1
438

What Is A Cervical Cerclage?

Cervical cerclage represents a treatment for cervical failure, respectively in the case when the cervix starts to shorten and open too early during pregnancy, leading either to pregnancy loss or premature birth.

What Is A Cervical Cerclage

A weak cervix might be the result of:

  • A history or miscarriages in the 2nd pregnancy trimester.
  • An electrosurgical excision procedure or a cervical biopsy.
  • The cervix being affected by a pregnancy interruption.

Table of Contents

What Is a Cervical Cerclage?

This medical procedure consists of placing a yarn in order to tighten the cervix. The technique is rather similar to squeezing a bag, which may open because of the high pressure produced by its content. While pregnant, the cervix has 2 functions:

  • Pregnancy constraint.
  • Dilation during delivery.

Thus, the normal state of a cervix is closed during the 9 pregnancy months and open at birth. In specific pregnant women, the cervix may open ahead of term, which may lead to premature birth. In this particular case, it`s recommended to perform a cervical cerclage. The procedure is performed in the first 6 months of pregnancy, and is a simple technique that uses a speculum. It`s made under general or local anesthesia (so, it won`t hurt), and involves sewing the cervix using a thick thread which will then be removed 3 weeks before the due date, or even earlier if it`s spontaneously triggered. The entire procedure takes roughly about 10 to 15 minutes.

Types of Cerclage

There are 3 different cerclage types:

  • A McDonald cerclage: it was first described in 1947 and is considered the most common type of cerclage. It`s basically a pursestring stitch that is used to cinch the cervical shut. This involves a band of suture at the cervix`s upper side while its lower side has by this time began to efface. This particular cerclage is generally applied between 16 and 18 pregnancy weeks, and then it`s removed around the week 37.
  • A Shirodkar cerclage: It`s quite similar to a McDonald cerclage, however, the sutures will now pass through the cervical walls, so they aren`t really exposed. This is a less common cerclage type and a bit more demanding than the previous one, and is thought to reduce any risks of infection, though it was never demonstrated.
  • An abdominal cerclage: Also known as TAC (transabdominal cerclage), this is the least common type of cerclage and will involve applying a band outside and at the top of the cervix. This particular procedure is only performed if doctors deal with a cervix that is too short to try an regular cerclage, as well as if a vaginal cerclage isn`t possible or has failed, because of several pregnancies carried to their term or perceived better results. For pregnant women giving birth with an abdominal cerclage, a C-section is needed. A TAC can be applied before pregnancy if the woman has been diagnosed with a cervical insufficiency.

What Is Cervical Insufficiency?

Cervical insufficiency, also known as cervical incompetence, commonly manifests at the week 18 – 22 of pregnancy by painless cervical dilation, pelvic pressure or increase mucus removal. The cervical inability to maintain the pregnancy inside the uterus occurs if no contractions or labor is involved. If left untreated, cervical insufficiency may result in abortion, the conception product not being viable at such a low gestational age. Cervical insufficiency is frequently detected when the first trimester finishes, at an ultrasound examination that discovers a lengthened or short cervix.

A weakened cervix may be caused by either one of the below conditions:

  • Previous cervical surgery.
  • Abnormal uterus or cervix from a congenital malformation.
  • DES exposure (diethylstilbestrol).
  • Damage during a birth with complications.
  • Previous cervical trauma, D&C from a miscarriage or a termination of pregnancy.

How Is a Cervical Stitch Done?

Cervical cerclage is performed by efficiently sewing the cervix, being programmed 12 to 14 weeks before it`s totally thinned (it`s seen as the optimal interval to be performed) or as an emergency measure after being already thinned (generally, in this case future pregnancies will also require this procedure). Rarely, cervical cerclage is performed after 24 pregnancy weeks. Specifically, a speculum is introduced into the woman`s vagina to remove the walls of her vagina. The procedure can happen in a few different ways:

  • Sutures can be placed around the cervical opening.
  • A special band may be placed around the cervix and sewn there.
  • A tiny incision may be performed in the cervix. Then, a special band is tied around the woman`s cervix to close it.

It a cervical insufficiency has been diagnosed late during pregnancy, the amniotic sac might start to penetrate through the cervix. This particular inconvenience can be treated by simply inserting a very thin tube through the cervix, and then swelling a balloon at the tube`s end.

Another medical technique will involve filling the bladder with fluid using a similar tube inserted through the woman`s urethra. The full bladder will help push the amniotic sac back into the woman`s pelvis and the cervix can be closed by suturing.

What to Expect Before & After Cervical Cerclage?

Before

  • A specialized doctor in pregnancies with high risk will perform a thorough cervical investigation, which include a transvaginal ultrasound.
  • The physician will explain the methods that he`ll use to control the pain during the procedure.
  • You may want to note any questions you may have to ask the doctor.

After

  • You may stay hospitalized for a few hours or even overnight in order to be supervised in the possible event of premature labor or contractions.
  • Soon after the procedure, mild cramping or bleeding might appear, but which should stop in a couple of days. These may be followed by a vaginal discharge which may continue later on during pregnancy.
  • You may receive drug treatment in order to prevent premature labor or infection.
  • You will need to stay home and try to avoid any physical activity 2 or 3 days after this procedure.
  • Your physician will explain when you are able to resume your usual activities.
  • Abstinence from any sexual contacts is usually advisable about 7 days before and after this procedure.

