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Is cervical cerclage safe for baby?

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Every loving couple would want the best for their child. While it may be easy for a lot of women to bear pregnancy, some women may have difficulty getting pregnant or to ensure their pregnancy ends with safe delivery. There are many conditions that cause a woman to have problems before and during pregnancy. Some of these conditions need a patient to ask a doctor. In this article, we will learn about cervical cerclage, being one of the medical procedures to aid in pregnancy.

Cervical cerclage is a procedure of temporarily sewing the cervix closed with stitches. It is often done in the second trimester of pregnancy to prevent preterm birth. Do you know what exactly a cervix is? Cervix is the lower, narrow end of the womb (uterus) connecting the uterus to the vagina. The cervix has 2 parts which are ectocervix and the endocervix. Ectocervix are the parts seen during pelvic exam whereas the endocervix are the one connecting vagina to the uterus. Functions of the cervix are to allow fluid such as menstrual blood and widens during baby delivery.

Reasons being why cervical cerclage is placed is to support the cervix. Weakness of the cervix or known as cervical insufficiency can cause preterm birth and quick delivery. This means that even with only mild contractions or any pain, the baby will be forced out from the uterus way before it should. Thus, the aim for a cerclage is to prevent cervical weakness which typically causes preterm birth.

Before going further about cervical cerclage, how do you know if a woman has cervical weakness? This condition is suspected if the woman has had a history of one or more second trimester pregnancy loss related to painless cervical dilation, multiple second trimester pregnancy losses or preterm birth and previous prior cerclage placed due to cervical insufficiency in the 2nd trimester. Beside the suspicion of cervical insufficiency based on history, ultrasound exams that show short cervix or other risk factors for preterm birth are recommended to get cervical cerclage.

There are 2 types of cerclage:

  • Transvaginal cerclage- cerclage done through the vagina to place the stitches in the cervix, cerclage will be removed around 37 weeks of pregnancy
  • Transabdominal cerclage- a cut is made in the abdomen to reach the cervix and place stitches, cerclage is left in place until delivery via caesarean birth or be left in between pregnancies to prevent future preterm birth and pregnancy loss

Cervical cerclage is usually performed by the 3rd month of pregnancy or easily said at the end of first trimester. Early detection of cervical insufficiency can help prevent further problems during pregnancy. Even so, there are actually emergency stitches which are done when the cervix has already started to open in order to prevent late miscarriage or early preterm birth. This emergency stitch is less likely to work compared to other cerclage due to the higher risks. However, if cervix opening is detected too late, cervical cerclage may not be an option and women may be put on bed rest instead.

Those undergoing cervical cerclage may wonder if there is something else they should expect to ease their worries. After a cerclage, it is common to have spotting or some bleeding for up to 3 days, a few days of light cramping and observe more clear discharge from the vagina. When spotting of discharge occurs, it is best to wear a sanitary pad and change as often needed. Patients are advised to avoid heavy activities for a few days and to check with their doctor first before enrolling in any sexual intercourse.  In case there are signs of contractions or cramping abdominal pain, continued or heavy vaginal bleeding, smelly or green vaginal discharge and water breaking or leaking, it is best to contact a doctor to ensure there is nothing serious happening.

Since cervical cerclage is a procedure done to prevent preterm birth, some might wonder if it is safe for babies. Yes, it is safe in most cases. Having a stitch in place will not affect the baby’s growth and development. As a matter of fact, patients can carry on with their lives normally. It is important for the mother to have a clear understanding of the plan to take care of their baby and themselves during the pregnancy.

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It can be concluded that cervical cerclage is a procedure of stitching the cervix to prevent preterm birth or pregnancy loss. It is often done in women suspected with cervical insufficiency. Cervical cerclage may be done in the doctor’s office or in the operating theatre. Transvaginal cerclage is the most common way done for cervical cerclage. Transabdominal cerclage is often used in cases where the women have had surgeries on cervix or previous transvaginal cerclage unable to prevent pregnancy loss. Apart from cervical cerclage, there are other ways available to help with cervical insufficiency such as hormone medication and pessary devices.