Cervical Cerclage During Pregnancy: What You Should Know

Recently, cervical cerclage has gained attention as a preventive procedure, especially for women carrying multiple fetuses or those with a history of miscarriage. Many pregnant women request this procedure to reduce the risk of preterm birth and protect the baby from complications. However, not all pregnancies require cervical cerclage, and there are specific medical criteria for performing it.

What is Cervical Cerclage?

Cervical cerclage is a minor surgical procedure in which the cervix is stitched closed to prevent early dilation. This helps:

• Prevent miscarriage in early pregnancy

• Reduce the risk of preterm birth in later pregnancy

The stitch is temporary and is usually removed when approaching labor, allowing for a normal vaginal delivery.

When is Cervical Cerclage Recommended?

1. Cervical Insufficiency (Incompetent Cervix):

   • A congenital condition where the cervix is short or weak.

   • Women with a history of early miscarriage or preterm birth may require the procedure to maintain pregnancy.

2. Timing:

   • Typically performed between 14–24 weeks of pregnancy.

   • After 24 weeks, the risk of complications rises, and the procedure may not be effective.

Steps of the Procedure

1. Preparation:

   • Assess the woman’s medical history and physical health.

   • Decide on anesthesia type (often local).

2. Procedure:

   • Access the cervix using a special tool.

   • Place a strong, non-absorbable stitch around the cervix to keep it closed.

3. Post-Procedure Care:

   • Monitor for bleeding, fever, or chills, which could indicate complications.

   • Administer medications if needed, such as antibiotics or antipyretics.

Cervical Cerclage and Twin Pregnancies

• No direct link exists between cervical cerclage and twin pregnancies.

• Twin pregnancies may proceed normally if the cervix is strong and healthy.

• The presence of multiple fetuses does not automatically increase miscarriage risk.

• Pregnant women carrying twins should maintain normal daily activities unless warning signs appear, such as bleeding or frequent contractions.

Statistics on Twin Pregnancies

• Natural occurrence of twins without fertility treatment: ~1.5%

• After fertility medications: 6–10%

• After ovulation injections: 10–20%

• After IVF (in vitro fertilization): up to 30%

Tips for a Healthy Twin Pregnancy

1. Regular Medical Check-Ups:

   • Monitor blood pressure, blood sugar, and urine protein monthly.

2. Prevent Preterm Labor:

   • Maintain normal blood pressure and healthy weight.

   • Avoid heavy lifting and manage stress.

3. Hospital Birth:

   • Deliver in a well-equipped hospital under specialized medical supervision.

   • This ensures immediate intervention for complications such as placental issues or reduced oxygen supply to the babies.

Summary:

Cervical cerclage is a safe, temporary procedure designed to prevent miscarriage or preterm birth in women with cervical insufficiency. It is not automatically required for twin pregnancies, which can often progress normally if the cervix is healthy. Careful monitoring, regular check-ups, and proper prenatal care are crucial for the safety of both mother and babies.