Types of Cervical Cerclage

cervical cerclage types

Types of Cervical Cerclage

Cervical Cerclage Types

Prior to getting the cerclage, your medical history will be reviewed, including an examination of your cervix and transvaginal ultrasound. Your doctor will determine the procedure best suited for your case, and will pick one of three options

The three types of cervical cerclage are : 

. Transvaginal Cerclage (TVC) – TVC may be placed anytime within the 12th week onwards. The TVC is removed around the 37th week so that there are chances of normal delivery after cervical cerclage.

. Transabdominal Cerclage (TAC) – TAC is a permanent procedure hence the delivery has to happen through C-section.

. Transvaginal Cervico-isthmic Cerclage (TVCIC) – TVCIC can be removed for vaginal delivery or can be left if it is a C-section.


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About Iranian Surgery

Iranian surgery is an online medical tourism platform where you can find the best Surgeons in Iran. The price of a cervical cerclage procedure in Iran can vary according to each individual’s case and will be determined based on an in-person assessment with the doctor. So if you are looking for the cost of cervical cerclage procedure in Iran, you can contact us and get free consultation from Iranian surgery.




Cervical Stitch Placement Procedure

In a cervical cerclage surgery stitches are placed in the cervix which is the outlet of the uterus to hold it closed. This is carried out using anaesthesia (general or regional). An instrument is used to spread the vaginal walls and the cervix is sewn in place. If you’re wondering about how long a cervical cerclage procedure takes, then the answer is about 30 minutes.

There are 3 ways in which the cervical stitches during pregnancy are done.

  1. In this procedure, a stitch is placed through the vagina in and around the cervix like a purse string and placed at the bottom of the cervix as high as the doctor can reach. This is called Transvaginal Cerclage (TVC).
  2. A band is placed around the outside of the cervix and then tied to control dilation. The band is placed either at the top or at the bottom of the uterus. It is placed laparoscopically or through an incision via the abdomen. In this procedure, the size of the cervix is not made smaller, the band stops it from dilating. This is called as the Transabdominal Cerclage (TAC).
  3. A small incision is made in the cervix and a special tape is tied through it to close the cervix. This cerclage is placed above the cardinal ligaments, but not as high as the TAC. This is the third type of cerclage, Transvaginal cervico-isthmic cerclage (TVCIC).

The cervical stitch may cause some pain, spotting or painful urination. Your doctor may prescribe you Acetaminophen to help you get relief from the cervical stitch pain. If the doctor has placed stitches to reposition the vaginal tissues due to the incision in the cervix you may notice the passage of the material in 2 to 3 weeks as the stitches take time to dissolve.


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Cervical Stitch Removal

The removal of cervical cerclage happens in or around the 37th week or at the onset of preterm labour. In case of any emergency, it may be removed earlier.

Removing the Transabdominal Cerclage (TAC) is a painless procedure which can be performed without any anaesthesia. It may cause light bleeding sometimes.

For Transabdominal Cerclage (TAC) removal a surgery has to be performed. The cerclage maybe left in place in case you plan to have a C-section.

You may go into labour (normal delivery) within 24 hours after the cervical stitch is removed. If you have had a Transabdominal Cerclage then you will need to go for a C-section.

How long is the Cerclage Left in?

The cervical cerclage procedure is performed between 12th and 14th weeks of pregnancy (at the beginning of the 2nd trimester) before symptoms of premature labor begin. Emergency cerclages are those placed at a later stage in pregnancy when cervical changes have already begun.

The cerclage can be left till the 37th week of pregnancy. Post which they can be removed. If you plan to go in for C-section then the cerclage can be left inside. It can be removed before your water breaks or contractions start.


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What are the Results?

In a woman who has had a previous preterm delivery and who is pregnant and has a short cervix (less than 25 mm), result of cervical cerclage will be preventing a preterm delivery and reducing the chances of death and illness in the baby.

Success Rate of Cerclage Stitch

Performing a cerclage stitch of a combination of procedures cannot assure a successful full-term pregnancy. The doctors at the most reduce the risk for you and your baby. Cerclages work best when they are placed early in pregnancy. The success rate for cervical cerclages is between 85%-90%. The success rate is calculated by assessing the number of pregnancies delivered closer to the term with the procedure. Emergency cerclage has the lowest success rate.

10 common questions about cervical cerclage types

1What are the different types of cerclage?
There are two different types of vaginal stitch: Low vaginal stitch (sometimes called a McDonald Cerclage) High vaginal stitch (sometimes called a Shirodkar cerclage or TVCIC – Transvaginal cervicoisthmic cerclage)
2Can your cervix open with a cerclage?
Your health care provider might recommend cervical cerclage if your cervix is at risk of opening before your baby is ready to be born or, in some cases, if your cervix begins to open too early
3How successful is a cervical cerclage?
Cervical cerclage helps prevent miscarriage or premature labor caused by cervical incompetence. The procedure is successful in 85% to 90% of cases.
4Do they put you to sleep for a cerclage?
Regional anesthesia — a spinal or epidural — numbs you from the chest or waist down, but doesn't put you to sleep for the procedure. Most cerclage procedures are done transvaginally (through the vagina). ... Your provider will open your vagina with a speculum and grasp the cervix with forceps.
5Can a cervical cerclage fall out?
Your doctor will take out the cervical stitches before you give birth. This is usually around 37 weeks of pregnancy. She'll do it sooner if you go into labor. If you deliver by C-section and hope to have more children, you may be able to keep the cervical stitches in place
6Is McDonald cerclage removal painful?
Does removing the cerclage hurt? YES! I had mine removed without numbing medication
7What is the success rate of a cervical cerclage?
Fetal survival rate (good apgar score) was 76%. Overall success rate of cervical cerclage was 80%. Conclusion: Application of cervical cerclage in pregnant women with previous preterm delivery reduces the preterm delivery rate at a reasonable cost with no additional risk to the mother and the fetus.
8What to expect after a cervical cerclage?
Mild cramping is normal and should go away within 3 days after your cerclage placement. Taking a warm shower or putting a heating pad on your abdomen may bring relief. Cervical Cerclage- A cerclage is a stitch used to close the cervix during pregnancy to help prevent pregnancy loss or premature birth.
9Can Cerclage cause miscarriage?
But it also has risks—it can cause infection or miscarriage. For women who have had a preterm birth because the cervix did not stay closed, cervical cerclage may prevent another preterm birth
10How long after cerclage removal did you deliver?
CONCLUSION: The mean interval between elective cerclage removal and spontaneous delivery is 14 days. Women with cerclage who achieved 36-37 weeks should be counseled that their chance of spontaneous delivery within 48 hours after elective cerclage removal is only 11%

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