Pregnancy & Baby 

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Cervical cerclage

Cerclage is the application of a purse-string type suture (stitch) to the cervix after the first trimester in a woman who suffers from an incompetent cervix. This condition is characterised by the loss of a pregnancy abruptly and without pain, usually in the second or early in the third trimester. A rupture of the membranes generally occurs and the foetus is expelled with little or no discomfort. Because this tends to recur with each pregnancy, the preferred treatment is cervical suturing.

Cerclage should be delayed until after 14 weeks so that early miscarriage caused by other factors is possible. There is no consensus about how late in pregnancy the procedure should be performed. The later in pregnancy it is done, the more likely it is that surgical intervention will stimulate premature labour or rupture of the membranes.

An ultrasound is done to check the foetus is living and to try to rule out major foetal anomalies. Infection, bleeding or contractions are contra-indications to cerclage. Abstinence from intercourse is recommended for one week before and at least one week after the procedure.

Cerclage does not prevent all pre-term deliveries, but success rates are as high as 85 to 90%. Complications may involve infection and/or ruptured membranes.

The suture is usually cut in the last month of pregnancy and labour is allowed to occur as it will.

Your doctor may wish to place certain restrictions on sexual and other activities. Aerobic exercise is not permitted, although walking and isometric exercise are sometimes allowed.

Many women have had this operation with great success. I wish you the best.

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