Pregnancy can involve complications that increase the risk of preterm birth or loss. In these cases, a common question is how to extend the safety of the pregnancy. One option is a cervical stitch, also known as cervical cerclage. In this article, we shall learn more about this procedure.
The cervix is the lower part of the uterus. During pregnancy, it acts like a gate that stays closed to keep the baby safe. As the baby gets bigger, the cervix needs to remain strong to support the uterus. In some women, the cervix may open too soon if it is weak or shorter than usual. This can increase the risk of miscarriage or premature birth, and this often happens without any pain or warning. If doctors notice this risk, they might recommend a cervical stitch to help protect the pregnancy.
A cervical stitch procedure is a straightforward process that supports the cervix during pregnancy. The doctor places one or more strong stitches around the cervix to keep it closed, providing additional strength as the pregnancy progresses. This helps ensure the baby remains safely in the uterus until closer to full term.
When placing a cervical stitch, doctors mostly use two methods. The choice depends on cervical length, past pregnancy history, and how much support is needed.
This is the most common method. The stitch is placed through the vagina. A speculum slowly opens the vaginal walls so the cervix can be seen clearly. The doctor then places stitches around the cervix to keep it closed. This approach is simple, does not need major surgery, and works well for most women who need cervical support.
This method is used if a vaginal stitch was unsuccessful in a previous pregnancy or if the cervix is too short or weak. A small abdominal incision allows access to the upper cervix, where a strong medical band is placed to provide support. This band helps keep the cervix closed as the baby grows and reduces the risk of early opening.
If a doctor feels this procedure is needed, it is usually done between 12 and 14 weeks of pregnancy, before the cervix starts to thin. It will remain throughout the pregnancy until the baby is delivered. Early intervention gives the fetus more time to grow safely in the uterus, which helps improve the chances of a healthy outcome.
A cervical stitch in pregnancy is advised when medical history or current findings show that the cervix may not stay closed as the pregnancy progresses. The goal is to reduce the risk of early cervical opening and protect the pregnancy during its most vulnerable months.
Congenital disorders, medical treatments, or surgeries on the cervix, such as removing abnormal cells, can weaken its structure. This may reduce the cervix’s ability to stay closed as the uterus grows, increasing the risk of early opening.
Losses that happen in the middle months of pregnancy often point to a cervix that opens too soon. These losses usually happen without pain or strong contractions. When this pattern appears, it suggests the cervix needs extra support in future pregnancies.
Some women are born with a uterus that has a different shape. This can place uneven pressure on the cervix as the baby grows. Over time, this pressure can cause the cervix to shorten or open earlier than it should.
Injuries from earlier deliveries or medical procedures can weaken cervical tissue. A damaged cervix may struggle to hold the pregnancy as it advances, making a cervical stitch an important protective step.
This section explains what happens before and during a cervical stitch procedure. The process is carefully planned to keep both mother and baby safe and to minimise discomfort as much as possible.
Before the cervical stitch is done, the doctor reviews the full medical history. This includes past pregnancies, any losses, and earlier procedures involving the cervix. The cervix is then examined using a speculum, similar to a routine pelvic or Pap examination, so it can be seen clearly. In many cases, a transvaginal ultrasound is performed to assess cervical length and strength. To reduce the risk of infection or irritation, sexual activity is usually avoided for about a week before the procedure. This stage is also when concerns are addressed, and the steps are explained in detail.
The procedure takes place in a hospital. The patient lies on an examination table with legs supported, similar to a vaginal exam. Pain relief is given to numb the cervix, so discomfort stays minimal. A brief pinching sensation is sometimes felt when the numbing medicine is applied. Once the area is numb, the doctor places strong stitches around the cervix and carefully tightens them.
After the cervical stitch is placed, patients are observed for a few hours. The medical team checks for pain, bleeding, or any early signs of problems. Most patients can go home the same day.
Careful aftercare plays a key role in helping the stitch do its job and support the pregnancy safely. Rest is advised on the day of the procedure. To lower the risk of infection, a short course of antibiotics may be prescribed.
A cervical stitch is suggested only when the expected benefits are greater than the risks. Still, like any medical procedure, it carries some risks of complications. These are not common, but it is important to be aware of them.
● Infection in or around the cervix, which can lead to fever, pain, or unusual discharge
● Bleeding from the cervix is often mild, but watched closely after the procedure
● Irritation or small injury to cervical tissue during stitch placement
● Early breaking of the water around the baby, which raises the risk of early delivery
● Labour starting before the pregnancy reaches full term
● Tightening of the cervix as it heals, which may affect how it opens later
● Scar tissue forms on the cervix after the stitches heal
● Tearing of the cervix or uterus if labour begins while the stitches are still in place
Some symptoms after a cervical stitch need fast medical care. These signs point to infection, early labour, or problems with the stitches.
● Heavy bleeding from the vagina
● Strong contractions or tightening in the lower abdomen
● Leaking fluid, which may mean the water has broken
● Fever or chills, especially with a temperature above 100°F
● Ongoing pain or a feeling of pressure
● Foul-smelling vaginal discharge
● Sudden increase in discomfort or bleeding
Recovery after a cervical stitch procedure focuses on giving the body time to heal and letting the stitches settle. Healing usually takes about ten days. If a few simple precautions are adopted during the first days after the procedure, the recovery process will go a lot smoother and faster.
1. Take it easy and get extra rest for the first few days
2. Keep your daily activities light and avoid anything that feels physically demanding.
3. Do not lift heavy objects or do intense exercise
4. Wait to have sex until you are fully healed and your doctor says it is okay
5. Do not insert anything into the vagina during the healing period
6. Short periods of light bed rest may be advised, based on individual needs
7. Try to avoid long trips or unnecessary travel during the first few weeks.
8. Be sure to go to your follow-up visits so your doctor can check your healing and keep a close eye on your pregnancy.
The cervical stitch is usually removed at the hospital near the end of pregnancy, most often around 36 to 37 weeks. If labour starts earlier, the stitch is taken out right away. In cases where a planned caesarean is scheduled, removal is often done during the surgery.
To remove the stitch, a speculum is placed in the vagina, and the thread is cut. The procedure is quick and typically does not require anaesthesia, though pain relief may be provided if recommended. Mild discomfort or light bleeding may occur afterward but this usually resolves within a day. Labour does not usually begin immediately after removal. If labour starts while the stitch is still in place, medical care is needed without delay.
A cervical stitch is a medical procedure to protect a pregnancy at risk. Although choosing this option can be difficult, the main goal is clear: to give the baby more time to develop. With good care, regular checkups, and rest, many women feel more confident and at ease as their pregnancy progresses.
A cervical stitch is used if the cervix is weak or starts to open too soon. It keeps the cervix closed. This helps the baby stay in the uterus longer, thus lowering the chance of pregnancy complications like miscarriage or early birth.
Full healing of the stitches takes about 7 to 10 days.
Light walking is permitted. Work and short travel may typically resume after several days. Long-distance travel, heavy lifting and strenuous physical activity should be postponed until your doctor says it’s safe.
In most cases, the stitch is removed near the end of pregnancy, and a vaginal delivery can happen if there are no other medical reasons for a caesarean.
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