CERVICAL INSUFFIENCY (Cerclage)

Cervical insufficiency occurs when the cervix opens too early during pregnancy. Normally, the cervix remains closed until labor begins and starts to open when the baby is mature. However, in women with cervical insufficiency, the cervix opens painlessly before labor contractions start. This condition can increase the risk of preterm birth or miscarriage.

The most common treatment for cervical insufficiency is the cerclage procedure. Cerclage is a surgical procedure used to close the cervix to help prevent premature opening. It is usually performed between the 12th and 14th weeks of pregnancy and is removed later in pregnancy, typically around the 37th week. Cerclage is recommended for women at risk of miscarriage or preterm birth due to cervical insufficiency.

What is Cerclage and Its Relation to Uterine Rupture?

Cerclage is a surgical procedure performed during pregnancy to close the cervix and reduce the risk of miscarriage. It is especially used for women who have experienced pregnancy loss due to cervical weakness. In this article, we will examine what cerclage is and how it is related to uterine rupture.

Cerclage Procedure and Purpose

Cerclage is performed to prevent the premature opening of the cervix. Cervical weakness occurs when the cervix, which should remain closed until birth, starts to open in the early stages of pregnancy. This condition increases the risk of miscarriage or preterm birth.

The cerclage procedure involves closing the cervix with stitches or tightening it with a special band. This prevents the baby from descending too early. The procedure is usually performed at the beginning of the second trimester and is removed near the time of birth to allow labor to proceed naturally.

Uterine Rupture and Its Connection to Cerclage

Uterine rupture is a condition where the muscle tissue of the uterus tears partially or completely. This can occur during labor or, in rare cases, during pregnancy. Uterine rupture poses a serious threat to both the mother and the baby and requires immediate medical intervention.

There is no direct link between cerclage and uterine rupture. However, it is believed that women who have undergone cerclage may have an increased risk of uterine rupture during labor. Therefore, women who have had cerclage should be closely monitored during delivery.

Key Points About Cerclage and Uterine Rupture

• Cerclage is a surgical procedure used to close the cervix and reduce the risk of miscarriage.
• Uterine rupture is the partial or complete tearing of the uterine muscle and is a life-threatening condition for both the mother and baby.
• Cerclage may increase the risk of uterine rupture during labor, requiring careful monitoring.

What is Cervical Insufficiency (Cerclage)?

Cervical insufficiency is a condition in which the cervix opens too early during pregnancy. Cervical insufficiency is medically referred to as cerclage. If there are risk factors present, a miscarriage may occur within the 11th or 12th week of pregnancy.

Women who experience miscarriage due to cervical insufficiency may face the same issue in subsequent pregnancies. Some expectant mothers may give birth prematurely between 24 and 32 weeks. Women who have had previous miscarriages and those who experience preterm birth often have the same underlying issue. After treatment for cervical insufficiency, stitches are placed on the cervix to help prevent preterm birth or miscarriage. Once the treatment process is complete, the expectant mother can give birth at the appropriate time.

Symptoms of Cervical Insufficiency

Cervical insufficiency can lead to preterm birth or miscarriage. To ensure a healthy delivery, it is essential to recognize the symptoms of cervical insufficiency. Symptoms of potential preterm birth due to cervical insufficiency include:

• Abdominal pain
• Bloody or mucus-like discharge
• Clear fluid leakage
• An unusual sense of pressure in the genital area
• Increased vaginal discharge

Treatment for cervical insufficiency helps minimize the risk of preterm birth or miscarriage. If preterm labor symptoms occur, immediate medical attention is required. In particular, severe abdominal pain, increased vaginal discharge, and bloody discharge may indicate cervical insufficiency.

How is Cervical Insufficiency Treated?

Cervical insufficiency treatment begins with an accurate diagnosis. Treatment options include medication or surgical intervention. Pessaries, or plastic rings, are used to support the cervix. In some cases, treatment can be performed vaginally or through the abdominal region.

• The treatment method is determined based on the expectant mother’s condition.
• It is important to check whether the mother has previously had cervical stitches.
• The current structure of the uterus is also evaluated before deciding on a treatment approach.

Initially, medication treatment is applied. If no improvement is observed, a cervical stitch procedure is performed. To prevent cervical insufficiency, the use of plastic pessaries is recommended.