How Painful Is A Cervical Cerclage Removal?
May 12, 2013
What causes an incompetent cervix?
The cervix is a narrow passage at the bottom of the uterus through which the menstrual blood passes out. It is also the passage through which the sperm travels into the uterus and up the fallopian tubes to fertilize the egg.
This tiny opening is shut once a woman becomes pregnant and remains closed until a few weeks before the delivery. Well into the third trimester of the pregnancy, the cervix starts to become shorter and dilates, getting the body ready for the delivery. When this dilation and effacing of the cervix happens too early, the condition is termed an incompetent cervix, and it may result in a miscarriage or a premature delivery. Also called a weakened cervix or cervical insufficiency, this condition can be diagnosed during a physical examination and confirmed by doing an fetal ultrasound test.
Causes of incompetent cervix could be a malformed cervix, abnormalities in the uterus, trauma to the cervix due to a late termination of a pregnancy, or a difficult previous delivery. Previous surgeries involving the cervix or exposure to the drug DES may also be the causes of incompetent cervix during pregnancy. Doctors usually perform, around the 14th week of the pregnancy, a procedure called cerclage where the opening of the cervix is closed with sutures to prevent a miscarriage and the sutures removed after the 36th week of the pregnancy.
Submitted by N on May 12, 2013 at 11:38
What are the Signs of an Incompetent Cervix?
When a woman is pregnant, nature closes the opening to the cervix, forming a protective cocoon to the baby in the uterus. When a cervix is too weak to stay closed during the entire length of a pregnancy, it is said to be an incompetent cervix. Insufficiency of the cervix can be detected during a routine internal exam by the gynaecologist, who may do a vaginal ultrasound test to confirm the finding and assess the need for intervention. The ultrasound may be used to measure the length of the cervix over two or three visits to the doctor and to check for any effacement of the internal os. This is one of the few signs of incompetent cervix. Doctors look for early signs of incompetent cervix in those women who have had cervical trauma during a previous difficult delivery or in those women who are born with uterine or cervical abnormalities.
Women who exhibit signs of an incompetent cervix during pregnancy and/or who have a history of second or third term miscarriages may be counselled to go for a procedure called cerclage before they are 16 weeks into the pregnancy. This procedure reinforces the cervix by sewing up the opening until a few weeks before the end of the full term - by when the sutures are removed.
Submitted by N on May 8, 2013 at 12:22
Cervical cerclage is the surgical procedure that is used to prevent a premature delivery or a miscarriage if the woman's cervix is opening up too early. This is often referred to medically as an "incompetent" cervix or a "weak" cervix. Typically, the woman's cervix remains closed all the way through in to the third trimester. If the doctor finds that the cervix is opening up early, then a cervical cerclage can be used. The procedure can also be used if the woman has a history of miscarriages especially during the second trimester. In this case then the procedure is typically done sometime at the beginning of the pregnancy's second trimester. In this cervical cerclage procedure, a band of very strong thread is used to stitch around the cervix and is then tightened to keep the cervix closed. It is normally done when the woman is under a general anesthesia. Recovery time from this procedure at home will normally be 2 - 3 more days. Generally the thread is taken out at during the 37th week of pregnancy. However it may be removed even earlier if the water breaks or the woman's starts her contractions. Removal of the cervical cerclage stitch is considered to be much less complicated; hence it can be done normally in the doctor's office.
The procedure is mostly successful at helping keeping the woman's cervix closed in about 90% of the cases. This thus helps in greatly reducing the risk of her miscarriage or of a premature delivery. But, rarely are there any risks to this particular procedure. As the procedure is done normally under a general anesthesia, normally there are the usual risks of use of anesthesia. Also, this cervical cerclage procedure can lead to premature labor. The cervix can also become infected. If the woman goes into labor while the stitching is in her cervix, then her contractions may possibly tear open her cervix. It is vital that the stitching of the cervical cerclage be removed well before or even during the early labor. Hence the removal of a cervical cerclage is necessary no matter how painful one may find it. But incidentally it is not considered to be too painful. It is just the removal of the stitch that is holding in place the closed cervix. Some doctors give an anesthetic while they remove this stitch in which case the woman feels no pain at all. It is necessary to follow the doctor's instructions implicitly and it is preferable to get the stitch out prior to going into labor.
Submitted by M T on April 1, 2010 at 05:51
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