In the Name of God, the Beneficent, the Merciful
Aria Specialized and Subspecialty Hospital
Self-Care Pamphlet in Illness:
Cerclage
Preparation and Regulation:
Obstetrics and Gynecology Department
One of the surgeries that is sometimes necessary for a pregnant woman is cerclage or stitching of the cervix. This procedure is performed when there is a suspicion of cervical insufficiency. Cervical insufficiency in women leads to premature labor, because the cervix is unable to withstand and bear the pressure caused by the weight of the fetus, amnion and uterus, so it opens by itself and premature labor occurs.
The best way to diagnose cervical insufficiency is a history of abortion in the second 3 months of pregnancy.
Cerclage is not a definitive treatment method, but by suturing the cervix, the possibility of premature labor in the patient is reduced. Another cause of opening of the cervix is the congenital problem of the cervix, which is often associated with an abnormal shape of the uterus, such as a bicornuate uterus.
Aftercare for cerclage surgery:
1- Eat a light dinner (soup) the night before surgery.
2- Do not have breakfast when you refer to the hospital.
3- One week before cerclage, avoid intercourse.
Post-surgical recommendations:
After surgery, there is a possibility of bleeding and spotting. In this case, do not worry because this is due to the presence of sutures in the opening of the cervix.
After the operation, if you need to urinate or defecate, inform the shift nurse to use the bedpan and avoid leaving the bed. It is important that you need absolute rest and you should not get out of bed. In case of uterine contractions, discharge and bleeding, inform the nurse immediately.
Cerclage surgery is carried out between 14 and 22 weeks of pregnancy. After local anesthesia or general anesthesia, cerclage surgery is performed via suturing under the cervical mucus. Cerclage surgery after 22 weeks of pregnancy is associated with a higher possibility of infection and premature rupture of the fetal amnion and is not recommended.
After cerclage surgery, there may be light bloody discharge for a few days, which normally turns into a thicker discharge after this time and may continue until the end of pregnancy.
After being discharged from the hospital, a pregnant woman needs absolute rest for 3 to 5 days, and after that she can do her daily routine with complete caution.
If you see the following symptoms after the cerclage surgery, see a doctor:
1- Abdominal contractions
2- Excessive bleeding
3-Waist or lower abdomen pain
4-Fever over 38 degrees or chills
5- Rupture of amnion
6-Severe nausea and vomiting
7-Smelly secretions from the genital area
If the doctor prescribes the medicine, the medicine should be used on time and completely.
Important Note:
Cervical sutures must be removed before the onset of labor pains so that delivery is possible. Generally, the sutures are removed at the 37th week of pregnancy, but they can be removed before the amnion ruptures or the pains begin. Most of the stitches are removed without any problem in the doctor’s office or during cesarean surgery or childbirth. This procedure is like a Pap smear test (using a speculum) and slight bleeding may occur.
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