What is a cerclage?

A cerclage is a procedure to prevent preterm birth or second-trimester miscarriage due to cervical insufficiency. During a cerclage, Dr. Okour places nonabsorbable sutures or tape around the cervix, ensuring it stays closed until you deliver the baby.

When would I need a cervical cerclage?

The cervix normally stays strong and firm until late in the third trimester of your pregnancy. Then it slowly softens, thins out, and dilates in preparation for delivering the baby.

If you have cervical insufficiency, you have a weak cervix that softens too early. As a result, the cervix can't support a full-term pregnancy and you lose the baby during the second trimester.

Dr. Okour uses three criteria to determine whether you need a cerclage:

History-based

You’re a good candidate for cerclage if you have a history of two second-trimester pregnancy losses due to painless cervical dilation and without other problems that might cause the loss.

Ultrasound-based

A cerclage can help if you had one preterm birth in the past and an ultrasound confirms your cervix is shortening.

Physical exam-based

A pelvic exam can reveal signs of cervical dilation, indicating the need for an exam-based cerclage, also called a rescue cerclage.

What is an abdominal cerclage?

You may undergo one of two types of cerclage:

Vaginal cerclage

During this procedure, Dr. Okour accesses the cervix through your vagina, placing the suture in the lower half of the cervix. Whenever possible, a vaginal cerclage is preferred over an abdominal procedure because it's less invasive.

Abdominal cerclage

You may need an abdominal cerclage if a previous vaginal cerclage failed or a condition prevents you from having a vaginal procedure. Dr. Okour prefers to perform an abdominal cerclage before you get pregnant. Otherwise, he does the procedure during early pregnancy.

Dr. Okour performs abdominal cerclage with minimally invasive laparoscopic surgery. He makes a tiny incision in your abdomen and inserts a slim scope to reach your cervix. Then he places the suture near the top of the cervix, where it meets your uterus.

Does an abdominal cerclage affect my delivery?

You need to have a cesarean (C-section) delivery after an abdominal cerclage because the stitch stays in until you have the baby. The stitch can be removed after you deliver, or it can remain in place indefinitely if you plan to get pregnant in the future.

By comparison, a vaginal cerclage is usually removed near your delivery date so you can have a vaginal delivery. 

If you have questions about vaginal or abdominal cerclage, call Southern California Center for Advanced Gynecology or book an appointment online today.