Cervical cerclage

A cervical cerclage is a procedure to place a special stitch in your cervix (neck of the womb) to help keep it closed during your pregnancy (see figure 1). It is usually recommended if you are at risk of a late miscarriage or a premature pregnancy. 

Cervical cerclageIf you are aware that you have a cervical incompetence (a weak cervix), a cervical cerclage can usually be performed from 14 weeks of your pregnancy.When you become pregnant, your cervix should close tightly and block off your uterus (womb) with a plug of mucous. As your baby grows, the pressure on your cervix increases. If you have a weak cervix, your cervix may open without any pain and cause your membranes to bulge out and rupture (your waters breaking). A weak cervix may cause you to have a late miscarriage (when your pregnancy ends after 12 weeks and before 24 weeks).

What are the benefits of a cervical cerclage?

Placing a special stitch in your cervix should help to prevent you from losing your baby because of a weak cervix. However, the procedure itself can cause your membranes to rupture early or you to go into premature labour.

Are there any alternatives to a cervical cerclage?

The only alternative is to spend most of the time resting. You should also avoid any strenuous activity.

What does the procedure involve?

A cervical cerclage is usually performed under a spinal anaesthetic. The procedure usually takes between twenty minutes and half an hour. Your legs will be put in ‘stirrups’. Your obstetrician will use antiseptic to clean your vagina. They will place instruments in your vagina and use them to place a stitch, using a thick synthetic tape, into and around your cervix.

What complications can happen?

  • Discomfort or mild cramping
  • Vaginal spotting or bleeding
  • Infection
  • Premature rupture of your membranes
  • Premature labour
  • Miscarriage
  • Damaged cervix

How soon will I recover?

You should be able to go home the following day. It is normal to have a small amount of bleeding for the first few days. You should be able to return to normal activities, including having sex, after seven to ten days. You should avoid strenuous activities.

If you get any pain, bleeding, contractions or think you may be going into labour, let your doctor know straightaway. Your obstetrician will remove the stitch at about 36 weeks, usually in the delivery suite.

Summary

A cervical cerclage involves placing a special stitch in your cervix to help keep it closed during your pregnancy. The procedure should help to prevent you from losing your baby because of a weak cervix.

Paying for your procedure

Cervical cerclage costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own procedure the cost will be explained and confirmed in writing when you book the procedure. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.

Acknowledgements Author: Mr Andrew Woods MBBS MRCOG FRANZCOG Illustrations: Hannah Ravenscroft RM This document is intended for information purposes only and should not replace advice that your relevant health professional would give you. Copyright © 2010 Nucleus Medical Art. This information is produced by EIDO Healthcare Ltd and is licensed by BMI Healthcare. You may not copy, print out, download or otherwise reproduce any of the information other than for your personal, non-commercial use. The information should not replace advice that your relevant health professional would give you.

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