Premature birth, defined as birth before 37 weeks of pregnancy, remains a significant concern in maternal health worldwide. It can lead to various complications for both the newborn and the mother, ranging from developmental issues in the baby to long-term health implications for the mother. In combating this challenge, medical science has introduced various interventions, one of which is cervical cerclage.
Cervical cerclage is a surgical procedure designed to prevent premature birth by reinforcing the cervix, the lower part of the uterus, to keep it closed during pregnancy. This procedure is typically recommended for women at risk of premature labor due to cervical incompetence or other cervical issues. By stitching a strong suture around the cervix, cerclage aims to provide mechanical support and stability, reducing the risk of premature dilation and subsequent preterm birth.
The importance of cervical cerclage in preventing premature birth cannot be overstated. Research has shown that cerclage significantly reduces the risk of preterm delivery and improves pregnancy outcomes in high-risk cases. It offers hope to women who have experienced previous preterm births or those with certain cervical conditions that predispose them to early labor.
However, like any medical intervention, cervical cerclage has its considerations and potential risks. It’s essential for healthcare providers to carefully assess each patient’s individual circumstances and weigh the benefits against the risks before recommending cerclage. Additionally, proper prenatal care and monitoring are crucial throughout the pregnancy to ensure the effectiveness and safety of the procedure.
In this comprehensive guide, we delve into the intricacies of cervical cerclage as a safeguard against premature birth. We explore its indications, procedure, effectiveness, potential risks, and considerations for patients and healthcare providers alike. By understanding the role of cervical cerclage in preventing premature birth, we aim to empower expectant mothers and healthcare professionals in making informed decisions to promote healthy pregnancies and childbirth.
What should you know about cervical cerclage?
Cervical cerclage, also known as a cervix stitch, involves a surgical procedure where a doctor physically sews the cervix shut to prevent it from opening. This intervention can be highly beneficial in preventing early labor or miscarriage in pregnant women.
Though it might be scary, this method is the right treatment for women who have incompetent cervix and rarely suffer from any kind of complications.
There are different kinds of cervical cerclage procedures and they are the following:
- McDonald Cerclage: In the McDonald cerclage method, surgeons bind the cervical opening shut using traditional surgical stitching between weeks 16 and 18. The most common type of cervical cerclage involves removing the stitch around week 37.
- Shirodkar Cerclage: The stitching will be done in the cervix walls than the opening in this method. This is a difficult process when compared to the traditional McDonald method though the deeper level is believed to lessen the risk of infection. This will be there for future pregnancies. The doctors take fascia lata piece out of woman’s thigh and then encircle cervix with it.
- Abdomen Cerclage: The cervix is stitched shut at the top of the cervical opening in the abdominal area. This process is permanent and done in cases where the conventional method of cervical cerclage is not feasible. Doing cerclage vaginally is difficult due to funnelling degree, cervical dilatation or effacement. This is usually a path when cervical cerclage has failed before.
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What can cervical cerclage be used for?
Cervical cerclage is a treatment for your incompetent cervix. A small percentage of women which is less than 1% – will suffer from this problem when they are pregnant. Cervical incompetency is usually diagnosed early during the pregnancy. But some women are already at greater risk for cervix complications and the doctor might preemptively decide to perform cervical cerclage to prevent possible complications. Some risk factors for weak cervix are the following:
- Having past history of second-trimester miscarriages
- Previous “LEEP” procedure or “cone biopsy”
- Having damage of cervix from previous abortion
What are the benefits of cervical cerclage?
It is important to discuss with the doctor about the proper route to follow for solving the complications related to pregnancy. Doctors will suggest cervical cerclage when they are aware that the benefits will outweigh the risks. A cervical cerclage properly done will protect your baby from any complications or miscarriage. It can show life-saving results and has been regarded as the best option for incompetent cervix.
What are possible risks with cervical cerclage?
There are extreme cases when side effects can range from mild to severe. Some of these risks include:
- Infection of the cervix
- Premature contractions
- Vomitting and nausea from anesthesia
- Cervical dystocia or cervix’s inability to dilate properly during labor
- Cervical laceration
- Rupture of membranes
Some side-effects denote something is wrong with the procedure. You need to talk to your doctor immediately when you experience any of these side-effects after the ptreatment:
- High fever above 100 F
- Contractions
- Bleeding from vagina
- Lower abdominal pain coming in waves and similar to labor
- Foul smell from vaginal discharge
- Water leaking or breaking
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About the process
The doctor will check your medical history and discuss any pregnancy complications you have already experienced. He will tell about different pain management options for the procedure nad suggest some localized or generalized anesthesia.
A physical examination of your cervix and transvaginal ultrasound will be done before the procedure. This will let the doctor to see your cervix and decide how to properly sew it. Feeling anxious about the procedure is obvious and you can ask any questions or concerns you have at the initial appointment to lessen the stress.
The method for cervical cerclage is obviously simple. The doctor uses a band of strong thread to sew around your cervix and tighten it after giving anaesthesia.
Once the procedure is done, you may have to remain in the hospital for a few hours or stay overnight. This will ensure there aren’t any further complications with early labor or contractions. You may experience light cramping and bleeding for a few days, followed by thick vaginal discharge lasting for several weeks. Your doctor will prescribe medication to prevent any cervical infection. Rest at home until the stitches have completely healed or until your doctor instructs you to resume normal activities.
Go now to your doctor who will suggest that you do not have sexual intercourse with your partner for one week before the procedure and at least one week after the procedure.
