Cervical Stitch (Cerclage)

What is a Cervical Stitch (Cerclage)?

A Cervical Stitch, also known as Cervical Cerclage, is a common medical procedure used to prevent premature birth or miscarriage in some women. This procedure involves stitching the cervix (the lower part of the uterus) to help it stay closed during pregnancy. It’s usually recommended if the cervix is weak or starts to open too early, a condition known as cervical incompetence or cervical insufficiency.

At My Lady Doc, we understand that hearing about this procedure can be overwhelming, but our team is here to guide you through the process with care and expertise.

When is Cervical Cerclage Recommended?

A cervical stitch may be suggested if you have:

• A history of preterm birth (before 37 weeks of pregnancy)
• Previous miscarriages in the second trimester
• A diagnosis of cervical incompetence, often found during routine pregnancy scans
• Shortened cervix identified on an ultrasound during pregnancy
• Physical examination showing early cervical opening during pregnancy

Types of Cervical Cerclage

There are three main types of cervical cerclage, which your healthcare provider will discuss with you depending on your medical history and current pregnancy status:

1. Transvaginal Cerclage (TVC): The most common type, where the stitch is placed through the vagina.
2. Transabdominal Cerclage (TAC): A less common procedure, done if a vaginal cerclage isn’t possible or has previously failed. The stitch is placed through the abdomen.
3. Emergency Cerclage: Performed if the cervix is already starting to open in the middle of pregnancy.

How is the Procedure Done?

The procedure is usually performed between 12 and 14 weeks of pregnancy, but it can be done later if necessary. Here’s what to expect:

1. Preparation: The procedure is typically done under regional anesthesia (spinal or epidural), but sometimes general anesthesia may be used.
2. The Stitch: The doctor will place a strong stitch (or multiple stitches) around the cervix, securing it closed.
3. Post-Procedure: You may be required to stay in the hospital for a few hours or overnight for observation. Most women are able to go home the same day.

Is Cervical Cerclage Safe?

Cervical cerclage is considered safe and has a high success rate in preventing premature births. However, like any medical procedure, it does carry some risks, such as:

• Infection
• Bleeding
• Premature rupture of membranes (water breaking)
• Preterm labor

At My Lady Doc, we will closely monitor you and your baby’s health before and after the procedure to minimize any risks.

What to Expect After the Procedure

After the cervical stitch is placed, you may experience:

• Light spotting or mild cramping for a few days
• Pelvic rest (avoiding sexual intercourse) for a short period as recommended by your doctor
• You will be advised to avoid strenuous activities or heavy lifting during the rest of your pregnancy

Follow-up care is crucial. Regular check-ups, including ultrasounds, will help ensure that your cervix remains closed and that your pregnancy is progressing smoothly.

When is the Stitch Removed?

The cervical stitch is usually removed around 36 to 37 weeks of pregnancy, or earlier if you go into labor. The removal is a simple procedure that doesn’t usually require anesthesia, and most women can go home the same day.

If you had a transabdominal cerclage, the stitch might not be removed, and you may need to have a Cesarean section (C-section) for delivery.

Can You Have a Normal Pregnancy After Cervical Cerclage?

Yes! Many women go on to have healthy, full-term pregnancies after having a cerclage. If you’ve had a cervical stitch in a previous pregnancy, you might need one in future pregnancies as well, but your doctor will assess each situation individually.