Cervical Cerclage – Cervical Incompetence
An "incompetent" cervix refers to a cervix that is weak and at risk of opening under the pressure of a growing pregnancy. During pregnancy, if a cervix shortens or opens too early, it can cause a premature delivery. This is most commonly a result of a previous procedure that damaged the cervix, or if the mother has a history of second-trimester miscarriages.
To reduce the risk of a premature delivery or a miscarriage, a cervical cerclage procedure may be recommended. This is when the cervix is sewn closed to keep the baby inside the uterus. This procedure is recommended if the cervix exhibits changes early in the pregnancy, usually by the 3rd month (12-14 weeks gestation) of pregnancy. It is usually kept in place until at least 37-38 weeks gestation. If the cervix does not exhibit changes until later in the pregnancy, a cerclage may not be indicated or the doctor may prescribe a procedure called emergent cerclage, or in some cases, bed rest is recommended, depending on how close the baby is to term.
When an incompetent cervix is timely diagnosed, cervical cerclage can be effective. However, there are risks of cervical infection, laceration, or the inability of the cervix to dilate normally during labor. A mother who has a suspected abnormal cervix should be thoroughly examined by her doctor, along with a detailed review of her medical history and a full disclosure of the procedure and potential complications.
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