If you are pregnant, your greatest hope is to deliver a healthy baby into the world. But sometimes, whether it is because you have had a previous miscarriage or because your doctor has told you that your cervix is a little weak, you may be worried that your uterus will open before the baby is born. Today, we are going to talk about a special treatment that is done to prevent premature birth for mothers who are at risk. That is called a cervical cerclage.
What is Cervical Cerclage?
Simply put, this is a special suture that keeps the opening of your uterus, or cervix , securely closed throughout your pregnancy . Think of your uterus as a little purse. Your baby is inside. Your cervix is the opening of that purse. Sometimes, the opening of this purse can become loose. Then the precious thing inside, your baby, tries to come out prematurely.
So, in a `(Cervical Cerclage)`, the doctor uses a strong thread to close the mouth of the purse, that is, the cervix, which can become loose. This allows the baby to stay safely inside the uterus until about 37 weeks, that is, until the baby is well developed.
Why is a cervical suture recommended?
Not every pregnant woman will need this. Your doctor will only recommend this treatment if there are specific reasons. This is why it is very important to be open with your doctor about your previous pregnancies and surgeries.
| Reason | Simple explanation |
|---|---|
| Incompetent Cervix | If the cervix is weakened due to previous surgery (such as LEEP ) or other reasons, the cervix may open spontaneously during pregnancy because it cannot support the weight of the baby. |
| Second trimester miscarriages | If you have had painless miscarriages in the middle of pregnancy (between 4-6 months), the cause may be a weakened cervix. |
| Abnormalities in the uterus or cervix | If the shape of the uterus has changed or the cervix has been damaged from birth, this may also have caused a previous miscarriage. |
This stitch is usually placed between 12 and 14 weeks into the pregnancy, before the cervix begins to thin and open.
What happens before and during this surgery?
It's normal to feel a little scared and nervous when facing something like this. So, ask your doctor any questions you have.
Before the surgery...
Before the surgery, your doctor will take a complete medical history . He or she will examine your cervix using a speculum, similar to a Pap smear. You may also have a transvaginal ultrasound. This will help to check the length and condition of your cervix. You will usually be advised to abstain from sex for a week before the surgery.
During the surgery…
This is a minor surgery that is usually done in a hospital and doesn't take long.
- You will be made to lie down on an examination table and asked to place your legs on special supports.
- Then, a local anesthetic is injected to numb the area around your cervix so you don't feel any pain . You may feel a slight sting when the needle is inserted, but you won't feel any pain afterward.
- Once you are well numb, the doctor will use strong thread to place a stitch around the cervix, tightening it tightly and closing it securely.
Is this painful? What happens after the surgery?
For a few days after the surgery, you may experience a slight cramping and spotting in your lower abdomen, similar to your period. This is normal. The pain is usually not severe. If you experience any pain, you can take something like paracetamol . However, if you experience severe stomach pain that is unbearable , you should call your doctor immediately.
You will be kept in the hospital for observation for a few hours after the surgery and will be sent home the same day if there are no complications. You may also be given antibiotics to prevent infection.
The most important thing is to rest well on the day of surgery. Do not go to work or do any other strenuous activity. Since it takes about 7-10 days for the stitches to heal, it is imperative to follow the doctor's instructions during that time.
What are the benefits and risks of a cervical stitch?
This is the best and most effective way to prevent premature birth for a mother with a weak cervix. This treatment has a high success rate of almost 90%. However, as with any medical treatment, there are some very small risks. The doctor suggests this treatment because the benefits far outweigh these risks.
| Significant Risks/Complications | |
|---|---|
| Infection | There is a small chance of a cervical infection. |
| Bleeding | Minor bleeding during or after surgery. |
| Premature rupture of membranes | Premature rupture of the membranes surrounding the baby. |
| Damage to the cervix | Damage or scarring to the cervix during suture placement or delivery. |
| Preterm labor | There is a very small chance that labor pains may occur due to the surgery itself. |
When will this stitch be removed?
When you are 37 weeks pregnant, which means the baby is safe to come out, the doctor will remove these stitches. This is also very simple. You will be made to lie down on the examination table, just as you were when the stitches were put in, and the stitches will be cut and removed in a few minutes. You will not even need anesthesia for this.
Even if your water breaks suddenly before that, or if labor pains begin, the doctor will remove the stitches immediately.
What are the situations when you should call the doctor immediately?
If you experience any of the following symptoms after surgery, you should contact your doctor immediately without delay. If necessary, go to the Emergency Department (ETU) of the nearest hospital.
| Warning signs to look out for | |
|---|---|
| 🌡️ High fever | If the body temperature is higher than 37.7 degrees Celsius (100 Fahrenheit). |
| 😖 Pain that comes at regular intervals | If the lower abdominal pain, like labor pain, continues to come at the same intervals. |
| 👃 A discharge with an unpleasant odor | If there is a foul-smelling discharge from the vagina. |
| 💧 Water bag breaks or leaks | If something like water comes out of the vagina. |
| 🩸 Heavy bleeding | If the bleeding is heavier than normal. |
Take-Home Message
- Cervical cerclage is a very effective and safe method for preventing premature birth in a mother with a weak cervix.
- This is not something that everyone should do. Doctors only recommend it for mothers with specific risk factors .
- It is very important to follow the doctor's instructions exactly after surgery (rest, no heavy lifting, no sexual intercourse).
- Talk openly with your doctor about any fears or concerns you may have. It will help you to make informed decisions and put your mind at ease.
- If you experience any warning symptoms (high fever, pain, heavy bleeding ) , seek medical advice immediately.
Cervical Cerclage, abortion prevention, premature birth, pregnancy health, cervix, incompetent cervix
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