How Do They Remove a Cerclage?

The cerclage is removed at 36 – 37 weeks with no anesthesia after the baby`s lungs has developed enough, but before the beginning of the spontaneous labor which may lead to suture avulsion.

Image courtesy of science-art.com

Show Comments

330 Comments

  1. Stromvar June 5, 2022
    • UncomeRem February 23, 2023
    • cloravy April 23, 2023
    • gissuri May 26, 2023
    • gissuri June 7, 2023
    • nWdNOUkvO July 4, 2023
  2. RalphLep June 5, 2022
    • Emikify March 3, 2023
    • Ethigue April 29, 2023
    • embarry May 31, 2023
    • tnarrjw July 11, 2023
    • KZMoas August 14, 2023
  3. ChesterDyesy June 7, 2022
    • Iodindila May 14, 2023
    • NpyKgztk July 31, 2023
    • Vejoift October 12, 2023
  4. IverDarm June 7, 2022
    • Emikify February 21, 2023
    • Ethigue April 22, 2023
    • embarry May 24, 2023
    • embarry June 5, 2023
    • kigHJMSEW July 2, 2023
    • TvqupMQ August 5, 2023
    • piomync October 21, 2023
  5. Bekkgp June 26, 2022
    • UncomeRem March 6, 2023
    • cloravy April 30, 2023
    • gissuri June 2, 2023
    • RGSgIJAz July 15, 2023
  6. PhillipReort July 9, 2022
    • Emikify February 22, 2023
    • Ethigue April 23, 2023
    • embarry May 26, 2023
    • embarry June 6, 2023
    • rwOYQlWi July 3, 2023
    • yuLqFw August 6, 2023
  7. ‏amazfit bip s July 27, 2022
    • Emikify March 7, 2023
    • Gyngeassy May 1, 2023
    • embarry June 2, 2023
    • QDRKFGFaR July 14, 2023
    • oPsuOoP August 17, 2023
  8. incuchrib August 20, 2022
  9. Clalsekew September 1, 2022
    • UncomeRem March 4, 2023
    • cloravy April 29, 2023
    • gissuri May 31, 2023
    • saSyyLY July 13, 2023
  10. fupChuddy September 2, 2022
    • Emikify February 26, 2023
    • Ethigue April 25, 2023
    • embarry May 28, 2023
    • embarry June 8, 2023
    • zqRZAPzj August 10, 2023
  11. Chooggued September 4, 2022
    • Iodindila May 19, 2023
    • Rublips June 18, 2023
    • TZrTHiPb August 6, 2023
  12. blooguete September 4, 2022
  13. Duemill September 5, 2022
  14. Frickus September 6, 2022
  15. zesserb September 8, 2022
    • Emikify March 5, 2023
    • Ethigue April 30, 2023
    • embarry June 1, 2023
    • sdPjCo July 12, 2023
    • DZOVeX August 15, 2023
  16. reoloulky September 8, 2022
  17. plalePasy September 11, 2022
    • Peeguic May 26, 2023
    • Rublips June 25, 2023
    • tbTJQp August 14, 2023
    • KJSpKM November 4, 2023
  18. bluelia September 11, 2022
    • UncomeRem February 19, 2023
    • cloravy April 20, 2023
    • gissuri May 23, 2023
    • gissuri June 4, 2023
    • VoNogacGU June 30, 2023
  19. Kneense September 14, 2022
  20. Scuctut September 17, 2022
    • UncomeRem February 25, 2023
    • cloravy April 24, 2023
    • gissuri May 27, 2023
    • gissuri June 8, 2023
  21. soifelo September 18, 2022
    • Emikify February 22, 2023
    • Ethigue April 22, 2023
    • embarry May 25, 2023
    • embarry June 6, 2023
    • ctnSzBfkg July 3, 2023
    • vPSgEYZXV August 6, 2023
  22. tuplilt October 8, 2022
    • Emikify March 1, 2023
    • Ethigue April 27, 2023
    • embarry May 30, 2023
    • ivjkWRCs July 9, 2023
    • NdefTWrS August 12, 2023
  23. Uplindy October 9, 2022
    • Peeguic May 26, 2023
    • Rublips June 25, 2023
    • mFXWUKbbj August 15, 2023
  24. neelery October 14, 2022
    • UncomeRem March 17, 2023
    • Unrelia May 10, 2023
    • gissuri June 17, 2023
    • qWZmXOaYg July 27, 2023
  25. Crurope October 15, 2022
    • UncomeRem March 12, 2023
    • Unrelia May 6, 2023
    • GbVISBX July 22, 2023
    • FPPLVcrF January 11, 2024
  26. EaseraKap October 31, 2022
  27. Ethislifs November 5, 2022
  28. driency November 8, 2022
  29. Edittef November 12, 2022
    • Peeguic May 27, 2023
    • Rublips June 26, 2023
