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Has your doctor suggested a cervical stitch? Are you wondering what this procedure is and how it is performed? Dr Komala’s Women Clinic has you covered, and we answer all your questions about the cervical stitch surgery performed during pregnancy. Read the article that follows and prepare for your treatment.
Cervical Stitch, also known as cervical cerclage, is the surgical procedure performed when a woman is pregnant to prevent a miscarriage or preterm delivery of the baby. During this procedure, doctors use sutures or a synthetic band to close your cervix.
A cervical stitch is usually implanted between 12 and 24 weeks of pregnancy. It is performed through the vagina (transvaginal cervical cerclage) or the abdomen (transabdominal cervical cerclage).
The cervix is the lower part of the uterus that acts as a passage between the vaginal and uterine cavities. Before pregnancy, it is closed, long, and firm. During pregnancy, it stays close until the late third trimester and gradually weakens, decreases, and opens to allow the baby to pass through the birth canal.
If your cervix is short or weak, it might get softened early in the first trimester itself, leading to bleeding, water breakage, miscarriage, and premature birth. Babies born prematurely have a risk of health problems. So, it is recommended to consult a specialist early in your pregnancy.
Cervical weakening or shortening happens because of several reasons. They are:
Your consultant doctor may perform specific transvaginal ultrasound scans to measure the cervix. If they find that the cervix is short (less than 2.5 cm long), specialists recommend a cervical stitch to prevent premature birth or miscarriage during pregnancy.
For surgery, consult the best obstetrician specialists near you or visit the best gynecology hospital for treatment.
Before the procedure, your specialist will go through your medical history, perform an ultrasound to check the baby’s growth, and check for cervical infections. If there is an infection, your doctor may prescribe antibiotics. Sometimes, stitches will not be placed if you have an infection, vaginal bleeding, or your water has already broken.
If ultrasound tests show that your cervix is opening, the obstetrician will suggest the cervical stitch. If you agree, specialists start the surgery by administering regional anesthesia to numb the pain or general anesthesia that puts you to sleep during surgical intervention. Most of the cervical stitches are inserted through the vagina. Abdominal cervical cerclage is only preferred if the transvaginal method is unsuccessful or a woman has a short or scarring cervix, making transvaginal cerclage difficult.
During transvaginal cervical cerclage, the surgeon will use a vaginal speculum to hold the cervix and stitch around it. Surgeons either tie the ends of the stitches to close your cervix or make tiny incisions and pass a needle of tape through the incisions to close the cervix.
During transabdominal cervical cerclage, your surgeon can make an incision on your abdomen or perform keyhole surgery. During this, they may also need to pull your uterus to reach the cervix. With the help of a needle, they close the cervix.
After the cervical cerclage, the doctor performs an ultrasound to check the health condition of your baby. You may observe symptoms of blood spots, cramps, and pain while urinating for a few days after the surgery. If pain persists, you may need to stay at the hospital for a while or visit the doctor every week.
When you reach 36 to 37 weeks or before the start of preterm labor, the stitch is removed. If you had transabdominal cerclage, you might need another incision to remove the cerclage, and you will need a cesarean section to give birth to the baby.
The risks of cervical stitch surgery could lead to problems such as:
It is recommended that you contact your obstetrician if you find any leakage from your vagina or signs of premature rupture of membranes. In such cases, your doctor might recommend the early removal of cerclage to avoid uterine infections.
Cervical stitch surgery reduces the risk of a miscarriage or preterm birth of the baby in pregnant women. However, the efficacy of the cervical stitch depends on when it is performed. SMILES suggests you consult an obstetrician specialist in the early stages of your pregnancy to avoid complications later.
If you have any signs of uterine infections, vaginal bleeding, or contractions, and your water has already broken, cervical stitch surgery is not recommended because it may pose risks to you and your baby.
If your cervix has already opened up, doctors suggest an emergency stitch to prevent miscarriage or preterm birth. It is called a ‘rescue stitch’. In general, doctors do not prefer it because of its high risk.
Suppose a cerclage is intact, you may experience the inability of the cervix to dilate during labor, or it can rupture membranes. It may further lead to cervical infections or pose risks of cervical lacerations if you deliver the baby before cerclage removal.
Vaginal progesterone is an alternative to cervical stitch. If your doctor suggests progesterone, it is inserted into your vagina as a pessary.
Komala’s Women Clinic is a multidisciplinary organization dedicated to the advancement of the art, science and practice of reproductive medicine.
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