McDonald cervical cerclage explained

McDonald refers to a commonly used method of placing a strong suture around the cervix. The suture is tightened like a drawstring, helping the cervical opening stay closed. The procedure does not stop contractions or treat infection, so clinicians first assess the reason for cervical change and look for circumstances that may make placement unsuitable.

It may be planned because of a suggestive pregnancy history, considered after ultrasound shows a short cervix in a suitable patient, or performed when the cervix has begun to open but the membranes remain intact and other clinical conditions allow it.

Before the procedure, tell the team about bleeding, contractions, fluid leakage, unusual discharge, fever, allergies and all medicines you take. Follow fasting and medication instructions exactly. Afterwards, temporary cramping or light spotting may occur, but your unit should explain what is expected and whom to contact if symptoms increase.

Use the discharge plan as your guide for work, exercise, sex, travel and follow-up. The stitch is commonly removed through the vagina before labour is expected, although timing changes if labour, membrane rupture or another complication develops.

Call your maternity unit without delay for regular or painful contractions, heavy or increasing bleeding, a gush or continuous leak of fluid, fever, chills, bad-smelling discharge, severe pelvic or abdominal pain, or concern about fetal movement. Do not wait for a routine appointment if labour or membrane rupture may have started while the stitch remains in place.

Ask why the McDonald method fits your situation, which type of anaesthesia will be used, whether you need medicines around the procedure, and when follow-up will occur. Confirm the removal plan and what would happen to the stitch if contractions begin or your waters break.