Cervical cerclage

Specialty of Obstetrics & gynaecology

What is a cervical cerclage?

A cervical cerclage is a small operation to reinforce the cervix with stitches and keep it closed during pregnancy.

Why is it done?

The cervix normally remains closed during pregnancy until the baby comes to term and the mother’s waters break. However, the pressure caused by a growing baby can sometimes cause the cervix to shorten and widen. If the cervix is weak, it might open too early, causing a miscarriage or a preterm birth.

A cervical cerclage is carried out if doctors think there might be a risk of this occurring. You may be considered at risk if you have a history of second-trimester pregnancy loss, or if the obstetrician has detected a shortening of your cervix during a routine pregnancy scan.

Cervical cerclage is not generally recommended if you’re carrying more than one baby, of if you have vaginal bleeding or an intrauterine infection.

What does it involve?

Before the operation you’ll have an ultrasound and a swab taken to check for infection.

Cervical cerclage is an outpatient procedure so you can usually go home on the same day. Most of the time the procedure is carried out via the vagina, but in some cases you may need a transabdominal cervical cerclage, which involves making an incision in the abdomen.

After the operation you’ll have another ultrasound to check that everything has gone well, and you’ll be advised on any activity to avoid for the next few weeks.

Aftercare

If you had a transvaginal cervical cerclage, this will be removed at around 36-37 weeks into pregnancy. If you had a transabdominal cervical cerclage, this is not generally removed before labour, and you’ll give birth via a caesarean.

Alternatives to this treatment

Because of the risks of bleeding, infection, or cervical damage, a cervical cerclage is not always recommended. The main treatment alternative is to take high dosages of progesterone to prevent an early labour.

Finally, some UK hospitals are trialling alternative method of reinforcing the cervix, called the Arabin pessary .

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