Cervical cerclage is a simple procedure that uses sutures to close the cervix during pregnancy for some women at risk of miscarriage or premature birth later in the pregnancy. The procedure is use din women who have a weak or compromised cervix that may not be able to remain closed and support a pregnancy to term. Cervical cerclage is not appropriate for every woman at risk for premature birth. Generally, it may be recommended for women who:
have a history of second trimester miscarriages caused by painless cervical dilation without any signs of labor or placenta problems
had cerclage performed during an earlier pregnancy
are revealed to have a painlessly dilated cervix during an exam
have a short cervical length that can make it difficult for the cervix to remain closed
In most cases, cerclage can be performed vaginally as an outpatient procedure. The doctor will use a speculum to widen your vaginal canal, using forceps to move the cervix forward so it can be more easily accessed. Sutures or special tape will be used to close the end of the cervix. In a few cases, cerclage may need to be performed through an incision in your belly. This approach can sometimes be performed laparoscopically through very small incisions. Dr. Chang will be able to determine which approach is most appropriate for you.
The sutures can be removed at about the 37th week of pregnancy, enabling you to have a normal vaginal birth. However, if you plan to have a C-section and have more children in the future, the cerclage can be left in place. Leaving a cerclage in place may affect your ability to become pregnant, so you should discuss this option carefully with Dr. Chang before deciding which route to take.