Introduction
Cervical cerclage is a medical procedure used to support a weakened cervix during pregnancy. Women with a history of cervical insufficiency or premature birth may benefit from this intervention. A stitch, known as a cervical stitch, is placed around the cervix to prevent it from opening too early, reducing the risk of miscarriage or preterm birth. Understanding this process, its types, and how to manage life post-procedure can help expectant mothers feel more in control and confident about their pregnancy.
What Is Cervical Cerclage?
A cervical cerclage, also known as a cervical stitch, is a surgical procedure where a strong stitch is placed around the cervix to prevent it from opening too early during pregnancy. This is often done when the cervix is weak or shortening before the baby is ready to be born.
When Is It Recommended?
Doctors may suggest this procedure if:
- You’ve had previous miscarriages in the second trimester
- The cervix is found to be shortening early in pregnancy through ultrasound
- There’s a history of premature birth due to cervical insufficiency
- You’re carrying multiples, and cervical length is a concern
In clinics like Harley’s Women’s Clinic under Dr. Shilpa, a gynecologist in Mumbai, this procedure is routinely performed for women who meet these criteria.
Types of Cervical Cerclage
There are three main types of cervical cerclage, chosen based on medical history and the stage of pregnancy.
1. Transvaginal Cerclage
- Most common type
- Placed through the vagina
- Usually done between 12 and 14 weeks
- Removed around 36–37 weeks or during labour
2. Transabdominal Cerclage
- Less common, done when vaginal cerclage is not possible
- Requires abdominal surgery
- May stay in place for future pregnancies
- Typically done before conception or early in pregnancy
3. Emergency or Rescue Cerclage
- Performed later in pregnancy if cervix is already dilated
- Considered a last resort when labour hasn’t started
- Higher risk of complications
How the Procedure Is Done
Cervical cerclage is typically done as a day procedure and involves the following steps:
- A spinal or general anaesthetic is used
- The cervix is stitched closed using strong medical thread
- The process takes about 30–60 minutes
- Most women return home the same day
You’ll be advised to rest for a day or two and may need regular follow-up scans to monitor the cervix.
Things Not to Do After Cervical Cerclage
Recovery is usually smooth, but certain actions can cause stress on the cervix and should be avoided.
Activities to Avoid:
- Heavy lifting or physical exertion
- Sexual activity (for at least 1–2 weeks or as advised)
- Travelling long distances, especially on bumpy roads
- Standing or walking for extended periods
- Inserting anything vaginally (including tampons)
Always follow your doctor’s advice based on your specific condition.
Common Symptoms After Cerclage
After the procedure, some discomfort is normal. However, you should be aware of what is usual and what requires medical attention.
Normal symptoms:
- Mild cramps
- Light bleeding or spotting
- Mild back pain
Contact your doctor if you notice:
- Severe cramping
- Heavy bleeding
- Leaking fluid from the vagina
- Fever or chills
- Strong pelvic pressure
In clinics like those run by Dr. Shilpa, post-procedure care is given high importance, with personalised instructions based on your health.
Benefits of Cervical Cerclage
Cervical cerclage can be life-saving for the baby in many cases. It helps keep the cervix closed until the baby is more developed.
Advantages include:
- Reduced risk of miscarriage
- Lower chance of premature birth
- Greater peace of mind during pregnancy
While not guaranteed to prevent early birth in all cases, it has shown strong results for women with a history of cervical insufficiency.
Risks and Complications
Every medical procedure has some risks, and cervical cerclage is no exception.
Possible Risks:
- Infection of the cervix or uterus
- Premature rupture of membranes
- Bleeding
- Stitch failure
- Irritation of the cervix
In rare cases, early removal of the stitch may be needed. However, most women have positive outcomes with proper monitoring.
How to Prepare Before the Procedure
Being prepared helps reduce anxiety and allows your body to respond better.
Pre-procedure checklist:
- Discuss your full medical history with your doctor
- Get necessary blood and ultrasound tests
- Arrange someone to take you home after surgery
- Avoid food or drink (as advised before anesthesia).
- Take prescribed medication only
Your gynecologist will guide you on how to manage any other health conditions, like diabetes or thyroid problems.
Recovery and Aftercare
Taking proper care of yourself after the procedure is important for healing and supporting the pregnancy.
Recovery tips:
- Take prescribed medications regularly
- Rest as advised for a few days
- Attend all follow-up visits
- Report any unusual symptoms immediately
- Eat a nutritious diet to support your baby’s growth
Most women are back to light activities within a week, but travel, work, or any high-strain tasks may be delayed.
When the Stitch Is Removed
The stitch is typically removed at 36–37 weeks, or earlier if labor begins. The removal process is usually simple and done without anesthesia.
Some women go into labor soon after the stitch is taken out, while others may carry to full term. In the case of transabdominal cerclage, a planned C-section may be needed.
FAQ
Q1. What is cervical cerclage, and when is it needed?
Answer: Cervical cerclage is a procedure where a stitch is placed around the cervix to keep it closed during pregnancy. It’s done when a woman’s cervix starts opening too early, raising the risk of miscarriage or preterm labor.
Q2. How long does recovery take after getting a cervical stitch?
Answer: Recovery varies, but most women can resume normal light activities within a few days. Rest is advised for at least a week, and full physical activity should be resumed only after medical clearance.
Q3. What things should I not do after cervical cerclage?
Answer: Avoid heavy lifting, intercourse, standing for long periods, travel, and strenuous physical activity. Follow medical advice strictly to reduce pressure on the cervix.
Q4. Is the cervical stitch procedure painful?
Answer: The procedure is typically done under anesthesia, so there is minimal discomfort during the surgery. Some cramping or spotting can occur afterwards.
Q5. When is the cervical stitch removed?
Answer: It is usually removed around 36–37 weeks of pregnancy unless labor begins earlier. Removal is quick and generally painless.
Q6. Can a woman have a normal delivery after cervical cerclage?
Answer: If a transvaginal cerclage is used, normal delivery is often possible once the stitch is removed. Transabdominal cerclage, however, requires a cesarean section.
Q7. What are the risks of not getting a cerclage when needed?
Answer: Without a cerclage, a weakened cervix can open prematurely, leading to miscarriage or very early birth. Your doctor will assess if you’re at high risk and advise accordingly.
Q8. Is bed rest necessary after cerclage?
Answer: Complete bed rest is not always needed, but limited physical activity and regular monitoring are advised.