Cervical Cerclage

WHAT YOU SHOULD KNOW:

  • A cervical cerclage, also called cervical stitch, is a surgery to keep the cervix closed during pregnancy. The cervix is the lowest part of the uterus (womb) and extends into the vagina. This surgery may help prevent a miscarriage or premature (early) delivery of your baby due to an incompetent cervix. An incompetent cervix is a condition where the cervix thins and dilates (widens) too early during the pregnancy. A cervical cerclage is usually done during pregnancy but may be done sometimes even before you get pregnant. An elective cerclage is usually carried out before the 16th week of pregnancy. It may be done to those with a past history of pregnancy loss or premature delivery. Depending on the symptoms, an urgent or emergency cerclage may be performed during the 16th to 24th week.

  • A cervical cerclage may be done through a laparoscopic abdominal (stomach) or vaginal approach. In a laparoscopic abdominal cerclage, a laparoscope will be inserted in the small incisions (cuts) made in your abdomen. A laparoscope is a long metal tube with a light and magnifying glass on the end. In transvaginal cervical cerclage, your caregiver will do the surgery through your vagina. In both approaches, caregivers will pass strong sutures (threads) around your cervix to hold the cervix firmly closed. The sutures may be removed when labor starts, or around the 37th week of pregnancy. If the sutures are left in place, your baby will be delivered by a surgery called Caesarean (C) section. By doing a cervical cerclage, the cervix will remain closed as your baby grows and gets ready to be born.

INSTRUCTIONS:

Medicines:

  • Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.

  • Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.

  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.

  • Pain medicine: You may need medicine to take away or decrease pain.

    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Constipation:

Do not try to push the bowel movement out if it is too hard. High-fiber foods, extra liquids, and regular exercise can help you prevent constipation. Examples of high-fiber foods are fruit and bran. Prune juice and water are good liquids to drink. Regular exercise helps your digestive system work. You may also be told to take over-the-counter fiber and stool softener medicines. Take these items as directed.

Rest:

You may need to rest in bed while lying on your left side most of the time. Avoid heavy work to prevent premature labor or delivery.

Vaginal or wound care:

When you are allowed to bathe or shower, carefully wash the incisions (cuts) and your vagina with soap and water. Afterwards, put on clean, new bandages or a sanitary pad. Change your bandages or pad any time it gets wet or dirty. Avoid placing anything inside your vagina, such as a douche or tampon. Ask your caregivers for more information about vaginal and wound care.

CONTACT A CAREGIVER IF:

  • You have a fever.

  • You have chills, a cough, or feel weak and achy.

  • You have nausea (upset stomach) or vomiting (throwing up).

  • Your bandage becomes soaked with blood.

  • Your skin is itchy, swollen, or has a rash.

  • You have questions or concerns about your surgery, condition, or care.

SEEK CARE IMMEDIATELY IF:

  • You feel something is bulging out into your vagina.

  • You have clear fluid coming from your vagina.

  • You have lower abdominal or back pain that comes and goes like labor pains.

  • You have pus or a foul-smelling odor coming from your vagina.

  • You have regular contractions.

  • You have trouble passing urine.

  • You have vaginal bleeding.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Cervical Cerclage (Aftercare Instructions)

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