Cervical Cerclage

About Cervical Cerclage

Cervical cerclage is a procedure in which a strong stitch is placed around the cervix during pregnancy to help keep it closed. It is used in selected pregnant people at risk of preterm birth due to cervical insufficiency, a condition in which the cervix shortens or opens too early without contractions. Indications include a history of previous second trimester losses suggestive of cervical insufficiency, a short cervix detected on ultrasound in someone with a history of preterm birth, and physical examination findings of a dilated cervix in the second trimester. The most common techniques are the McDonald procedure, a purse string suture placed vaginally, and the Shirodkar procedure, which places the stitch higher after dissecting tissue. An abdominal or transabdominal cerclage, placed through laparoscopy or an abdominal incision, is used for people in whom vaginal cerclage has failed or is not feasible. The procedure is performed under regional or general anesthesia. Vaginal cerclage stitches are usually removed near term or when labor begins.