cervical cerclage - also known as a cervical stitch
is a treatment used to prevent the cervix opening too early and causing either a late miscarriage or preterm birth
cerclage may be performed as a prophylactic measure where the woman has a history that increases the risk of spontaneous second-trimester loss or preterm delivery and/or cervical shortening seen on ultrasound
can also be performed as a salvage measure ('rescue' or non-prophylactic cerclage) when a woman presents with premature cervical dilation, often with exposed fetal membranes, and in some cases where the membranes have prolapsed into the vagina
'Rescue' cervical cerclage
'rescue' cervical cerclage should not be offered to women with:
signs of infection or
active vaginal bleeding or
uterine contractions
consider 'rescue' cervical cerclage for women between 16+0 and 27+6 weeks of pregnancy with a dilated cervix and exposed, unruptured fetal membranes:
take into account gestational age (being aware that the benefits are likely to be greater for earlier gestations) and the extent of cervical dilatation
this decision should be after discussion between a consultant obstetrician and consultant paediatrician
if 'rescue' cervical cerclage is used, ensure that a plan is in place for removal of the suture
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