Cervical Cerclage

Surgery Overview

Cervical cerclage (say "SER-vuh-kul ser-KLAZH") is a procedure that helps keep the cervix from opening too soon before delivery.

The cervix is the lower part of the uterus. It leads to the vagina. During pregnancy, it is tightly closed to protect the baby. Normally, it doesn't open until the baby is ready to be born. Most of the time, this happens at 37 to 42 weeks. But sometimes it opens too early.

In cervical cerclage, the doctor sews the cervix shut early in the pregnancy. The stitches are removed in time for the baby to be born.

You may get medicine that makes you unconscious. Or you may get medicine that makes the cervix numb. The procedure will take less than an hour. You may go home the same day.

This procedure can help some high-risk pregnancies last longer. But it also has risks. It can cause infection or miscarriage.

What To Expect

How long it takes to recover depends on the type of cerclage procedure you had. Your doctor can give you an idea of what to expect. You may get antibiotics for infection.

Why It Is Done

Cervical cerclage may be done if you have cervical insufficiency or have a history of cervical insufficiency. This means that the cervix starts to open too early in pregnancy. You may have a history of cervical insufficiency if you:

• Had a previous pregnancy loss in the second trimester or an early delivery that occurred with few or no contractions. This is a clue that your cervix may not stay closed during pregnancy.
• Have a short cervix and have a history of early delivery.

How Well It Works

Success of the cervical cerclage procedure is defined as a pregnancy that lasts until term or close to term.

Cerclage can help some high-risk pregnancies last longer. For people who have had a preterm birth because the cervix did not stay closed, cervical cerclage may help prevent another preterm birth.

Risks

Problems from cervical cerclage are rare. They include:

• Infection.
• Damage to the cervix during the procedure.
• Excessive blood loss.
• Preterm prelabor rupture of membranes (pPROM). This means your water breaks long before it should.
• Preterm labor.
• Permanent narrowing or closure of the cervix (cervical stenosis).
• Tearing of the cervix or uterus if labor progresses with the stitches still in place.