Pregnancy is a very special time in a mother's life. However, many health problems can arise during this time. For some mothers, the cervix begins to open a few weeks before the expected date of delivery. This can lead to premature birth. Today, we are talking about a special treatment that doctors recommend in such times of risk. That is, placing a suture on the cervix, or in medical terms (Cervical Cerclage) .
What is Cervical Cerclage?
This is very simple to understand. Think of your uterus as a small sac. The baby grows safely inside this sac. The cervix is the mouth of that sac. Normally, the mouth of this sac, the cervix, should remain tightly closed until the baby is born.
But sometimes this cervix can become weak. Then, as the baby gains weight, the cervix starts to open prematurely. (Cervical Cerclage) is when the cervix, which is about to open, is stitched with a strong thread and tightened. To be precise, it is like tying a bag with a string . This is done to keep the baby safe inside the uterus until the due date.
Why do you need to do something like this?
Your doctor is not suggesting this treatment for no reason. There may be several specific reasons for that.
- Incompetent Cervix: This is the main cause. Previous cervical surgeries, such as LEEP procedures, can cause the cervix to become weak.
- Previous miscarriages: If you have had miscarriages, especially in the second trimester of pregnancy, that is, between months 3 and 6, the cause may be a weakened cervix.
- Abnormalities in the shape of the uterus: Sometimes this condition can also be caused by certain congenital changes in the uterus.
Therefore, if you have had any problems with previous pregnancies or have had miscarriages, it is extremely important to tell your doctor about all of this.
This stitch is usually placed between 12 and 14 weeks of pregnancy, that is, before the cervix begins to thin.
What happens before and during treatment?
Before this, the doctor will review your complete health history. Then he will examine you.
Before treatment
Your cervix will be examined with a speculum, similar to a Pap test. You may also have a transvaginal ultrasound scan. You will also be advised to avoid sexual intercourse for about a week before the test. It is normal to feel a little nervous or anxious before this test. This is a good time to ask your doctor any questions you may have.
During treatment
This is usually over in a few minutes.
1. You will be asked to lie down on an examination table and place your legs on specially designed supports.
2. Then you will be given a local anesthetic to numb the area . You will feel a small prick when the injection is given, but you will not feel any pain afterwards.
3. After numbing, the doctor uses a strong thread to place a suture around the cervix, tighten it, and tie it.
Is there any pain after the treatment?
It is normal to experience some mild menstrual-like cramping and spotting for a few days after treatment. Don't worry. The pain can usually be controlled with paracetamol.
But remember, if you experience unbearable stomach pain , you should call your doctor immediately.
After the treatment, you will be kept under observation in the hospital for a few hours, and if there are no problems, you will be sent home the same day. You may also be given some antibiotics to prevent infection. It is best to rest well on that day. Since it takes about 10 days for the stitches to heal, the doctor advises you to avoid strenuous work and sexual intercourse during that time.
What are the benefits and risks of this treatment?
Cervical Cerclage is the best and most effective way to prevent premature birth in someone with a weak cervix. Its benefits are clear. But like any medical treatment, it also has some risks. A doctor will always recommend it only if the benefits outweigh the risks.
| Risk / Complication | Simply explained |
|---|---|
| Infection | There is a small chance of infection at the suture site or in the uterus. |
| Damage to the cervix | There may be minor damage to the cervix during treatment. |
| Premature rupture of membranes | The baby is inside a bag of water called amniotic fluid. There is a small risk that this will burst prematurely. |
| Premature birth | Sometimes this same treatment can cause premature birth. |
| Cervical rupture | If labor begins while stitches are in place, there is a risk of tearing the cervix or uterus. |
When are the stitches removed?
These stitches are usually left in place until your pregnancy is complete, which is about 37 weeks . Removing the stitches is very simple. It can be done right in your doctor's office.
Just like when stitches are placed, you will be made to lie down on an examination table, and the stitches will be removed in a few minutes. This does not even require anesthesia. Delivery can occur at any time after the stitches are removed. If for some reason your water breaks before then, or if labor begins, the stitches will be removed before then.
When should you call the doctor immediately?
If you experience any of the following symptoms after treatment, you should contact your doctor immediately without delay .
| Symptom | What to pay attention to |
|---|---|
| High fever | Body temperature over 100°F (37.7°C). |
| Pain that comes at regular intervals | If the pain in the lower abdomen, like labor pain, comes and goes at a set time (contractions). |
| A foul-smelling vaginal discharge | A foul-smelling vaginal discharge may be a sign of an infection. |
| Water bag rupture or water leak | Continuous discharge of a watery liquid from the vagina. |
| Excessive bleeding | Not just a few drops of blood, but heavy bleeding. |
It's normal to feel a little scared when you hear about this treatment. But it's a treatment that's about 90% successful . If this condition occurs in one pregnancy, it's likely to occur in subsequent pregnancies. So it's important to talk openly with your doctor and plan for a healthy pregnancy.
Take-Home Message
- Cervical Cerclage is a very effective treatment to strengthen a weakened cervix and prevent premature birth.
- This is usually done between 12-14 weeks of pregnancy.
- It is normal to experience some mild pain and bleeding for a few days after treatment. However, if you experience severe pain, fever, or heavy bleeding, you should seek medical attention immediately.
- It is very important to follow your doctor's advice, especially regarding rest and activity restrictions.
- Never hesitate to openly discuss any concerns or fears you have with your doctor.
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