Creating Space For What’s Important - Cervical Cerclage

Date :2018-08-06 Writen By :Srishti Hospital

These days almost 10% of pregnancies end in premature delivery and there is 3 times more possibility for a pregnant woman to experience premature labour if she has a weak cervix. Sometimes called an incompetent cervix (cervical insufficiency), this is the cause of 25% of losses during the second trimester.

A normal cervix opens up at the end of your gestation for the baby to be born. But a weak cervix opens up much earlier during pregnancy, increasing the risk of premature birth or miscarriage. The baby growth during pregnancy puts a strain on the cervix and under that pressure, a weak cervix may begin to enlarge during the second or third trimester. This may lead to a very premature delivery/ (preterm) miscarriage. To thwart the damage to the foetus, a weak cervix may need to be sewn during pregnancy. This process is known as cervical cerclage, and takes place even before the signs of premature labour start to appear.

Cerclage practice has facilitated some high-risk pregnancies last longer; however, it is not risk-free. The good news is that a successful cervical cerclage can lead to a full-term pregnancy (37 weeks). The procedure is performed usually at the beginning of the 2nd trimester (between 12th and 14th weeks of pregnancy) before symptoms of premature labour begin. But, in some cases there may be a requirement of cerclage later in pregnancy; this is known as an emergency cerclage which is done to prevent foetal loss before viability of very preterm babies with poor survival.

The cerclage can be left until the 37th week of pregnancy, after which they can be removed. It can be removed before your water breaks or contractions start. The cerclage can be left inside if you plan to go in for C-section.

Who may need cervical cerclage?

Cerclage cannot be performed for women who have dilated more than 4 cms, an intrauterine infection and for those who have ruptured membranes or prolapsed foetal membranes. On the other hand, cervical cerclage is necessary for the following scenarios –

  • Women who have a history of late miscarriages because of the damaged cervix or abnormal uterus.
  • Those who had a previous 2nd trimester pregnancy loss with painless dilation of the cervix or a delivery that occurred with few or no contractions, signifying that the cervix may not remain closed during pregnancy.

The three types of cervical cerclage are-


  • Transvaginal Cerclage (TVC) – TVC is preferred option for patients striving for normal delivery. TVC may be placed anytime within the 12th week onwards and removed around the 37th week so that there may be likelihood of normal delivery after cervical cerclage.
  • Transabdominal Cerclage (TAC) – TAC is a permanent procedure hence the delivery has to happen through C-section. This is the most uncommon type of cerclage.

What are the benefits of a Cerclage?

Cervical cerclage is known to prevent miscarriages or preterm delivery. A cervical cerclage is usually performed under a spinal anaesthetic and it usually takes between twenty minutes and half an hour. The success rate of this procedure is about to 90%. This procedure is effective if there is truly a weak cervix, however, the diagnosis should be accurate. The only alternative to cervical cerclage is to spend most of the time resting. You should also avoid any strenuous activity.

Srishti Hospital is the first Reproductive Medicine Center in Puducherry which presents all aspects of subfertility diagnosis, treatment and laboratory services that you may need for assisted reproduction. Srishti is Pondicherry's first Fertility Clinic as well as Test Tube baby center and this is the only center registered with the Government of Puducherry, for Assisted Reproductive procedures. Shristi have been in the forefront of advanced Gynecological Endoscopic procedures and Fertility care offering top-notch care with excellent clinical outcomes, at affordable costs. They provide the best cervical stitching treatment in Tamil Nadu and known as the best IVF clinic in India.

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