What is cerclage?
Cerclage is a procedure to keep the cervix closed during pregnancy to prevent premature birth. In pregnant women who have a weak and loose cervix, the gynecologist prescribes this procedure and the fetus is preserved until the time of delivery. For this purpose, the doctor puts one or more stitches in the opening of the cervix to keep it closed during pregnancy. Cervix is actually the lower part or cervix. The uterus is like a bag and the cerclage is similar to the straps that keep the bag closed.
What does cerclage mean?
Cervical cerclage is a surgical procedure for women with problems such as cervical instability or similar cases, which is performed in order to reduce the possibility of miscarriage. In this method, which is usually performed between 14 and 18 weeks of pregnancy, the cervix is closed using stitches. Of course, in emergency situations, cerclage may be performed at week 25 or even later.
Applications of cerclage
Some of the applications of cerclage include:
Preventing and reducing the possibility of premature birth: In case of symptoms of premature birth, you should see a doctor.
Strengthening the cervix and preventing its premature opening in women who have a weak cervix.
Prevention method in women who have a history of frequent miscarriage. First, the reasons for frequent abortions should be investigated.
For prevention in women suffering from structural abnormalities of the cervix.
Cerclage in pregnancy
Cervical cerclage is a method of temporarily closing the cervix with stitches during pregnancy, which is performed in the second trimester of pregnancy with the aim of preventing premature birth. In pregnant women, the cervix acts as the entrance to the uterus and the gap between the uterus and the vagina.
In some cases, this cervix weakens and is unable to hold the fetus inside the uterus until delivery. In such conditions, cerclage is performed during pregnancy. The type and time of performing cerclage in pregnancy depends on factors such as previous pregnancy history, history of premature birth, cervical structure and physician’s opinion.
For whom is cerclage suitable?
It is natural that this operation cannot be prescribed for all people, and for this reason, you only need to perform cerclage if you have special conditions.
Mel cerclage is not suitable for whom?
If the length of the cervix is less than or equal to 25 mm before the 24th week of pregnancy and the patient does not have a history of premature singleton delivery, there is no need to perform cerclage. Even if the cervix begins to dilate very early, it is not a good option for cerclage if the patient has the following conditions:
premature birth
Vaginal bleeding
Infection in the uterus
Cervical length for cerclage
If the length of the cervix is more than 35 mm, it is considered as a normal condition. If the length of the cervix is less than 30 mm, the gynecologist thinks about cerclage.
Benefits of cerclage
Among the benefits of cerclage surgery, the following can be mentioned:
Prevention of unwanted abortion
Prevent premature birth due to weak cervix
Birth of a healthy baby
The fetus stays in the mother’s womb during normal times
Cerclage procedure (How is cerclage performed?)
Cervical suturing is performed using one of McDonald’s, Shirodkar or abdominal methods. Depending on the condition of the patient, after examining the health condition of the mother and the baby, one of the methods of local anesthesia, spinal or in special cases epidural are chosen to anesthetize the patient.
In some cases, the cervix is also numbed using local anesthetics; In mothers who have special problems, the use of anesthesia is also possible.
After preparing the patient, the doctor inserts a speculum into the vagina to keep it open and then performs surgery using one of the McDonald or Shirodkar methods. The method of performing these two types of surgery is different from each other, but their results are the same.
If using the above methods is not possible or fails, the gynecologist connects the cervix to the upper parts by making an incision on the patient’s abdomen. In this method, due to the complete closure of the cervix, delivery must be performed by cesarean section.
How many weeks is cerclage done?
Cerclage is performed between 12 and 14 weeks of pregnancy, that is, before 15 weeks of pregnancy, and after that, cerclage is maintained until 37 weeks of pregnancy. At the end of the 37th or 38th week of pregnancy, the cerclage is opened.
How many hours does the cerclage procedure take?
This procedure is usually very short-term and will not take much of your time. Usually, this surgery takes about an hour.