Cervical Insufficiency; Cervical Cervical Surgery
Ultrasound (cervix)It is the exit part of the uterus and while the uterus grows during pregnancy, this part remains hard and closed until birth begins. In pregnant women with weak cervix (cervical insufficiency), the cervix begins to open and fade early. The result of this is premature birth. To prevent premature birth, it is necessary to stitch the cervix in suitable pregnant women. The stitching process is called cervical cervical ligation. Our aim in cervical circlage is for the baby to grow up to 37 weeks.
In case of cervical insufficiency, stitches are placed on the lower part of the cervix, that is, the part visible from the vagina. Cervical cerclage is applied to pregnant women in the risk group.
Cause of Cervical Insufficiency
- A history of second trimester miscarriage without any other reason
- Cervical LEEPor conization
- Damage to the cervix during abortion
Time to Perform Cervical Circlage
The most appropriate time to perform cerclage in cervical insufficiency is the 3rd month of pregnancy (12-14 weeks). However, if cervical effacement and dilation are detected earlier, cervical cervical cancer can be performed without waiting for the 12th week.
If the cervical change occurs in the last trimester or there is a significant dilatation in the cervix, bed rest may be the best solution.
When Performing Cervical Circlage
- Medical history should be evaluated carefully
- The condition of the cervix should be evaluated very well with transvaginal ultrasound, and the opening and wiping of the cervix should be checked
- Pain relief should be (anesthesia) during circumcision (general, spinal or epidural)
- The benefits and complications should be carefully evaluated
- After the procedure, uterine pain and contraction monitoring should be done for a few hours, if necessary, a day
- Light vaginal bleeding and mild cramp-like pain that occur immediately after the procedure stop after a few hours. In the following days, intense vaginal discharge may be observed.
- Medicine must be used for infection and premature labor.
- You should rest at home for a few days after the procedure.
- Regular checks should be performed. It is done at frequent intervals.
- Restarting activities is only possible with the permission of the doctor.
- There should be no sexual activity.
- Premature contraction
- Cervical dystocia (inability to open the cervix when labor begins)
- Membrane rupture ( water breaking)
- Cervical infection
- Tear in the cervix if birth occurs without removing the cervical cervix
- Anesthesia complications
- Contraction and cramps
- Similar to labor pain Pain that comes and goes in the groin and waist
- Vaginal bleeding
- Breaking of water
- Fever or chills above 37.8 degrees
- Nausea, vomiting
- Foul-smelling vaginal discharge
Benefit of Cervical Circlage
Cervical cerclage can prevent miscarriage and premature birth. In suitable cases, the procedure works 80-90%. Cervical circlage works in pregnant women with cervical insufficiency, but it is very difficult to diagnose cervical insufficiency.
Cervical circlage works only in pregnant women with cervical insufficiency. If it is performed on people who do not have cervical insufficiency, it may cause complications such as premature birth and infection. Pregnant women who undergo cerclage are more likely to suffer from infections and premature labor.
Follow-up after Cervical Circlage
Cervical cervical ligation is left in place until the 37th week. However, if labor pains are regular in the previous period and labor begins, the cerclage is removed. The removal process does not involve any membrane
Risks of Cervical Circlage
Cervical Circlage risks are very rare and it is a useful procedure when done properly. Possible risks:
Cervical Circlage Emergencies
Situations in which you should call the doctor urgently after cervical curclage:
Pregnant women who have discharge in their first pregnancy will most likely need cervical cervical discharge in subsequent pregnancies.
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