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Cervical Cerclage

Cervical cerclage is a procedure in which stitches are used to close the cervix—the lower part of the uterus that opens to the vagina--during pregnancy to help prevent premature birth or pregnancy loss. Before pregnancy, the cervix is closed and rigid, and during pregnancy, it gradually softens, effaces, and dilates in preparation for birth. An incompetent or weak cervix may begin to open too soon, before the baby can safely be born. 

Ideally, a history-indicated cervical cerclage is done between 12 and 16 weeks of pregnancy, but can be done up until 24 weeks of pregnancy. This procedure is typically avoided after 24 weeks due to the risk of rupturing the amniotic sac and triggering premature birth. The cerclage is usually removed at 37 weeks of gestation, when the baby is considered to be at term.

Purpose
A cervical cerclage is placed to prevent premature birth due to the early opening of the cervix. Premature birth puts the fetus at risk and so it is important that the pregnancy continues for as long as possible, as determined by the doctor.
  1. Rupture of membranes (amniotic sac), leading to infection or premature birth.
  2. Miscarriage.
  3. Premature labor.
  4. Increased vaginal discharge or infection of the cervix or vagina.
  5. Rupture of the cervix or uterus during childbirth if cerclage is not removed in time.
  6. Bleeding at the site of the procedure, causing abnormal vaginal bleeding.                                
See your doctor immediately if you show any signs of labor, if the fetus’s movements slow down or stop, and/or if you experience fever, abdominal pain, and/or vaginal bleeding.
 
Cervical cerclage can prevent preterm labor and birth in up to 85-90% of patients.
 
What if the procedure is not performed?
You may experience preterm birth or miscarry.
 
Alternatives
There are no alternatives to cervical cerclage.
 

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