Cervical Cerclage

Cervical cerclage is a surgical procedure that involves placing a stitch or a band around the cervix, the lower part of the uterus that connects to the vagina, to prevent premature birth or the loss of a pregnancy. This procedure is typically recommended for women who have a history of cervical incompetence or a short cervix. Cervical incompetence refers to a condition where the cervix begins to open prematurely, which can lead to a miscarriage or premature birth. A short cervix is defined as a cervical length of less than 25 millimetres.

Types of Cervical Cerclage

There are two main types of cervical cerclage:

• Transvaginal cerclage: This procedure is performed through the vagina and is typically done early in the pregnancy, often between 12 and 14 weeks.

• Abdominal cerclage: This procedure is performed through an incision in the abdomen, and is typically done later in the pregnancy, usually between 14 and 16 weeks.

Indications for Cervical Cerclage

Cervical cerclage is usually recommended for women who have a history of cervical incompetence or a short cervix, as well as women who have had a previous premature birth, multiple miscarriages, or a history of cervical surgery. It may also be recommended for women who have a cervical infection, such as chlamydia or gonorrhoea, or for those who have a condition that affects the cervix, such as Ehlers-Danlos syndrome.

Risks and Complications of Incompetent Cervix

Like all surgical procedures, cervical cerclage carries some risks. The most common risks include bleeding, infection, and tearing of the cervix or uterus. There is also a risk of the cerclage breaking or coming loose, which can lead to preterm labour or a miscarriage.

Recovery after Cervical Cerclage

After the procedure, most women are kept in the hospital for a day or two to be monitored for any complications. Women will be advised to avoid heavy lifting and strenuous activity during recovery and may be prescribed bed rest.