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A medical procedure called a Cerclage is frequently carried out during pregnancy to avoid an early delivery or miscarriage. To give extra support and keep the cervix from opening too soon, it is stitched or bound shut. Premature opening of the cervix, which is the bottom portion of the uterus that links to the vagina, can result in miscarriage or preterm labour. Women who have a history of preterm delivery, cervical insufficiency, or certain cervical abnormalities are usually advised to have a Cervical Cerclage. In certain instances, it can also be given as a preventive measure when a woman's cervix is considered to be susceptible to opening early during pregnancy. Cervical reinforcement is the goal of Cerclage, which tries to increase the length of the pregnancy and lower the risk of problems from an early birth.
Manipal Hospitals in Mukundapur is a well-known hospital in India renowned for providing cutting-edge care and specialised therapies. The hospital offers complete obstetrics and gynaecology treatments, which include Cerclage procedures and other obstetrics services to ensure the optimal health of the mother and the child. Experienced obstetricians and gynaecologists specialising in high-risk pregnancies conduct Cerclage at Manipal Hospitals. We use cutting-edge technology and equipment to ensure the procedure's success and safety.
If you have experienced a history of multiple gestations, early births, cervical trauma, incompetence, a short cervix, prior second-trimester pregnancy losses, recurrent miscarriages, uterine abnormalities, cervical trauma, prior cervical surgery, or other cervical conditions that increase the risk of your cervix dilating or opening too early during pregnancy, you may require a Cerclage. A history of Conization (Cone Biopsy) or LEEP (Loop Electrosurgical Excision Process) is one of the other important factors for performing Cerclage. Other significant conditions include cervical weakness, incompetent cervix, congenital cervical abnormalities, polyhydramnios, past premature labour, and multiple D&Cs.
A cervical Cerclage is often carried out between gestational weeks 12 and 14; however, it can be done earlier or later if required, based on the specifics of each case and the recommendation of a doctor. The presence of cervical insufficiency, a history of second-trimester pregnancy losses, ultrasound results showing a short cervix, early cervical dilation symptoms or recurrent miscarriages are some of the factors that may affect the period. If an ultrasound reveals severe cervical shortening or funnelling, or if there are other signs of premature labour, an urgent or rescue Cerclage may be performed later in the second trimester.
To ensure comfort and reduce pain, the patient is often placed on an operating table before receiving either a regional or general anaesthetic during the Cerclage procedures. To observe the cervix during a Transvaginal Cerclage, the surgeon inserts a speculum into the vagina. The cervix is then gently stitched with a suture using specialised tools and effectively closed to offer support and stop premature dilatation.
As an alternative, the surgeon can directly reach the cervix by making an incision in the abdomen during a Transabdominal Cerclage. After that, sutures are placed around the cervix to provide external support.
Cervical anatomy, past obstetric history, and surgeon preference are some of the factors that influence the decision between Transvaginal and Transabdominal cerclage. Following the surgery, the patient is usually discharged with instructions for postoperative care after being briefly observed. Follow-up visits are planned to evaluate the cervix's reaction to the Cerclage and track the development of the pregnancy.
You should anticipate taking a few days off following a Cerclage to enable your body to recover. During this period, mild spotting and cramps occur. Particular instructions about activity levels, such as refraining from heavy lifting or physically demanding tasks, will be given by your doctor. If you notice any odd symptoms or have questions about your recovery, do not hesitate to call your doctor.
Usually, the Cerclage stitch is taken out around week 37 of pregnancy; however, it may be taken out earlier if labour starts early. Usually, this removal procedure can be completed in the course of a standard visit to your doctor. To protect yourself and your child, it is crucial to follow the advice of your healthcare practitioner regarding when to remove your Cerclage. Before the planned removal, if you exhibit any symptoms of preterm labour or difficulties, get in touch with your healthcare professional right away for additional assessment and care.
Cerclage is usually regarded as safe, although there are some possible risks and consequences to be aware of. Cervical stenosis, bleeding, infection, premature labour or delivery, miscarriage, and uterine or cervical tears are a few of these. Throughout the surgery and the duration of your pregnancy, your doctor will keep a careful eye on you to quickly detect and address any possible issues. Before undergoing the surgery, it's critical to address any worries or inquiries you may have regarding these risks with your healthcare professional.
After the Cerclage operation, it's normal to experience slight cramps and perhaps small spotting. Your doctor may advise you to rest and avoid intense activity and heavy lifting for a few days. You will be arranged for follow-up sessions to track the general course of your pregnancy as well as the cervix's response to the Cerclage. If you encounter any unexpected symptoms, such as intense pain, profuse bleeding, fever, or fluid leaking, you must immediately notify your healthcare professional. For a speedy recovery, your physician will offer you personalised recommendations based on your unique situation.
Routine follow-up appointments are crucial for assessing the health of the cervix during every stage of pregnancy. To closely monitor the length of the cervix and any indications of cervical abnormalities, your doctor will arrange for physical examinations and ultrasounds. These consultations enable early identification of any possible problems and making the required modifications. To maximise the effectiveness of the Cerclage, your healthcare professional may recommend lifestyle modification.