What is a cervical cerclage and why is it used?

Cervical cerclage is a surgical procedure used to prevent a miscarriage or premature delivery if your cervix is opening too early (referred to as an "incompetent" or "weak" cervix).  Typically, the cervix remains closed until some time in the third trimester.  If your doctor finds that your cervix is opening early, a cervical cerclage may be used.  The procedure may also be used if you have a history of miscarriages during the second trimester.  In this case it is typically done at the beginning of the second trimester.  

In this procedure, a band of strong thread is stitched around th cervix and then tightened to hod the cervix closed.  It is typically done under a general anesthesia.  You may stay in the hospital the rest of the day or overnight after having a cervical cerclage.  Recovery time at home will usually be 2 to 3 more days.  Generally the thread is removed at or around the 37th week of pregnancy, but may be removed before if your water breaks or you start contractions.  Removal of the stitch is much less complicated, and can be done usually in the doctor’s office. 





The procedure is successful at keeping the cervix closed in roughly 90% of cases, reducing greatly the risk of miscarriage or premature delivery.  However, rarely there are risks to this procedure.  As the procedure is done under a general anesthesia, there are th usual anesthesia risks.  Also, this procedure can cause premature labor.  The cervix may become infected.  If you go into labor with the stitching in your cervix, your contractions may tear open your cervix. It is important that the stitching be removed before or during early labor.

The best time for the cervical cerclage procedure is in the third month (12-14 weeks) of pregnancy. However, some woman may need a cerclage placed later in pregnancy.  This is known as an emergent cerclage and is necessary after changes such as opening or shortening of the cervix have already begun.  If a emergent cerclage is required, future pregnancies will probably also require a cervical cerclage.

The main alternative treatment for an incompetent cervix is bed rest that may last for several months.

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