Cervical cerclage surgery: what to expect

It may be offered when the cervix has opened too early before, appears to be shortening or opening in the current pregnancy, or needs added support. The obstetric team weighs the likely benefit against risks such as bleeding, infection, contractions or the waters breaking.

Most cerclages are placed through the vagina under anaesthesia. A clinician uses a speculum to see the cervix, positions strong suture material around it and tightens the stitch to provide support. A cerclage placed through the abdomen is used in selected circumstances, such as when a vaginal approach is unsuitable or has not worked previously.

The stitch supports the cervix; it does not stop every pathway that can lead to preterm labour. Follow-up may include checking symptoms, the cervix and the pregnancy according to the reason the cerclage was placed.

Before surgery, tell the team about medicines, allergies, bleeding, unusual discharge, cramps or possible fluid leakage. Follow the hospital's instructions about eating, drinking and which medicines to take. Arrange transport home because anaesthesia and pain relief can affect driving.

Mild cramping or light spotting can occur after a vaginal cerclage. Use only pain relief approved for pregnancy, and follow personalised advice about work, exercise, sex and travel. Keep follow-up appointments and make sure you know the plan for removing the stitch or managing it at birth.

Contact your maternity unit urgently for heavy or increasing bleeding, regular tightening or contractions, a gush or ongoing trickle of fluid, fever, worsening pelvic or abdominal pain, or foul-smelling discharge. Also seek assessment for reduced fetal movement once you have begun to recognise your baby's usual pattern. These symptoms need evaluation whether or not a cerclage is present.

Ask why cerclage is being recommended in your situation, which surgical approach and anaesthetic are planned, and what alternatives are reasonable. Confirm what symptoms are expected afterward, who to contact out of hours, whether activity restrictions apply, how the pregnancy will be monitored and when the stitch is expected to be removed.