    • thKEDlib August 17, 2023
    • QPwZRK October 19, 2023
  30. Asseptors November 14, 2022
    • UncomeRem March 3, 2023
    • cloravy April 28, 2023
    • gissuri May 31, 2023
    • whkGRhD July 13, 2023
  31. deelvinia November 15, 2022
    • Iodindila May 22, 2023
    • Rublips June 20, 2023
    • nIZBAh August 10, 2023
  32. Bifaple November 19, 2022
    • Peeguic May 24, 2023
    • Rublips June 24, 2023
    • QIIvbv August 13, 2023
  33. roarrop November 20, 2022
  34. Hlkgdd November 27, 2022
  35. blivybiab December 8, 2022
  36. Bonsirl December 10, 2022
  37. Edgetdype December 11, 2022
  38. Equillalk December 15, 2022
  39. Adopity December 16, 2022
  40. Davidopera January 23, 2023
  41. Dario Peel January 24, 2023
  42. amourne January 25, 2023
  43. Cresteriz January 25, 2023
  44. IndigonoR January 25, 2023
  45. Engague January 25, 2023
  46. jepledo January 26, 2023
  47. Cresteriz January 27, 2023
  48. ErrodaY January 29, 2023
  49. IndigonoR January 30, 2023
  50. Cresteriz January 31, 2023
  51. ETHIPMENE February 1, 2023
  52. gakeldera February 2, 2023
  53. ignopay February 2, 2023
  54. Gypereaph February 3, 2023
  55. IndigonoR February 3, 2023
  56. Cresteriz February 4, 2023
  57. ignopay February 5, 2023
  58. Wgcplk February 6, 2023
  59. Fafeseesk February 8, 2023
  60. insubylib February 11, 2023
  61. Insucky February 14, 2023
  62. kit February 16, 2023
  63. Pagiahhom February 17, 2023
  64. Elels February 20, 2023
  65. itemync February 24, 2023
  66. fefevenly February 26, 2023
  67. Thobre March 18, 2023
  68. Abemnvew March 18, 2023
  69. vaf April 25, 2023
  70. alex been April 30, 2023
  71. Higuilk April 30, 2023
  72. sor May 1, 2023
  73. Den May 3, 2023
  74. Jam May 13, 2023
  75. Mic May 18, 2023
  76. Iodindila May 19, 2023
  77. Rublips June 4, 2023
  78. ReTerTwpzfc June 9, 2023
  79. ReTerTwgxlj June 9, 2023
  80. ReTerTwadta June 10, 2023
  81. ReTerTwrktd June 11, 2023
  82. ReTerTwfavm June 11, 2023
  83. ReTerTwvvds June 12, 2023
  84. ReTerTwkspk June 13, 2023
  85. ReTerTwcahp June 13, 2023
  86. ReTerTwwtxl June 14, 2023
  87. vew June 14, 2023
  88. ReTerTwwqay June 15, 2023
  89. ReTerTwcvly June 15, 2023
  90. ReTerTwlgwx June 16, 2023
  91. Rublips June 18, 2023
  92. kix July 1, 2023
  93. DeTerTwnvut July 2, 2023
  94. DeTerTwslmu July 3, 2023
  95. bezogoroda.ru July 3, 2023
  96. DeTerTwawcn July 5, 2023
  97. bezogoroda.ru July 5, 2023
  98. bezogoroda.ru July 5, 2023
  99. DeTerTwatnw July 6, 2023
  100. DeTerTwiuhl July 9, 2023
  101. DeTerTwutrk July 10, 2023
  102. DeTerTwduwj July 14, 2023
  103. tvGKOV July 15, 2023
  104. DeTerTwhagz July 15, 2023
  105. GET July 20, 2023
  106. Vejoift July 26, 2023
  107. MTiiDi August 6, 2023
  108. Dereknon August 7, 2023
  109. Jimmykaply August 7, 2023
  110. zzlkalice August 19, 2023
  111. hfeqalice August 20, 2023
  112. yyojalice August 22, 2023
  113. idnhalice August 23, 2023
  114. lfwvalice August 25, 2023
  115. nackalice August 26, 2023
  116. nldmalice August 27, 2023
  117. mjlmalice August 28, 2023
  118. hveyalice August 29, 2023
  119. Terryswola October 9, 2023
  120. jug October 12, 2023
  121. reoma October 24, 2023
  122. BVZ_Moskva_S November 26, 2023
  123. nuamy December 4, 2023
  124. BVZ_Moskva_S December 10, 2023
  125. BVZ_Moskva_S December 14, 2023
  126. ppu-prof_Oa January 19, 2024
  127. Tena Boutilier January 30, 2024
  128. goB February 5, 2024
  129. Lob February 8, 2024
  130. Nat February 12, 2024
  131. CxufArrek February 16, 2024
  132. KtbPLUPS February 25, 2024
  133. Xjeadelt February 25, 2024
  134. binance February 29, 2024
  135. ppu-prof_Oa March 11, 2024
  136. ppu-prof_Oa March 13, 2024
  137. ms flange manufacturer March 25, 2024

Leave a Reply to soifelo Cancel reply