Cervical Cerclage Removal and Other Information
What is a cervical cerclage?
A cervical cerclage is a simple procedure where the opening of the uterus is stitched together and closing it. This is done in order to prevent a miscarriage. It also helps in preventing a premature birth.
It is a known fact that most pregnancies last for forty weeks. However, a few births happen even before the thirty seventh week. This is defined as a preterm delivery. Close to a tenth or ten percent deliveries are preterm deliveries. Preterm births lead to a lot of complications. These babies suffer from a lot of health problems. Some common problems include breathing problems, trouble with regulation of the body temperature and susceptibility to infection. A very high seventy five percent of births in babies occur due to preterm births. Long term problems in babies also occur due to preterm births.
The cervix of the mother plays a huge role in premature births. If the mother has cervix that is not strong enough, it might lead to preterm births. Mothers with such cervixes are 3.3 times more prone to giving birth prematurely. The cervix is the opening of the uterus through which the baby leaves the uterus. This is ideally closed until the baby is ready to be born. The cervix will open up or dilate when the baby is ready to be born. Ideally, the cervix expands about four inches. In mothers with weak cervixes, this might open prematurely leading to a preterm birth. This might happen as early as in the second trimester itself. The foetus grows in size everyday and applies a great strain on the cervix. This might result in a miscarriage. A miscarriage occurs just twenty weeks into the pregnancy. The percentage of women with an incompetent cervix is about one percent. The chances would be around one in five hundred to two thousand pregnancies. Twenty five percent of the losses during the second trimester can be explained by preterm births.
A woman is advised to have a cervical cerclage procedure if she has had a previous pregnancy where she delivered before term. It might also be advised if the mother has had previous surgery on the cervix or if there has been any trauma. It is also advised if the mother’s water breaks early. This is known as rupture of the membranes. If the mother has a lot of hormonal activity, the doctor might deem it necessary that the mother has the procedure. If there have been any abnormalities in the uterus or the cervix, a cervical cerclage might be performed. It might also be performed if the foetus is exposed to any diethylstilbestrol or DES. This is a hormone, manufactured synthetically, that was used in the mid twentieth century.
Elective cervical cerclage is a very minor procedure that is usually performed at the beginning of the second trimester. This is performed anywhere between twelve to fourteen weeks. This is done early ensuring no signs of premature birth are visible. The emergency cervical cerclages are procedures that are performed at much later stages in one’s pregnancy. This will be done after a few changes in the cervix have already begun.
The patient is given anaesthesia, either epidural or spinal. However, it is not uncommon to use general anaesthesia. Spinal anaesthesia is given directly to the spine. It is performed by inserting a needle in between the vertebrae in the lower back and administering anaesthesia. In an epidural, instead of a needle a catheter is inserted. It is not uncommon to find many women experience a drop in blood pressure when administered these anaesthetics. These can be easily countered using different fluids and medications.