Cervical cerclage is a procedure done to stitch the cervix closed during pregnancy. The cervix is the opening from the uterus into the birth canal. Normally the cervix stays closed during pregnancy until the last few weeks or hours of your pregnancy. If the cervix is weak or has some other problem, it may open too soon, causing your baby to be born too early.
This procedure is also called a cervical stitch.
When is it used?
Cervical cerclage helps prevents miscarriage or early delivery caused by a weak cervix. A stitch keeps your cervix closed. Cervical cerclage may be recommended if:
You have had several second-trimester miscarriages.
You have had a premature birth due to a problem with your cervix.
Your cervix is opening too early.
It can be done only if you are not yet having contractions.
If you have cervical cerclage for one pregnancy, you may need it again in future pregnancies.
How do I prepare for the procedure?
Plan for your care and a ride home after the procedure.
Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
Pregnant women should not smoke, but if do you smoke, follow your provider’s instructions about not smoking before and after the procedure. Smoking can decrease your babyâ€™s movements.
You may or may not need to take your regular medicines the day of the procedure. Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. Tell your healthcare provider about all medicines and supplements that you take. Ask your provider if you need to avoid taking any medicine or supplements before the procedure.
Tell your healthcare provider if you have any food or medicine allergies.
Follow any other instructions your healthcare provider gives you.
Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.
What happens during the procedure?
You will be given a general or regional anesthetic to keep you from feeling pain. General anesthesia relaxes your muscles and you will be asleep. Regional anesthesia numbs part of your body while you stay awake. If you have regional anesthesia, you may also be given medicine to help you relax.
Your healthcare provider will stitch 1 or 2 bands of strong suture thread around your cervix. Your provider will tighten the thread to keep the cervix closed.
What happens after the procedure?
You may stay in the hospital for several hours or overnight so that you can be checked for premature contractions or labor. Your healthcare provider may give you medicine to lower the chance that the procedure will start early labor.
The thread will be removed when itâ€™s safe to deliver your baby. This is generally around the 36th to 37th week of pregnancy. If you have contractions or your bag of water breaks while the thread is still in, call your healthcare provider right away. The stitch will need to be removed so that your contractions donâ€™t tear open your cervix.
If your baby is born by C-section (an operation that delivers your baby through a cut in your belly and uterus) rather than vaginally, the thread is usually removed after surgery. Sometimes the thread is left in.
Follow your healthcare provider’s instructions. Ask your provider:
How long it will take to recover
If there are activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.
What are the risks of this procedure?
Every procedure or treatment has risks. Some possible risks of this procedure include:
You may have problems with anesthesia.
You may go into early labor.
It may cause the bag of water to break.
Other parts of your body may be injured during the procedure.
Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.
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Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-06-03 Last reviewed: 2014-06-03
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Surgery to Close the Cervix (Cervical Cerclage): References
ACOG Practice Bulletin: Cerclage for the Management of Cervical Insufficiency, Number 142, February 2014.
ACOG Practice Bulletin: Prediction and Prevention of Preterm Birth. Number 130, October 2012.
ACOG Practice Bulletin: Premature Rupture of Membranes. Number 139, October 2013.
Cunningham, F., K. Leveno, S. Bloom, J. Hauth, et al. Williams Obstetrics. 23nd ed. The Mcgraw Hill Companies, Inc. 2008. Accessed December 26, 2010 from http://www.accessmedicine.com.
Gibbs, R. B. Karlan, A. Haney, I. Nygaard. Danforthâ€™s Obstetrics and Gynecology. 9th ed. Lippincott Williams and Wilkins, 2008. Accessed on June 27, 2012 from http://www.ovidsp.tx.ovid.com.
Lockwood, C. Guidelines for Perinatal Care. 7th ed. AAP and ACOG. 2012.