Cerclage is the placement of a pursestring suture in the cervix to hold it closed. This procedure is used to keep a weak (incompetent) cervix from opening early. When a cervix opens early, it may cause preterm labor and delivery. If you have an incompetent cervix, your doctor may recommend cervical cerclage.
Cerclage can be done preventively at 12 to 14 weeks before the cervix thins out, or as an emergency measure after the cervix has thinned. It is rarely used after 24 weeks.
Cerclage is usually done while you are under regional anesthesia (such as spinal injection). The cerclage is placed vaginally, similarly to having a pap smear.
After your cerclage is placed you will be monitored in the recovery and delivery suite to ensure you and your baby are doing well.
After your cerclage we will give you antibiotics to prevent infection.
It is best not to have vaginal intercourse or use anything vaginally with the cerclage in place.
If you have bleeding, contractions, leaking of fluid after cerclage placement notify us immediately.
Success of the cervical cerclage procedure is defined as a pregnancy that lasts until term or close to term.
Cerclage has helped some high-risk pregnancies last longer, but it also has risks-it can cause infection or miscarriage. For women who have had a preterm birth because the cervix did not stay closed, cervical cerclage may prevent another preterm birth.1
The risks of cervical cerclage are rare but can include:
- Excessive blood loss.
- Preterm premature rupture of membranes (PPROM).
- Preterm labor.
- Permanent narrowing or closure of the cervix (cervical stenosis) or damage to the cervix.
- Tearing of the cervix or uterus if labor progresses with the stitches still in place.
Before having cerclage placed:
a) We will meet with you the week before for a pre-operative evaluation. b) Go to pre-operative intake at the hospital you are scheduled at. c) Do not eat or drink for 8 hours before your surgery.
d) Present to hospital at scheduled time.
After placement of your cerclage:
a) You will be monitored for a few hours to evaluate you and your baby’s well being and to allow time for you regional anesthesia (spinal) to where off. b) You will be sent home with prescriptions for antibiotics.
c) You will be scheduled for follow up evaluation of your cerclage and cervix throughout the remainder of your prenatal care.
d) If you are unsure about any of the above or any concerns please contact us immediately.