A cervical cerclage is a procedure in which a doctor surgically sews a pregnant woman’s cervix closed. This is done in order to allow the woman to carry the baby as close to full term as possible, which is at least 37 weeks gestation. The cervix is the part of the uterus that reaches into the vagina, through which the baby passes during delivery. In pregnancy, some women have what is called an incompetent cervix, meaning the cervix opens (dilates) or shortens (effaces) too early, causing early labor and possibly a premature baby.
There are several possible causes of an incompetent cervix, including previous miscarriages that occur in the second trimester and prior Loop Electrosurgical Excision Procedures (LEEPs) or cone biopsies. The cervix can also sustain damage during an abortion, which necessitates a cervical cerclage in subsequent pregnancies. A cervical cerclage is typically performed early in the second trimester, or from 12 to 14 weeks gestation. An emergent cervical cerclage is sometimes called for later in a pregnancy due to unexpected, premature changes in the cervix. Some doctors may prescribe bed rest before opting to perform a cervical cerclage.
A cervical cerclage works in 85 to 90% of pregnancies when used in the proper circumstances. Incompetent cervix is difficult to diagnose, and unfortunately, many women endure at least one miscarriage before a doctor can come to the conclusion that the cervix is opening too early. Women who are diagnosed with incompetent cervix usually require a cervical cerclage in all subsequent pregnancies.
Because a cervical cerclage is a surgical procedure, aneasthesis is required, either epidural or general. It is usually an outpatient procedure, depending on the doctor’s policy. Patients can expect some light bleeding accompanied by cramping. Preventing infection and monitoring contractions are a priority for cervical cerclage aftercare.
A cervical cerclage is not without its share of risks. These include contractions, problems with normal dilating during labor, infection, and the breakage of the bag of waters. The cervical cerclage is removed at 37 weeks, at which time the baby is considered full term.