Has your doctor suggested a cervical stitch? Are you wondering what this procedure is and how it is performed? SMILES has you covered, and we answer all your questions about the cervical stitch surgery performed during pregnancy. Read the article that follows and prepare for your treatment.
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What is a Cervical Stitch?
A Cervical Stitch is usually implanted between 12 and 24 weeks of pregnancy. It is performed through the vagina (transvaginal cervical cerclage) or the abdomen (transabdominal cervical cerclage).
Why is Cervical Stitch Surgery Performed?
If your cervix is short or weak, it might get softened early in the first trimester itself, leading to bleeding, water breakage, miscarriage, and premature birth. Babies born prematurely have a risk of health problems. So, it is recommended to consult a specialist early in your pregnancy.
Cervical weakening or shortening happens because of several reasons. They are:
- ● If you have undergone any treatment for the cervix (a cone biopsy to remove abnormal cells and tissue from your cervix)
- ● If your cervix got damaged during a previous delivery
- ● If you had a miscarriage in your pregnancy
- ● If you had a previous delivery or your water broke before 34 weeks of pregnancy
- ● If you have a short cervical length before completing 24 weeks in the current pregnancy
Your consultant doctor may perform specific transvaginal ultrasound scans to measure the cervix. If they find that the cervix is short (less than 2.5 cm long), specialists recommend a cervical stitch to prevent premature birth or miscarriage during pregnancy.
How to Prepare for Cervical Stitch Surgery?
Before the Surgery:
Before the procedure, your specialist will go through your medical history, perform an ultrasound to check the baby’s growth, and check for cervical infections. If there is an infection, your doctor may prescribe antibiotics. Sometimes, stitches will not be placed if you have an infection, vaginal bleeding, or your water has already broken.
If ultrasound tests show that your cervix is opening, the obstetrician will suggest the cervical stitch. If you agree, specialists start the surgery by administering regional anesthesia to numb the pain or general anesthesia that puts you to sleep during surgical intervention. Most of the cervical stitches are inserted through the vagina. Abdominal cervical cerclage is only preferred if the transvaginal method is unsuccessful or a woman has a short or scarring cervix, making transvaginal cerclage difficult.
During the Surgery:
During transvaginal cervical cerclage, the surgeon will use a vaginal speculum to hold the cervix and stitch around it. Surgeons either tie the ends of the stitches to close your cervix or make tiny incisions and pass a needle of tape through the incisions to close the cervix.
During transabdominal cervical cerclage, your surgeon can make an incision on your abdomen or perform keyhole surgery. During this, they may also need to pull your uterus to reach the cervix. With the help of a needle, they close the cervix.
After the Surgery:
After the cervical cerclage, the doctor performs an ultrasound to check the health condition of your baby. You may observe symptoms of blood spots, cramps, and pain while urinating for a few days after the surgery. If pain persists, you may need to stay at the hospital for a while or visit the doctor every week.
When you reach 36 to 37 weeks or before the start of preterm labor, the stitch is removed. If you had transabdominal cerclage, you might need another incision to remove the cerclage, and you will need a cesarean section to give birth to the baby.
What are the Risks of Cervical Stitch?
- ● Vaginal bleeding
- ● Damage to the cervix
- ● Bacterial infections
- ● Early water breaking
- ● Premature labor or birth
- ● Miscarriage
- ● Neonatal death
It is recommended that you contact your obstetrician if you find any leakage from your vagina or signs of premature rupture of membranes. In such cases, your doctor might recommend the early removal of cerclage to avoid uterine infections.