Cerclage placement is a procedure performed during pregnancy to reinforce your cervix to help keep it closed. This is done to prevent your cervix from softening and opening too soon, which can lead to premature birth or miscarriage. Cerclage is typically performed at the end of the first trimester or beginning of the second trimester. Our team will evaluate your individual diagnosis and pregnancy needs and determine the appropriate care plan for you.

The experienced surgeons at the Center for Maternal Fetal Medicine in partnership with the advanced OB-GYN hospitalist group at Orlando Health Winnie Palmer offer the latest treatment options, including two types of cerclage procedures:

• Transvaginal cerclage (through the vagina)
• Transabdominal cerclage (through the abdomen)

If our team feels a cerclage is right for you, we will have a conversation, present all of the options and recommend the least invasive, best treatment plan for you.

During a transvaginal cerclage, the weakened cervix is stitched shut through the opening in the vagina. A transvaginal cerclage is the preferred and less invasive method since no abdominal surgical incision is needed. If the decision is made that a vaginal cerclage is right for you, your MFM provider will partner with the advanced OB-GYN hospitalist group at Orlando Health Winnie Palmer to perform and ensure a successful procedure.

What to Expect During Transvaginal Cerclage

This procedure is typically performed during the 12th and 14th week of pregnancy to minimize risks to you and your baby. Before the procedure, you will receive regional anesthesia (medicine to put you to sleep), so you will not feel pain. Your provider will open the vagina using a speculum to view the cervix. They will then stitch the cervix closed.

You may need to stay in the hospital for several hours for monitoring after the procedure but likely will return home the same day. You may have some mild cramping and light bleeding after cerclage. You can take Acetaminophen (Tylenol) to ease any pain or discomfort. These symptoms should go away after two to three days.

What to Expect After Transvaginal Cerclage

Your care team will discuss how long you should rest at home and avoid physical activity, heavy lifting or sex after a transvaginal cerclage.

You should have regular check-ups with your MFM provider throughout pregnancy to make sure you and your baby are healthy. The stitch placed during a transvaginal cerclage procedure is typically removed around 37 weeks of pregnancy and must be removed before a vaginal delivery is possible.

A transabdominal cerclage is when surgery is performed through an incision made in the lower abdomen, close to the bikini line. Your MFM provider will perform the abdominal cerclage surgery. This surgery is typically performed prior to pregnancy in women who have a history of incompetent cervix or have had a previous transvaginal cerclage that was not successful. If a woman must have a transabdominal cerclage placement during pregnancy, surgery will be done between the 9th and 14th week of pregnancy to minimize risks to the mother and baby.

What to Expect During Transabdominal Cerclage

Before surgery, you will receive either spinal anesthesia (numbing injection) or general anesthesia (medicine to put you to sleep), so you will not feel pain. Your surgeon will make the incision in your lower abdomen and will stitch your cervix closed through this incision.

You may need to stay in the hospital for several hours or overnight for monitoring after the procedure. You may have some mild cramping and light bleeding after cerclage. These symptoms should go away after two to three days.

What to Expect After Transabdominal Cerclage

Following surgery, you may need to take medication for several days to prevent infections. Your care team will discuss how long you should rest at home and avoid physical activity after having transabdominal cerclage.

Women with abdominal cerclages should have regular check-ups with their MFM provider throughout their pregnancy to make sure they and the baby are healthy. Abdominal cerclages require a Cesarean (C-section) for the baby’s delivery.

Abdominal cerclages are typically kept in place until a woman has reached the end of her childbearing years or she has decided she no longer wants children. Your MFM provider will discuss with you the best time to remove your transvaginal cerclage.