What is a cerclage?

A cerclage is a stitch that is placed around the cervix to help hold it closed. It can be placed at different times in pregnancy, but is usually removed once a women is early term or full term.

A cerclage can be used to help a few different scenarios. Once is known as cervical insufficiency. This is when a woman’s cervix is unable to hold the baby in the uterus. A woman who has this will dilate without knowing, meaning she has no signs of labor despite her cervix shortening and opening. Women who have cervical insufficiency will be unable to carry a baby to term without an intervention like a cerclage.

A short cervix is another reason a woman might have a cerclage placed. This is different from cervical insufficiency because in this scenario the cervix shortens, but it does not open. This is usually found accidentally, such as when the length of the cervix is checked during the 20-week anatomy ultrasound.

In general, a normal cervix is about 3 to 4 centimeters long, and a short cervix is diagnosed when it is less than 2.5 centimeters in length. This doesn’t mean all women with a cervix measuring 2.5 centimeters or less have a cerclage placed, however. It is also important to take into account her history of births; for example, have you given birth preterm before or not?

Lastly, some women who have a history of preterm delivery may also be advised to have a cerclage placed. The recommendation will depend on the details of her prior deliveries and what the length of her cervix is during her current pregnancy.

There are different kind of cerclages, but the majority are placed vaginally. This is usually done using an epidural or a spinal to numb up the lower part of the woman’s body so she doesn’t feel anything. The stitch is then placed around the cervix like a purse string and pulled closed. The entire procedure usually only takes a few minutes, and most women go home the same day.

One type of cerclage is actually placed through an incision in the abdomen, known as an abdominal cerclage. These are quite rare and are usually only done under certain circumstances.

Women with a cerclage in place will be asked to refrain from sex and to monitor for any signs of bleeding or contractions. The cerclage will be removed if there are any signs of labor, infection, or heavy bleeding. If none of this occurs, it will be removed as the pregnancy gets near the end so that labor can take its course when it is time. The removal is often much easier and be done in the office.