When the cervix of a pregnant woman is weak, the chances of giving birth to a premature baby are raised by the shortening or premature opening of the cervix.
To prevent premature birth, the opening to the uterus is stitched or closed by means of a method called cervical cerclage, which ensures the developing baby stays inside the uterus until you are 37 to 38 weeks pregnant.
Causes of incompetent cervix:
- Cervical damage due to pregnancy termination;
- History of miscarriage [signs of miscarriage]during second trimester;
- Undergoing LEEP procedure or cone biopsy previously.
When to undergo cervical cerclage:
The best time to undergo this method is in the third month, i.e. between the gestational ages of 12 to 14 weeks.
But, some pregnant women require cerclage in late pregnancy, a procedure called emergent cerclage. If you undergo emergent cerclage, your future pregnancies will also need a cervical cerclage.
Alternatives to cervical cerclage:
If cervical changes only surface during late pregnancy or if the cervix is already opened up, the best solution is complete bed rest.
Doctors recommend cervical cerclage if you have any of the following risks:
- Hormonal influences;
- Previous pre-term delivery;
- Uterine or cervical abnormalities;
- Premature rupturing of the membranes or breaking of water;
- Previous trauma or any cervical surgery;
- Exposure of the fetus to diethylstilbestrol (DES), a synthetic hormone used for treating recurrent miscarriage.
While a pre-term baby is a high risk factor, cerclage is only necessary for women who have an abnormal or incompetent cervix, and frequent doctor’s checks for infection are needed.
Before undergoing cervical cerclage, you need to be administered with general, spinal or epidural anesthesia to control the pain. Your practitioner will use a strong thread to stitch and tighten your cervix.
While most practitioners feel cerclage is a life-saving precaution, there are few side-effects and minimal risk factors which need to be observed::
- Infection of the cervix;
- Premature contractions;
- Premature rupturing of membranes;
- Cervical laceration if labor occurs before the removal of cerclage;
- Cervical dystocia (Cervix is unable to dilate normally during the labor course);
- Nausea and vomiting (Risks due to general anesthesia).
If you notice any of the following symptoms after undergoing this procedure, contact your healthcare provider:
- Vaginal bleeding;
- Vomiting and nausea;
- Cramping or contractions;
- Foul-smelling vaginal discharge;
- Water leaking or breaking;
- Chills or fever more than 100 F or 37.8 C;
- Back pain or lower abdominal pain that seems like labor pain.