To begin with, Cervical Cerclage medically is also known as a cervical stitch, but a treatment for cervical incompetence or insufficiency, when the cervix starts to shorten and open too early during the pregnancy process causing either a case of late miscarriage or for that matter, preterm or premature birth.
Cerclage Treatment in Delhi
Cervical Cerclage or Cervical Stitch can be performed in two procedures:
- Transvaginal cervical cerclage – the process is conducted through the vagina.
- Transabdominal cervical cerclage – here, the procedure is performed via abdomen.
The gynecologist recommends cervical cerclage in the following cases:
- Cervix opens too early or carries the risk of opening prior to the baby getting ready to be conceived
- The cervix has been formerly subjected to surgery
- A damaged cervix
- A history of late miscarriages
- History of second trimester pregnancy loss
However, it is worthwhile to know that the success rate for cervical cerclage is approximately at a scale of 80-90% for elective cerclages, and 40-60% for emergency cerclages. A cerclage is considered successful if labor and delivery is delayed to at least 37 weeks (full term).
For women who are pregnant with one baby (a singleton pregnancy) and at risk for a preterm birth, when cerclage is compared with no treatment, despite there being a reduction in preterm birth, there is no reduction in death rates of the baby before or after birth, or reduction in illness in the baby after birth. There is no evidence that cerclage is effective in a multiple gestation pregnancies for preventing preterm births and reducing prenatal deaths or neonatal morbidity.
In an ideal scenario, cervical cerclage is carried out in between 12th to 16th week of pregnancy. However, going by the rule of exceptions, however, in the case of exceptions, the procedure can be carried out uptill 24 weeks of pregnancy.
Before the process of cervical cerclage is performed, the physician will do the following steps:
- Scrutinize your medical history
- Conduct an ultrasound to check the vitals of the baby and ensure there are no major birth defects as found out via ultrasound
- Examine your cervix – whether it has already started to open or is too short. In either case, medical will be prescribed.
For prolapsed fetal membranes, your doctor will first treat the condition by placing a catheter in your urethra and repositioning the amino sac.
Cervical Cerclage will not be done when you have excessive vaginal bleeding, pre – term labor, infection of the uterus, leaking amino sac or risk of miscarriage owing to abnormalities in the fetus.
Cervical Cerclage treatment in Delhi is carried on the patient under regional or general anesthesia. The procedure can be Transvaginal or Transabdominal.
- Transvaginal Cervical Cerclage: It is performed through the vagina. Your doctor will insert the speculum in the vagina and make use of forceps to grab the cervix. Your doctor might use McDonald or Shirodhkar technique to perform the procedure.
- McDonald Cerclage: A band of a suture is involved in the cervix stitching. The Circlage is put on the upper part of the cervix when the effacing of the lower part has already begun. It is to be taken note that usually the stitch is removed around the 37th week of pregnancy.
- Shirodhkar Cerclage: Here, the sutures pass through the cervix walls. Sometimes, in the Shirodhkar Cerclage, a permanent stitch is made around the cervix, this will not be removed, so the baby will be removed via a Caesarian section.
- Transabdominal Cervical Cerclage: If the cervix is short or damaged, then your doctor will carry out the process through the region of abdomen. A cut is made into the abdomen and the uterus is removed and the uterus is elevated to make the cervix accessible following which the uterus will be settled to its original position.