Cervical plasty after childbirth

Cervical surgery (cervical cerclage) or reconstruction of the cervix may be necessary after childbirth in certain situations related to cervical insufficiency or complications arising during or following delivery. At the "Dobrobut" Medical Center, such surgeries are performed by experienced gynecologists using modern equipment and international guidelines.

Indications for Cervical Surgery After Childbirth

Cervical surgery may be needed in the following cases:

• Isthmic-cervical insufficiency (ICI): if ICI was diagnosed in previous pregnancies or if there was premature dilation of the cervix leading to preterm labor;
• Cervical lacerations during childbirth resulting in scar formation;
• Shortening of the cervix during pregnancy;
• Recurrent preterm deliveries;
• Congenital or acquired cervical anomalies;
• Postoperative changes: complications following gynecological surgeries involving the cervix.

In some cases, more extensive surgical intervention may be required—reconstruction of the cervix.

Contraindications for Cervical Surgery After Childbirth

In some cases, surgery may not be possible. This can be related to infectious diseases, severe chronic illnesses of the woman, pregnancy (first trimester), cervical tissue insufficiency, or previous gynecological interventions.

Each case is assessed individually to determine the most appropriate treatment option.

Benefits of Cervical Surgery

• Prevention of preterm labor: cervical surgery for ICI can help prevent preterm births.
• Restoration of cervical integrity: surgical intervention helps eliminate even significant cervical damage sustained during childbirth and restores normal anatomy and function.
• An effective method for treating habitual pregnancy loss.
• Individual selection of the optimal intervention method.

However, like any method, cervical surgery has its drawbacks. These may include: surgical risks, including complications, lower effectiveness than expected, and a longer recovery period.

Features of Cervical Surgery

Cervical surgery has specific features that distinguish it from other surgical interventions. These include:

1. Different Types of Procedures:
   • Cervical cerclage: usually performed to support the cervix during pregnancy, especially in cases of isthmic-cervical insufficiency. It involves suturing around the cervix to keep it closed.
   • Cervical reconstruction to address injuries sustained during childbirth.
2. Timing of the surgery: The procedure can be performed in the postpartum period or during a subsequent pregnancy if it is cerclage.
3. Minimally invasive methods: At the "Dobrobut" Medical Center, laparoscopic options for surgery are preferred, as these are deemed less traumatic. If more complex reconstruction is needed, it is performed vaginally. This approach leads to a shorter recovery period and a lower number of complications, including postoperative pain.
4. Multidisciplinary Approach: Cervical plastic surgery often involves collaboration between obstetrician-gynecologists, surgeons, and sometimes urologists or other specialists, especially in the case of extensive injuries or anomalies.
5. Impact on Reproductive Function: When planning the surgery, future pregnancy plans are always taken into account.

Rehabilitation After Cervical Surgery

This is an important stage that ensures proper healing and reduces the risk of complications. It is necessary to follow the doctor’s instructions carefully:

1. Remain under medical supervision for as long as needed for state stabilization, reporting any possible symptoms of complications;
2. Take pain relief strictly as recommended;
3. Use heat or cold to alleviate pain and swelling;
4. Avoid heavy physical exertion until complete recovery;
5. Monitor the condition of the surgical wound;
6. Avoid intimate contacts until the doctor’s approval;
7. Attend all scheduled follow-up visits.

Cervical plastic surgery after childbirth allows for the restoration of integrity and functions of the cervix in women who have experienced traumatic births. However, the decision regarding the advisability of surgery is always made individually, based on their reproductive plans and health status.