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Cervical Cerclages

Cervical cerclage refers to a variety of procedures that use sutures or synthetic tape to reinforce the cervix during pregnancy in women with a history of a short cervix. The cervix is the lower part of the uterus that opens to the vagina.

Cervical cerclage can be done through the vagina (transvaginal cervical cerclage) or, less commonly, through the abdomen (transabdominal cervical cerclage).

We might recommend cervical cerclage if your cervix is at risk of opening before your baby is ready to be born or, in some cases, if your cervix begins to open too early. However, cervical cerclage isn’t appropriate for everyone. It can cause serious side effects and doesn’t always work. Some women who have a cerclage placed for a short cervix might experience preterm labor. Understand the risks of cervical cerclage and whether the procedure might benefit you and your baby.

Why it’s done
Before pregnancy, the cervix is closed, long and firm. During pregnancy, the cervix gradually softens, decreases in length (effaces) and opens (dilates) in preparation for birth. If you have an incompetent or short cervix, however, your cervix might begin to open too soon. As a result, you could experience pregnancy loss or give birth prematurely.

We might recommend cervical cerclage during pregnancy to prevent premature birth if you have:
1. A history of second trimester pregnancy loss related to painless cervical dilation in the absence of labor or placental abruption (history-indicated cervical cerclage)
2. Prior cerclage due to painless cervical dilation in the second trimester
3. Painless cervical dilation diagnosed during the second trimester
4. A short cervical length (less than 25 millimeters) before 24 weeks of pregnancy, in a singleton pregnancy

Cervical cerclage isn’t appropriate for everyone at risk of premature birth and we might not recommend a cervical cerclage if you have:
1. Active vaginal bleeding
2. Active preterm labor
3. An intrauterine infection
4. Preterm premature rupture of membranes, when the fluid-filled membrane that surrounds and cushions the baby during pregnancy (amniotic sac) leaks or breaks before week 37 of pregnancy
5. Twin or higher order pregnancy
6. A fetal anomaly incompatible with life
7. Prolapsed fetal membranes, a condition in which the amniotic sac protrudes through the opening of the cervix

Risks associated with cervical cerclage include:
1. Inflammation of the fetal membranes due to a bacterial infection
2. Vaginal bleeding
3. A tear in the cervix (cervical laceration)
4. Preterm premature rupture of membranes, when the fluid-filled membrane that surrounds and cushions the baby during pregnancy (amniotic sac) leaks or breaks before week 37 of pregnancy
5. Suture displacement

Cervical cerclage removal
A transvaginal cervical cerclage is typically removed at around week 37 of pregnancy, or at the start of preterm labor.After having a transvaginal cervical cerclage removed, you’ll typically be able to resume your usual activities as you wait for labor to begin naturally. If you expect to have a C-section the stitch may be removed after delivery of the baby.

Research suggests that cervical cerclage reduces the risk of premature birth in women with proven cervical insufficiency. However, the timing of cervical cerclage can also affect the outcome. Emergency cervical cerclage done in the presence of advanced cervical change and prolapsed membranes has a poorer outcome.

At Manasi Clinic we have been treating women with repeated pregnancy losses, short cervix ,cervical incompetence for over 20 years now with a success rate of more than 90%.All procedures are done in the affiliate corporate hospitals with complete aseptic precautions and optimal care.


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