Cervical cerclage operation: before, during and after

Most cervical stitches are placed through the vagina under anaesthesia. A clinician passes a suture around the cervix and tightens it to help keep the cervical opening closed. In selected situations, a stitch may instead be placed through the abdomen, particularly when a vaginal approach is not suitable or has not provided adequate support before.

Cerclage provides mechanical support; it does not treat contractions, ruptured membranes or infection. Checks before surgery may include assessment of the cervix, fetal wellbeing, membranes and possible infection so the team can decide whether proceeding remains appropriate.

Tell the surgical team about medicines, allergies, previous anaesthetic problems and any new bleeding, cramps, discharge, fever or fluid loss. Follow instructions about fasting and which medicines to take on the day. Before leaving, obtain a contact number, a follow-up date and specific guidance on activity, sex, bathing, work and pain relief.

Light spotting or cramping may occur after a vaginal procedure, but symptoms should follow the limits explained by your unit. Removal depends on the type of stitch and the birth plan: a vaginal stitch is often removed before labour, whereas an abdominal stitch may remain and usually requires birth by caesarean.

Get prompt assessment for regular tightening or contractions, severe or persistent abdominal pain, heavy or increasing vaginal bleeding, fluid leakage, fever, chills, foul-smelling discharge or concern about fetal movement. If your waters break or labour begins with a vaginal stitch still present, contact the maternity unit immediately because the cervix and stitch need review.

Ask which cerclage approach is planned and why, what anaesthesia and observation it involves, and what findings could lead the team to postpone the operation. Discuss how the stitch affects pregnancy follow-up, when or whether it will be removed, and how it fits with your intended route of birth.