When is cervical cerclage recommended for cervical insufficiency?

The cervix is the lower, firm part of the uterus that normally stays closed during pregnancy. Cervical insufficiency means it may shorten or open without strong labour symptoms, which can raise concern about pregnancy loss or early birth. Ultrasound measurements, an examination and previous pregnancy details help guide the decision.

A planned stitch is placed through the cervix during pregnancy. In some situations, an ultrasound finding leads to a targeted cerclage; in others, the history is strong enough for a preventive discussion. A stitch is not suitable when there are signs of infection, active labour, significant bleeding or waters that have already broken.

Attend cervical-length scans and report pelvic pressure, new discharge, spotting, fluid loss or cramps. Ask how long recovery may take, which activities should be limited and when follow-up is due. The stitch is usually removed before labour is expected, but your maternity team will give timing based on your pregnancy and symptoms.

Call your maternity unit promptly for regular tightening, pelvic pressure, bleeding, watery leakage, fever, unpleasant-smelling discharge or worsening pain. These symptoms can indicate labour, infection or ruptured membranes, and a stitch needs assessment in that setting. Seek emergency help for heavy bleeding, severe pain, fainting or feeling seriously unwell.

Ask what your scan and pregnancy history show, whether monitoring alone is reasonable, what type of cerclage is being considered, and which findings would make it unsafe. Discuss anaesthesia, recovery, warning symptoms, removal timing and what happens if labour starts with the stitch in place.