Before cervical cerclage, your health care provider will do an ultrasound to check your baby's vital signs and rule out any major birth defects. Your health care provider might take a swab of your cervical secretions or do amniocentesis — a procedure in which a sample of amniotic fluid is removed from the uterus — to check for infection. If you have an infection that requires antibiotics, you'll complete treatment before the cerclage is done — if possible.
Ideally, a history-indicated cervical cerclage is done between weeks 12 and 14 of pregnancy. However, cervical cerclage can be done up until week 24 of pregnancy if a pelvic exam or ultrasound shows that your cervix is beginning to open. Cervical cerclage is typically avoided after week 24 of pregnancy due to the risk of rupturing the amniotic sac and triggering premature birth. In some cases, cervical cerclage can be done before pregnancy.
If you have prolapsed fetal membranes — a condition in which the amniotic sac protrudes through the opening of the cervix — and your health care provider recommends cervical cerclage, he or she will treat the condition before doing the procedure.
March 17, 2015
- Berhella V, et al. Cervical insufficiency. http://www.uptodate.com/home. Accessed Jan. 20, 2015.
- Norwitz ER. Transabdominal cervical cerclage. http://www.uptodate.com/home. Accessed Jan. 20, 2015.
- Norwitz ER. Transvaginal cervical cerclage. http://www.uptodate.com/home. Accessed Jan. 20, 2015.
- Laughlin-Tommaso S (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 5, 2015.
- Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2012. http://www.clinicalkey.com. Accessed Jan. 20, 2015.
- Alfirevic Z, et al. Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008991.pub2/abstract. Accessed Jan. 20, 2015.
- Rafael TJ, et al. Cervical stitch (cerclage) for preventing preterm birth in multiple pregnancy. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009166.pub2/abstract. Accessed Jan. 20, 2015.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Obstetrics. ACOG Practice Bulletin No.142: Cerclage for the management of cervical insufficiency. American College of Obstetricians and Gynecologists. Obstetrics and Gynecology. 2014;123:372.