When is a cervical cerclage used?
The best time for the cervical cerclage procedure is in the third month (12-14 weeks) of pregnancy. However, some women may need a cerclage placed later in pregnancy; this is known as an emergent cerclage and is necessary after changes such as opening or shortening of the cervix have already begun. If an emergent cerclage is required, future pregnancies will probably also require a cervical cerclage.
The success rate for cervical cerclage is approximately 80-90% for elective cerclages, and 40-60% for emergent cerclages. A cerclage is considered successful if labor and delivery is delayed to at least 37 weeks (full term).
After the cerclage has been placed, the patient will be observed for at least several hours (sometimes overnight) to ensure that she does not go into premature labor. The patient will then be allowed to return home, but will be instructed to remain in bed or avoid physical activity for two to three days. Follow-up appointments will usually take place so that her doctor can monitor the cervix and stitch and watch for signs of premature labor.
While cerclage is generally a safe procedure, there are a number of potential complications that may arise during or after surgery. These include:
* risks associated with regional or general anesthesia
* premature labor
* premature rupture of membranes
* infection of the cervix
* infection of the amniotic sac (chorioamnionitis)
* cervical rupture (may occur if the stitch is not removed before onset of labor)
* injury to the cervix or bladder
There are three types of cerclage:
* A McDonald cerclage, described in 1957 is the most common, and is essentially a pursestring stitch used to cinch the cervix shut; the cervix stitching involves a band of suture at the upper part of the cervix while the lower part has already started to efface. This cerclage is usually placed between 12 weeks and 16 weeks of pregnancy. The stitch is generally removed around the 37th week of gestation.
* A Shirodkar cerclage is very similar, but the sutures pass through the walls of the cervix so they're not exposed. This type of cerclage is less common and technically more difficult than a McDonald, and is thought (though not proven) to reduce the risk of infection. The Shirodkar procedure sometimes involves a permanent stitch around the cervix which will not be removed and therefore a Caesarean section will be necessary to deliver the baby. The Shirodkar technique was first described by Dr. Shirodkar in Bombay in 1955. In 1963, Dr. Shirodkar traveled to NYC to perform the proceedure at the New York Hospital of Special Surgery; the procedure was successful, and the baby lived to adulthood.
* An abdominal cerclage, the least common type, is permanent and involves stitching inside the abdomen. This is usually only done if the cervix is too short to attempt a standard cerclage, or if a vaginal cerclage has failed or is not possible.
Are there signs I should look for after the cerclage is placed that indicate a problem?
It is important to contact your doctor if you experience any of the following symptoms after your cerclage is placed:
* Contractions or cramping
* Lower abdominal or back pain that comes and goes like labor pain
* Vaginal bleeding
* A fever over 100 F or 37.8 C, or chills
* Nausea and vomiting
* Foul-smelling vaginal discharge
* Your water breaking or leaking
What about future pregnancies?
Most women who need a cerclage in one pregnancy will need to have a cerclage placed in future pregnancies.
I found this info at-
Hope that wasn't too much info...
Hopefully everything goes well for you.
Stay positive, rest and keep us updated!
I will be thinking of you!
im so sorry to hear of your worry, im sure every one on here will be thinking of you let us know how you get on,
all my love
Atlantisea: Thanks for the information it was great! I am going to the Drs today and will let you know what he says.
Thankfully I got a new laptop for Christmas last year so I will be able to update everyone even if I continue to be on bed rest...
Thanks for the kind words emmiemac!
I am so sorry that you are going through this. I can tell you everything you would like to know about the subject as I have been studying it for 14 years now. I just had a Cerclage put in on August 1, 2008 and a high risk doctor will take you immediately. I have been with my high risk OB/GYN since I was 4 weeks pregnant. He was performing ultrasounds every week since I was 4 weeks to make sure my cervix was not opening early. Once I hit 12 weeks (exactly to the day) he did the Cerclage. I am now 16 weeks and 1 day and by the grace of God doing well. Please feel free to email me and we can discuss the process. I will keep you and your little boy in my prayers.
I'm so sorry for what you are going through but stay positive & I wish you the best of luck.
Oh mi gosh I cannot believe you have to go through this but hopfully being on bedrest will couteract the effects of gravity and you can halt the shortening in its tracks. I am praying and pulling for you!!!
pregnancy is supposed to be a happy and exciting journy for the mother to be, but sometimes stuff like this ruins it for us, I had two miscarriages before this pregnancy, one was at 8 weeks and the other was at 6 weeks, I am now 20 weeks and 4 days pregnant, but till now I havent enjoyed this pregnancy the way I should, and the way all the other women do, when I was 10 weeks pregnant, the doctore did an US, and told me that I had a big blood clot in my uterus, she said that it was about twice the size of the baby, and that I shouls rest as much as I can, she told me that there is a chance for me to have a miscarriage, so I did as I was told, thank god when I was 16 weeks the doctor told me that it was gone and that I was having a boy, and till now i am always scared if something happens, every time I go to the bathroom I pray not to see blood.
My point is that you shouldnt be afraid, if something is going to happen god forbid, it would happen whether you are afraid or not, so just do what the doctor tells you, and pray for the best for you and for your son.
We will all pray for you, because I went through the same thing and i know how you are feeling, hopefully later on in your life you will remember what the doctore told you and just thank god that nothing happened.
My thought and prayers are with you. Stay positive, and believe that everything is goanna be O.K.
God bless you
My thoughts are with you. I had a Shidokar cerclage done with my 1st pregnancy at 16 weeks due to funneling in 2004 and had no complications (thank goodness) but even with the cerclage you will be limited in what you can do. They'll be no exercise for you. If you push yourself, you'll end up on bedrest for the rest of your pregnancy (trust me on this). I'm actually pregnant again and seeing a dr on Tuesday to go through this all over again so hang in there!
Hi, i know how u feel, scared, worried and fustrated, that was how i felt 4 yrs ago when i had my daughter. i had to stay in the hospital for the whole nine months with a cervical stich, i was feeling just like u but if u have to stay in the hospital on bed rest i think u should it is for the sake of ur baby to be born alive and healthy, i'm now pregnant with my second child at 2 weeks 4 days and i know i might have to stay in the hospital but if that is what i have to do i will do it to have my baby. Don't worry just pray to god and everything will be alright.
Hi.. Can u gave me some advice, i'm on my 4 to 5 weeks of pregnancy,i was scareds and worry, last saturday feb. 11, i've got my trans v ultrasound, and doctors says, early intrauterine 4-5 weeks by gs, no yolk sac nor embryo seen yet,no subchorionic hemorrage noted,normal ovaries with corpus luteum in the right, suggest repeat scan after 2-3 weeks for pregnancy visibility.i was so scared and worried during that tim. Monday feb. 13 while im in the ofc. I was scared and nervous cause i saw a brown color and pinkish in my panty, and i called thru phone to my doctor & she says that i take a 1 week bedrest and get the medicine to her clinic for the protection of my baby or for the threatening of abortion, so that my huband will pickup the medicine and while im waiting in our home i saw a fresh blood on my panty and i was cried my husband arrived that time and gave me the medicine, and drunk it immediately, and my husband gave me strenght dont to loose hope and have faith in God..the medicine will be take it for 3 times a day for 1 week bedrest, and since yesterday,tuesday still spotting of brown and today wednesday it was a littlebit color of brown & black..but it just looks like a sesame seeds only unlike monday it was so scarry for me and nervous..my husband only and my mother gave me strenght to fight this spotting..also my doctor.pls. Gave me some advice to solve this problem..if this is normal? Thanks for reading.jane