Suturing on the cervix during pregnancy

Throughout pregnancy, a woman's cervix is tightly closed for the rest of the pregnancy and gradually shrinks and relaxes when it is time for labor. Too early its shortening and dilation can lead to miscarriage or premature labor. In the clinics of MC "Dobrobut" perform such a procedure as cervical serclage - an effective surgical treatment of this pathological condition.

Сervical serclage - this is a minimal surgical intervention that involves placing stitches on the cervix during pregnancy to prevent premature labor. They are usually removed before the end of the pregnancy. In some cases, depending on the course of the pregnancy, the stitches are left in place at the time of delivery and the woman undergoes a Caesarean section.

Causes of cervical shortening

Cervix length of more than 25 mm is normal. If the length of the closed part is less in the 16-24th week of pregnancy, its shortening is diagnosed, or isthmic-cervical insufficiency (ICI), which can lead to premature labor.

The main causes of SCI are:

• Congenital anomalies;
• mechanical injuries;
• history of cervical surgery;
• traumatization of the walls of the organ during previous childbirth;
• hormonal disorders;
• genital infections.

Early diagnosis of ICH is important for the timely appointment of surgical treatment. Cervical cerclage of the cervix during pregnancy is an effective way to solve the problem to avoid premature labor.

Indications and contraindications for cervical cerclage

The main indication for suturing is ICH. Cervical cerclage is performed to correct this pathologic condition to reduce the likelihood of fetal incompletion and preterm labor.

Contraindications for cervical suturing include frequent heavy bleeding, heart defects, chronic diseases of the urinary system, inflammatory processes in the body, increased uterine tone, which is not eliminated by medication, as well as complications against the background of fetal development disorders.

Preparation for surgery

Preoperative examination involves ultrasound to assess the condition of the uterus and fetal bladder. Before the procedure, the woman lies in the hospital for tocolytic therapy to prevent uterine contractions. Vaginal sanitation may also be performed to prevent infection.

How the serclage is performed

The course of the procedure depends on the chosen method of suturing the cervix during pregnancy to prevent preterm labor. It can be:

1. McDonald's method: narrowing of the internal pharynx at the level of the vaginal vaults by applying a cicatricial suture without opening the mucous membrane.
2. Shirodkar method: preliminary opening of the vaginal mucosa and placing a circular suture on the cervix.
3. Method Scendi: compression of a thin strip of cervical mucosa around the external yawn of the cervix and complete suturing with catgut or silk threads. 

The price of cervical serclage depends on the method of suturing. The procedure lasts from 10 to 20 minutes. Postoperative stay in the hospital can be from 2-3 days to 1-2 weeks.

If an obstetrician-gynecologist has diagnosed ICH at the appointment, cervical serclage can eliminate this problem to avoid premature labor. The Dobrobut Medical Network has experienced experts who provide detailed advice and assistance on this issue.