Surgery Overview

Cervical cerclage (say "SER-vuh-kul ser-KLAZH") is a procedure that helps keep a pregnant woman's cervix from opening too soon before delivery.

The cervix is the lower part of the uterus. It leads to the vagina. During pregnancy, it is tightly closed to protect the baby. Normally, it doesn't open until the baby is ready to be born. Most of the time, this happens at 37 to 42 weeks. But sometimes it opens too early.

In cervical cerclage, the doctor sews the cervix shut early in the pregnancy. The stitches are removed in time for the baby to be born.

This procedure may be used when:

• The woman has a history of preterm labour.
• A physical examination early in the pregnancy shows that the cervix has started to open.

The anesthesia may make you sleep. Or it may just numb the area being worked on. The procedure will take less than an hour.

Many women go home the same day.

This procedure has helped some high-risk pregnancies last longer. But it also has risks. It can cause infection or miscarriage.

What To Expect

How long it takes to recover depends on the type of cerclage procedure you had. Your doctor can give you an idea of what to expect. You may get antibiotics to prevent infection.

Why It Is Done

Cervical cerclage may be done if you:

• Have an incompetent cervix.
• Had a miscarriage because of an abnormally shaped uterus or damage to the cervix. A damaged cervix may not stay closed during pregnancy.
• Had a previous pregnancy loss in the second trimester or a delivery that occurred with few or no contractions. This is a clue that your cervix may not stay closed during pregnancy.

How Well It Works

Success of the cervical cerclage procedure is defined as a pregnancy that lasts until term or close to term.

Cerclage has helped some high-risk pregnancies last longer. But it also has risks—it can cause infection or miscarriage. For women who have had a preterm birth because the cervix did not stay closed, cervical cerclage may prevent another preterm birth.^{footnote 1}

Risks

The risks of cervical cerclage are rare. They include:

• Infection.
• Damage to the cervix during surgery.
• Excessive blood loss.
• Preterm prelabour rupture of membranes (pPROM). This means your water breaks long before it should.
• Preterm labour.
• Permanent narrowing or closure of the cervix (cervical stenosis).
• Tearing of the cervix or uterus if labour progresses with the stitches still in place.