If you had a transabdominal cervical cerclage, you'll need to have another abdominal incision to remove the cerclage. Your health care provider might take a swab of your cervical secretions or do amniocentesis — a procedure in which a sample of amniotic fluid is removed from the uterus — to check for infection. He or she might elevate your uterus to gain better access to your cervix. Next, he or she will tie the ends of the sutures to close your cervix. Cervical cerclage is typically avoided after week 24 of pregnancy due to the risk of rupturing the amniotic sac and triggering premature birth. Cervical cerclage removal A transvaginal cervical cerclage is typically removed at around week 37 of pregnancy — or at the start of preterm labor. Risks associated with cervical cerclage include: If you had history-indicated cervical cerclage, you'll likely be able to go home after you recover from the anesthetic. During the C-section, you can choose to have the cerclage removed or leave it in place for future pregnancies.
What you can expect Cervical cerclage is typically done as an outpatient procedure at a hospital or surgery center under regional or general anesthesia. If you expect to have a C-section and plan to have children in the future, you might choose to leave a Shirodkar cerclage in place throughout your pregnancy and after the baby is born. Cervical cerclage might be done through the abdomen if transvaginal cerclage is unsuccessful or anatomically difficult due to an extremely short, lacerated or scarred cervix. If you had cervical cerclage because your cervix had already begun to open or an ultrasound showed that your cervix is short, you might need to remain in the hospital for observation. During the McDonald operation, your health care provider will use a needle to put stitches around the outside of your cervix. He or she might use ultrasound for guidance. He or she might elevate your uterus to gain better access to your cervix. You might experience some spotting, cramps and painful urination for a few days. Acetaminophen Tylenol, others is recommended for pain or discomfort. If your health care provider used stitches to reposition vaginal tissue affected by incisions in your cervix, you might notice passage of the material in two to three weeks as the stitches dissolve. However, cervical cerclage can be done up until week 23 of pregnancy if a pelvic exam or ultrasound shows that your cervix is beginning to open. After the procedure After cervical cerclage, your health care provider will do an ultrasound to check your baby's well-being. Your health care provider might take a swab of your cervical secretions or do amniocentesis — a procedure in which a sample of amniotic fluid is removed from the uterus — to check for infection. As a precaution, your health care provider might recommend avoiding sex for a few weeks or more, depending on the reason for the cerclage. After having a transvaginal cervical cerclage removed, you'll typically be able to resume your usual activities as you wait for labor to begin naturally. Your baby will be delivered through an incision made above the cerclage. How you prepare Before cervical cerclage, your health care provider will do an ultrasound to check your baby's vital signs and rule out any major birth defects. Cervical cerclage removal A transvaginal cervical cerclage is typically removed at around week 37 of pregnancy — or at the start of preterm labor. Next, he or she will make small incisions in your cervix where it meets your vaginal tissue. Then he or she will set your uterus back into place and close the incision. Research suggests that cervical cerclage reduces the risk of premature birth in women with proven cervical insufficiency. Risks associated with cervical cerclage include: Results The effectiveness of cervical cerclage is a topic of debate. Your health care provider will recommend removing the cervical cerclage early if you have preterm premature rupture of membranes or if you have symptoms that suggest a uterine infection. However, the timing of cervical cerclage can also affect the outcome.
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