It is usually done between 12 and 24 weeks of pregnancy although occasionally it may be done at later stages in pregnancy. A cervical stitch is more commonly put in vaginally transvaginal and less commonly by an abdominal route transabdominal.
Babies born early before 37 completed weeks of pregnancy have an increased risk of short- and long-term health problems. There are many possible causes for giving birth early. One possible cause is because your cervix shortens and opens too soon. A cervical stitch may help to prevent this. Your healthcare team may arrange for you to have transvaginal ultrasound scans to measure your cervix. Your healthcare professional should discuss the benefits and risks in your individual situation.
Sometimes a cervical stitch is not advised because it may carry risks to you and it would not improve the outcome for your baby.
This may be if:. If you are pregnant with more than one baby, there is no definite evidence to show that a cervical stitch will prevent you going into labour early.
Insertion of a cervical stitch takes place in an operating theatre. You may have a spinal anaesthetic where you will stay awake but will be numb from the waist down, or you may be given a general anaesthetic where you will be asleep. Your team will discuss the best option for you. In the operating theatre, your legs will be put in supports and sterile covers will be used to keep the operating area clean. The surgeon will then insert a speculum into your vagina, hold the cervix and put a stitch around it see the illustration above.
The stitch is then tightened and tied, helping to keep the cervix closed. You may also have a catheter tube inserted into your bladder that will be removed once the anaesthetic has worn off. You will be offered medication to ease any discomfort after the surgery.
You are likely to be able to go home the same day although you may be advised to stay in hospital longer. It is an uncommon procedure but may be recommended if a vaginal cervical stitch has not worked in the past or if it is not possible to insert a vaginal stitch. It may be done through a cut on your abdomen or via keyhole surgery.
This sort of stitch is not removed and your baby would need to be born by caesarean section. Occasionally, you may be offered a stitch as an emergency procedure after your cervix has already opened up, to help prevent having a late miscarriage or preterm birth. The stitch may not always work and you might still experience a late miscarriage or preterm birth.
A transvaginal cervical cerclage is typically removed at around week 37 of pregnancy — or at the start of preterm labor. A McDonald cerclage can usually be removed in a health care provider's office without anesthetic, while a Shirodkar cerclage might need to be removed in a hospital or surgery center. 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 and plan to have children in the future, you might choose to leave a Shirodkar cerclage in place throughout your pregnancy and after the baby is born. However, it's possible that the cerclage could affect your future fertility. Consult your health care provider about your options. If you had a transabdominal cervical cerclage, you'll need to have another abdominal incision to remove the cerclage. As a result, a C-section is typically recommended.
Your baby will be delivered through an incision made above the cerclage. During the C-section, you can choose to have the cerclage removed or leave it in place for future pregnancies. 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.
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This content does not have an Arabic version. Overview Cervical cerclage Open pop-up dialog box Close. Cervical cerclage In a cervical cerclage, strong stiches sutures are used to close the cervix during pregnancy to help prevent premature birth. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Berhella V. Cervical insufficiency. Accessed Feb. Norwitz ER, et al. Transabdominal and laparoscopic cervicoisthmic cerclage.
Norwitz ER. Transvaginal cervical cerclage. Accessed March 12, American College of Obstetricians and Gynecologists. Obstetrics and Gynecology. But it also has risks—it can cause infection or miscarriage. For women who have had a preterm birth because the cervix did not stay closed, cervical cerclage may prevent another preterm birth.
The risks of cervical cerclage are rare but can include:. If you have a cervical cerclage in place, talk to your doctor about whether you can have intercourse. Author: Healthwise Staff. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.
Your use of this information means that you agree to the Terms of Use and Privacy Policy. Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Top of the page. Surgery Overview Cervical cerclage is the placement of stitches in the cervix to hold it closed.
The surgery can be done in different ways: Stitches can be placed around the outside of the cervix. A special tape can be tied around the cervix and stitched in place. A small incision can be made in the cervix. A special tape is then tied through the cervix to close it. What To Expect After Surgery The time required for recovery depends on the type of cerclage procedure done. Had a miscarriage because of an abnormally shaped uterus or damage to the cervix.
A damaged cervix may not remain closed during pregnancy.
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