Incompetent cervix mostly affects women. It occurs due to shortage or weakening in the cervix during pregnancy. This leads to premature birth, miscarriage and other common issues if it is left untreated. Its other name is cervical insufficiency.
Cervical cerclage prevents premature birth by keeping the cervix closed. This approach is a best treatment method and mainly applicable for adult females. Doctors recommend ultrasound tests, screening etc., for its preparation.
What is Cervix?
A cervix is a small canal which involves the connection between the two body parts i.e. uterus and vagina. This organ is located at a pelvic cavity and plays an essential role in menstruation, pregnancy etc. It is most important for the female reproductive system.
When it gets weakened then it causes cervical insufficiency. Women face trouble during pregnancy and they are unable to give birth to their child. This health condition is harmful and rare for them, which does not get cured easily.
Types
This therapy is of three types. These are as follows:
- Emergency Cerclage: This procedure can be performed for the management of cervical insufficiency or dilation. It is not applicable for patients with active labor, vaginal bleeding or infection symptoms.
- Elective Cerclage: It treats women with premature birth at a higher risk and mainly recommended as a lower procedure than emergency cerclage. A doctor performs this surgery between 12 to 14 weeks.
- Transabdominal Cerclage: A synthetic band can be stitched around a cervix for the prevention of pregnancy loss in females. It is a highly effective treatment and can be performed when other methods are unable to manage incompetent cervix symptoms.
Why can this Surgery be Performed?
A healthcare provider may recommend this procedure for several reasons. These include the following:
- Incompetent or weakened cervix
- Past miscarriage or preterm birth
The past pregnancies, miscarriage or any other pregnancy issue must be discussed with your provider. After that, a cervical cerclage procedure can be performed if he or she thinks that it is a right choice or beneficial for a patient. It is an outpatient surgery which can be conducted from 12 to 14 weeks.
Advantages
Cerclage consists of two benefits, which are as follows:
- It closes the incompetent cervix, which prevents premature labor during pregnancy.
- This method is also beneficial for females with miscarriage in the second or third trimester.
Risks and Complications
The complications of this surgery are the following:
- Infection
- Excessive blood loss
- Scar tissue
- Damage in cervix
- premature rupture of membrane
- Tearing of cervix or uterus
- Cervical stenosis
- High-order pregnancy
- Prolapsed fetal membrane
Before Procedure
A few steps need to be taken before surgical procedure. These include the following:
- An appointment can be scheduled with a healthcare provider to discuss the potential risks and benefits associated with cervical cerclage.
- A medical history must be reviewed by a provider, which include miscarriages, past or previous pregnancies, surgeries etc.
- The cervical length and overall status of a pregnancy must be identified through ultrasound tests.
- Before making an informed decision, a patient discusses with their provider and can ask any questions related to cerclage.
- Avoid eating or drinking for a certain period and consult with your healthcare provider before taking any pain medicine.
- Patients must bring only essential items, which are provided by their healthcare professional. It can be identification, insurance information etc.
- Follow specific hygiene instructions and wear comfortable clothing during surgery.
- The relaxation technique or meditation are most important for stress and anxiety management since undergoing surgery is emotionally challenging for patients.
During Procedure
The following things that can be possible during surgery are as follows:
- A patient can be admitted into a hospital and wear a hospital gown during surgical procedure.
- The vital signs can be checked and an intravenous injection must be inserted for the delivery of fluid and medications.
- A general or local anesthesia is provided to perform cerclage, depending on the procedure and preferences of a provider.
- The patient will lie on their back on their operating table with their opening legs and feet in stirrups.
- Surgeons will clean and sterilize a genital area for the reduction of infectious risk.
- A speculum will be attached in your vagina for cervix visualization. The special instruments will be used for grasping gently.
- The stitch can be placed around a cervix for the prevention of premature dilation. It can be of any type depending on specific circumstances and preference of a healthcare provider.
- Make sure that a stitch is secure and supports the cervix appropriately, once it gets attached.
- A surgeon removes the speculum and cleans the vaginal area before closing the incision with stitches.
After Procedure
- A patient will be taken to their recovery area where vital signs and other immediate complications are observed by their healthcare provider.
- Women feel pain or discomfort after the surgery. The pain medications or over-the-counter antibiotics can be prescribed or recommended for them. If they experience light bleeding, severe pain or vaginal spotting as the serious complications, then they must consult with their healthcare provider.
What are the instructions that can be followed after the surgery?
A healthcare professional provides certain instructions for female patients. These are as follows:
- Strenuous activities and heavy objects must be avoided.
- Stay hydrated and follow a balanced and nutritious diet for overall health.
- Avoid harmful habits such as smoking cigarettes and drinking alcohol as it can have an adverse effect on pregnancy.
- Maintain a positive outlook and avoid sexual intercourse for a certain period during pregnancy.
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