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Best Cervical Cerclage Treatment Doctors in Coimbatore | Expert Care

Cerclage

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What is Cerclage?

Cerclage is a procedure wherein a suture (stitch or tape) is placed around the cervix (neck of the womb) in a purse-string manner to keep the mouth of the uterus closed and prevent miscarriage or premature labour.

The exact cause of premature labour or late miscarriages is not always clear, but it may be related to cervical changes such as shortening or early opening. A cervical suture helps keep the cervix closed and supports the pregnancy.

Types of Cerclage

  • Cerclage may be done using a suture or a tape.
  • Vaginal route: McDonald or Shirodkar cerclage
  • Abdominal route: Open surgery or laparoscopy
  • Shirodkar or abdominal cerclage may be advised in women with a previously failed McDonald cerclage.

Indications

Prophylactic Cerclage

This is a planned elective procedure indicated in women with cervical length less than 25 mm who have one of the following:

  • History of spontaneous premature birth or mid-trimester pregnancy loss
  • Preterm pre-labour rupture of membranes in a previous pregnancy
  • History of cervical trauma

Rescue Cerclage

This is performed as an emergency procedure in women between 16 and 26 weeks of pregnancy with:

  • Prematurely dilated cervix
  • Exposed but unruptured fetal membranes
  • No infection, bleeding, or uterine contractions

Common findings may include a weakened cervix, vaginal bulge, and bulging membranes.

Timing

  • Usually performed between 12 and 16 weeks of pregnancy after the NT scan.
  • Abdominal cerclage can also be done laparoscopically during the interval period between pregnancies.

Hospital Stay & Anaesthesia

  • The procedure can be done under regional (epidural or spinal) or general anaesthesia.
  • Hospital stay is usually 12–24 hours for vaginal cerclage.
  • Hospital stay may extend up to 3 days following open abdominal cerclage.

Complications

During the Procedure

  • Bleeding
  • Bladder injury
  • Rupture of membranes and fluid leak

After the Procedure

  • Risk of miscarriage
  • Risk of premature labour

Post-Cerclage Care

  • Bleeding may be expected for a few days after the procedure.
  • Avoid physical strain and sexual intercourse during the initial recovery period.
  • Complete bed rest is not recommended.
  • Routine antenatal care should be continued as advised.

Removal of Cerclage

For Vaginal Cerclage

  • The suture is removed at 37 weeks of pregnancy.
  • Vaginal delivery can then be planned.

For Abdominal Cerclage

  • Delivery is done through a planned Caesarean section at 38 weeks.
  • The tape may be left in place for future pregnancies.
  • Removal may be required in cases of premature labour, bleeding, leaking, or fetal demise, which may require additional procedures under anaesthesia.