What is a Cervical Cerclage and Who is a Candidate for One?
A cervical cerclage is a stitch that is placed in the cervix of a patient who has cervical insufficiency (previously called cervical incompetence) either preventatively at 12 weeks of gestation or emergently when the cervix is found to be short on ultrasound in the mid-trimester (also called a rescue cerclage).
Pre-term labor is a contraindication to placement of a cervical cerclage, so the patient with painless cervical dilation leading to loss of prior pregnancy is a candidate in the next pregnancy for a cerclage.
If a patient has a mid-trimester sonogram that shows significant cervical shortening and/or dilation without any contractions, a cervical cerclage may be indicated. The patient is usually given epidural anesthesia (in select cases general anesthesia is used) and a purse-string stitch is placed circumferentially around the cervix.
Risks include iatrogenically rupturing the membranes, introducing infection, or subsequent labor that can lead to tearing through the cerclage with loss of the pregnancy and trauma to the maternal cervix.
THINKING ABOUT GETTING PREGNANT OR HAVE QUESTIONS ABOUT YOUR PREGNANCY?
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