Cervical Cerclage

Overview

What is cervical cerclage?

Cervical cerclage is a medical procedure in which your doctor places a single stitch around your cervix, the opening to your uterus. The stitch sews your cervix closed.

Doctors perform cerclage to prevent late (second trimester) miscarriages and preterm (early) delivery. Women may be at risk for these complications because of cervical incompetence (when your cervix opens too soon during pregnancy).

Your doctor will perform cervical cerclage, also called cervical stitch, in a hospital. The procedure usually takes less than one hour. Many women return home the same day.

Who is a candidate for cervical cerclage?

Women at higher risk of cervical incompetence (when your cervix begins to open before pregnancy is full-term) may have cerclage between the 12th and 14th weeks of pregnancy. Your doctor may insert a stitch up to the 24th week of your pregnancy if your cervix begins to either shorten or open early. Doctors remove the suture as the full-term due date approaches or if other indications arise.

Your doctor may recommend cervical cerclage if you have a weakened cervix. Your cervix may be weak if you have had:

  • Previous cone biopsy or loop electrical excision procedure (LEEP). During a cone biopsy, your doctor removes a cone-shaped sample of tissue from your cervix for examination in a laboratory. A LEEP uses a small electrical wire to remove irregular cells and tissue from your cervix.
  • A history of miscarriage in the second trimester.
  • Previous delivery before 34 weeks of pregnancy and cervical shortening in the current pregnancy before 24 weeks.

Procedure Details

What should I expect from cervical cerclage?

Your doctor performs cervical cerclage in a hospital operating room. In the operating room, your doctor inserts a tool called a speculum into your vagina to access your cervix. Then the doctor places the stitch around the upper part of the cervix and tightens the stitch. The stitch holds the cervix closed.

Many women go home soon after their procedure. Your doctor may recommend that you stay in the hospital overnight, depending on your overall health and the risk to your pregnancy.

What should I expect after cervical cerclage?

Many women undergoing cervical cerclage return home the same day as the procedure.

Following cervical stitch, you may experience mild cramping, light bleeding, and vaginal discharge. Your doctor may recommend two to three days of rest after cervical cerclage.

In general, your doctor removes the cervical stitch during the 37th week of your pregnancy. Stitch removal usually occurs at your doctor’s office.

Risks / Benefits

What are the benefits of cervical cerclage?

Cervical stitch helps prevent preterm births or miscarriages caused by cervical incompetence.

What are the risks of cervical cerclage?

Most women have no complications from cervical cerclage. Like any surgical procedure, some risks exist. These may include:

  • Infection
  • Bleeding
  • Premature contractions
  • Rupture of membranes (water breaking)
  • Miscarriage or preterm delivery if the stitch fails

When to Call the Doctor

When should I contact my doctor?

Contact your doctor immediately if you experience any of the following after cervical cerclage:

  • Fever, chills, nausea, vomiting or foul-smelling vaginal discharge
  • Contractions, cramps or abdominal pain
  • Heavy or persistent vaginal bleeding
  • Your water breaking
  • Problems with urinating

Last reviewed by a Cleveland Clinic medical professional on 10/11/2018.

References

  • American Pregnancy Association. Cervical Cerclage. (http://americanpregnancy.org/pregnancy-complications/cervical-cerclage/) Accessed 10/15/2018.
  • Royal College of Obstetricians & Gynaecologists. Cervical stitch. (https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-cervical-stitch.pdf) Accessed 10/15/2018.
  • Alfirevec Z, Stampaliga T, Medley N. Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy. (https://core.ac.uk/download/pdf/131165057.pdf) Cochrane Database of Systematic Reviews 2017, Issue 6. Art. No.: CD008991. Accessed 10/15/2018.

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