Cervical cerclage is a surgical procedure in which sutures (or tapes) are placed around the cervix to prevent its premature dilation. This helps to prevent miscarriage or preterm birth in women diagnosed with cervical insufficiency (also known as cervical incompetence)—a condition in which the cervix is weakened and unable to maintain pregnancy until term.
Cervical cerclage is often recommended for women with a history of miscarriages or preterm births caused by premature cervical dilation.
Indications for cervical cerclage
- Cervical insufficiency. The cervix begins to dilate prematurely and is unable to support the pregnancy. This may be associated with congenital weakness of cervical tissue or trauma sustained during previous childbirth or abortions.
- History of preterm birth or miscarriage. In women with a history of late miscarriages or preterm deliveries, cerclage may help reduce the risk of recurrence.
- Short cervical length on ultrasound. Transvaginal ultrasound performed in early pregnancy may reveal significant cervical shortening, which is a marker of increased risk of preterm birth.
- Multiple pregnancy. In twin or triplet pregnancies, the risk of premature cervical dilation is higher, and cerclage may be considered to prevent complications.
Types of cervical cerclage
- Prophylactic (elective) cerclage. Performed between 12 and 16 weeks of gestation in women with a known history of cervical insufficiency or previous preterm births. This type is placed before clinical signs of cervical dilation appear.
- Emergency (therapeutic) cerclage. Used when cervical dilation is already detected later in pregnancy (usually after 16 weeks). Emergency cerclage is performed in an attempt to preserve the pregnancy.
- Abdominal cerclage. A less common and more complex procedure used when vaginal cerclage is not feasible or has previously failed. Abdominal cerclage involves placing a suture around the cervix through an abdominal incision.
How is the procedure performed?
Cervical cerclage is a surgical procedure that may be performed under local, spinal, or general anesthesia. The procedure usually takes 20–30 minutes and is often carried out on an outpatient basis.
- Preoperative assessment. Before cerclage placement, examinations are performed, including ultrasound, to assess the condition of the cervix and the fetus. The physician discusses potential risks and benefits with the patient.
- Placement of sutures. Using vaginal instruments, the physician places strong sutures or tapes around the cervix to reinforce it and prevent further dilation. The sutures remain in place until late pregnancy or until removal is deemed appropriate.
- Postoperative care. If no complications occur, the woman may return home the same day. Short-term bed rest and restriction of physical activity are commonly recommended.
When are the sutures removed?
The sutures are usually removed at 37–38 weeks of gestation, before the onset of labor. This allows the cervix to dilate naturally in preparation for vaginal delivery. In some cases, if a cesarean section is planned, the sutures may be left in place until delivery.
Cervical cerclage in Belarus is an effective intervention for women at risk of preterm birth or miscarriage associated with cervical insufficiency. When properly performed and followed by appropriate monitoring, the procedure helps prolong pregnancy to term and significantly reduces the risk of premature cervical dilation, thereby increasing the likelihood of a successful outcome.
Q&A
Да, после успешного завершения беременности и снятия швов женщина может забеременеть вновь. Однако при повторной беременности может потребоваться повторная процедура циркляжа.
После циркляжа рекомендуется избегать физической активности, тяжёлых нагрузок и половых контактов в течение первых нескольких недель. Ваш врач даст конкретные рекомендации в зависимости от вашего состояния.
