Cervical Cerclage

• Transvaginal cervical cerclage
• Transabdominal cervical cerclage

Symptoms

A cervical cerclage may be needed in case the following symptoms are observed:

• Contractions 
• Pain in the abdomen and lower back, similar to labor pain
• Bleeding from the vagina
• Fever and chills
• Nausea
• Vomiting
• Unusual vaginal discharge

Diagnosis

A physical exam of the cervix carried out by the gynecologist can help diagnose cervical dilation in the second trimester of the pregnancy. Ultrasounds can help view the position of the fetus and its size and weight. Cervical cerclage is needed in case the ultrasound shows that the cervix is opening. Cervical length is measured to diagnose pre-term pregnancy. Uterine monitoring can also be done to measure duration of contractions. Cervical cerclage will be needed in case of signs of premature birth and labor.

Treatment

Usually, cervical cerclage is of trans-vaginal type. A speculum is inserted into the vagina to get maximum access to the cervix. An ultrasound may be used in order to see the fetus and the cervix during the surgery.

There are several ways of carrying out a cervical cerclage. Stitches may be placed outside the cervix and the sutures are tied to close the cervix. Another way is to make small incisions in the cervix and tape up the cervix. 

Risks

There are several risks involved in the process of cervical cerclage. There may be an infection at the site of incision or bleeding from the vagina. Due to the procedure, there may be a tear in the cervix known as cervical laceration. There are possibilities of the fetal membranes to prolapse into the vagina. The amniotic sac may break resulting in preterm labor and premature birth of the baby. There is also a little risk of miscarriage after a cervical cerclage.

After Procedure

The patient should not worry in case of experience spotting, pain and some bleeding after the procedure.