Cervical cerclage
Cervical cerclage
- cervical cerclage - also known as a cervical stitch
- is a treatment used to prevent the cervix opening too early and causing either a late miscarriage or preterm birth
- cerclage may be performed as a prophylactic measure where the woman has a history that increases the risk of spontaneous second-trimester loss or preterm delivery and/or cervical shortening seen on ultrasound
- cerclage may be performed as a prophylactic measure where the woman has a history that increases the risk of spontaneous second-trimester loss or preterm delivery and/or cervical shortening seen on ultrasound
- can also be performed as a salvage measure ('rescue' or non-prophylactic cerclage) when a woman presents with premature cervical dilation, often with exposed fetal membranes, and in some cases where the membranes have prolapsed into the vagina
- is a treatment used to prevent the cervix opening too early and causing either a late miscarriage or preterm birth
'Rescue' cervical cerclage
- 'rescue' cervical cerclage should not be offered to women with:
- signs of infection or
- active vaginal bleeding or
- uterine contractions
- consider 'rescue' cervical cerclage for women between 16+0 and 27+6 weeks of pregnancy with a dilated cervix and exposed, unruptured fetal membranes:
- take into account gestational age (being aware that the benefits are likely to be greater for earlier gestations) and the extent of cervical dilatation
- this decision should be after discussion between a consultant obstetrician and consultant paediatrician
- if 'rescue' cervical cerclage is used, ensure that a plan is in place for removal of the suture
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