregnancy to prevent premature birth or miscarriage.
Cervical Cerclage can be performed in 2 ways:
Your gynaecologist might recommend cervical cerclage in either of the following cases:
In case of cervical dilation - when amino sac protrudes from the cervix - Cervical Cerclage can be performed in emergency.
In ideal scenario, cervical cerclage is perfomed between 12 to 16 weeks of pregnancy. However, in case of emergencies, the procedure can be performed upto 24 weeks of pregnancy.
Before cervical cerclage is performed, your doctor will do the following:
For prolapsed fetal membranes, your doctor will first treat the condition by placing catheter (a thin tube) in your urethra and repositioning the amino sac. In some cases, balloon catheter is also insterted to reposition the amino sac.
Cervical Cerclage will not be done when you have excessive vaginal bleeding, pre-term labor, infection of the utreus, leaky amino sac or risk of miscarriage due to abnormalities in the fetus.
Cervical cerclage is performed on the patient under regional or general anesthesia. The procedure can be transvaginal or transabdominal.
Transvaginal Cervical Cerclage - It is performed through the vagina. Your doctor will insert speculum in the vagina and use forceps to grab the cervix. Your doctor might use McDonald or Shirodkar technique to perform the procedure.
Transabdominal Cervical Cerclage - If the cervix is short or damaged, then your doctor will perform the procedure through the abdomen. A cut is made in your abdomen and uterus is elevated to access the cervix. The doctor will close the cervix tightly by placing a tape around the passage connecting uterus and cervix. The uterus will then be settled to its original position.
After the procedure, your doctor will check the following:
Medications will be prescribed for preventing infection. You might experience cramps, spotting and pain while urinating, for a few days.
Your doctor will recommend you to avoid unnecessary physical activity including sex for 5 to 7 days after the surgery. If you had cervical cerclage in emergency situation, then you will be recommended against any physical activity till the end of pregnancy.
There will be follow-up appointments for the doctor to monitor the cervix and do what is needed, including watching for indications of premature labour.
The following are a few of the possible risks and complications: