- MEDICINE ATHENS MED4WOMAN ATHENS
- MEDICINE VOLOS MED4WOMAN VOLOS
- 2103390838
- 2421022988
Obstetrician Gynaecologist
Doctor of Medicine, University of Athens Medical School
Panagiotis Polyzos, Gynaecologist Obstetrician, is active at the Institute of Life - IVF Unit of Iaso Maternity Hospital.
Cervical cerclage is a surgical procedure in which a stitch is placed around the cervix (the lower part of the uterus). It is typically performed between the 12th and 24th week of pregnancy, although in some cases it may be done later in gestation.
Babies born prematurely (before 37 weeks of gestation) are at higher risk for short- and long-term health complications.
There are many causes of preterm birth; one of them is cervical insufficiency, in which the cervix shortens and dilates prematurely. Cervical cerclage can help prevent this from occurring.
A group of high-risk pregnant women who may require close monitoring from the early stages of pregnancy includes those who:
If, in any of the above cases, the cervical length is measured by transvaginal ultrasound to be less than 25 mm, your doctor may recommend:
In certain situations, the potential risks of cerclage outweigh its benefits. These include:
Cervical cerclage is performed vaginally, in the operating room, under spinal anesthesia. The bladder is first emptied, and a vaginal speculum is inserted to visualize the cervix. The cervix is then held gently using a surgical instrument, and a suture is placed around it to keep the cervical canal closed.
The procedure usually takes no more than 30 minutes. Mild analgesia may be prescribed afterward, and most patients can go home the same day.
Cervical cerclage can also be performed transabdominally rather than vaginally. This method is rarely used and is generally reserved for women in whom a vaginal cerclage has failed in the past.
Abdominal cerclage can be done before pregnancy or during early gestation. It may be performed laparoscopically or through an abdominal incision.
In the case of an abdominal cerclage, the suture is not removed, and delivery is carried out by cesarean section.
Sometimes, cervical cerclage is performed as an emergency or rescue procedure after painless cervical dilation has already begun. This is considered a last-resort intervention to try to prevent miscarriage or preterm birth. However, the risk of failure in such cases is high.
Potential risks include:
Cervical cerclage is not always successful and does not guarantee prevention of miscarriage or preterm delivery.
Vaginal cerclage does not increase the likelihood of requiring a cesarean section.
After cerclage placement, you may experience mild vaginal bleeding or brownish discharge for one to two days. Bed rest is not recommended. You may resume sexual activity once all symptoms have completely resolved.
You should contact your doctor immediately if you experience any of the following:
The stitch is usually removed in the clinic between 36 and 37 weeks of pregnancy, unless labor begins earlier.
Under normal circumstances, anesthesia is not required. A vaginal speculum is inserted, the suture is located, cut, and removed.
The process takes only a few minutes and may cause minimal discomfort. You may notice slight vaginal bleeding for about 24 hours, though brownish discharge may persist a bit longer.
If contractions begin while the stitch is still in place, you must go to the clinic immediately for removal to prevent cervical injury.
If premature rupture of membranes occurs without the onset of labor, the stitch is usually removed due to the increased risk of infection.
