Cerclage

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What is cerclage?

Cerclage is the surgical treatment for cervical incompetence during pregnancy. Cervical incompetence refers to the increased risk of the cervix opening during pregnancy. During this procedure, the weakend servix is sewn closed to prevent further opening. A weak cervix may be the result of:

  • Previous second-trimester miscarriages
  • A previous “cone biopsy” or a “LEEP” procedure
  • Additional damage to the cervix

When is it used?

The best time for the cervical cerclage procedure is in the third month (12-14 weeks) of pregnancy. However, some women may require this procedure later in pregnancy; this is known as an emergent cerclage and may be necessary if the cervix begins to open prematurely. If an emergent cerclage is required, future pregnancies will probably also require a cervical cerclage.

What are the risks associated with this procedure?

As with any procedure, there are risks. You should talk with your doctor to learn all of the risks involved before undergoing any procedure. Some of the risks associated with Cerclage include:

  • Damage to a vein or artery that could cause serious bleeding.
  • Making a hole in your bladder that could cause a tract (fistula) between your vagina and bladder.
  • Making a hole in your rectum that could cause a tract (fistula) between your vagina and rectum.
  • That you may have difficulty emptying your bladder.
  • Damage to your ureters, the tubes that carry urine from your kidneys to your bladder.
  • That you may develop bulging in your vagina (vaginal vault eversion).
  • That you may develop infection in your incisions.
  • Ruptured amniotic membranes resulting in the preterm delivery and possible death of your child.

How do I prepare for a cerclage?

Your medical history will be reviewed. A doctor who specializes in high-risk pregnancies will perform a thorough exam of your cervix, including a transvaginal ultrasound. Your doctor will discuss pain control options for the procedure. You should write down any questions or concerns you may want to discuss with your health care provider.

What happens after the procedure?

You may stay in the hospital for a few hours to be monitored for premature contractions or labor. Immediately after the procedure you may experience light bleeding and mild cramping, which should stop after a few days. This may be followed by an increased thick vaginal discharge, which may continue for the remainder of the pregnancy. You may receive medication to prevent infection or preterm labor. For 2-3 days after the procedure, plan to relax at home; avoid any unnecessary physical activity. Your doctor will discuss with you when would be the appropriate time to resume regular activities. Abstinence from sexual intercourse is often recommended for one week before and at least one week after the procedure.

When should I call my Greenville OB/GYN?

Call our emergency number at any time if:

  • You have a fever over 100 F (37.8 C)
  • Contractions or cramping
  • Lower abdominal or back pain that comes and goes like labor pain
  • Vaginal bleeding
  • Nausea and vomiting
  • Foul-smelling vaginal discharge
  • Your water breaking or leaking

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