CERCLAJE CERVICAL PDF

Risks associated with cervical cerclage include: Inflammation of the fetal membranes due to a bacterial infection Vaginal bleeding A tear in the cervix cervical laceration Preterm premature rupture of the membranes — when the fluid-filled membrane that surrounds and cushions the baby during pregnancy amniotic sac leaks or breaks before week 37 of pregnancy Suture displacement After receiving a cervical cerclage, contact your health care provider immediately if you have leakage of fluid from your vagina, a sign of preterm premature rupture of membranes. Your health care provider will recommend removing the cervical cerclage early if you have preterm premature rupture of membranes or if you have symptoms that suggest a uterine infection. Your health care provider might take a swab of your cervical secretions or do amniocentesis — a procedure in which a sample of amniotic fluid is removed from the uterus — to check for infection. Ideally, a history-indicated cervical cerclage is done between weeks 12 and 14 of pregnancy. However, cervical cerclage can be done up until week 23 of pregnancy if a pelvic exam or ultrasound shows that your cervix is beginning to open.

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Risks associated with cervical cerclage include: Inflammation of the fetal membranes due to a bacterial infection Vaginal bleeding A tear in the cervix cervical laceration Preterm premature rupture of the membranes — when the fluid-filled membrane that surrounds and cushions the baby during pregnancy amniotic sac leaks or breaks before week 37 of pregnancy Suture displacement After receiving a cervical cerclage, contact your health care provider immediately if you have leakage of fluid from your vagina, a sign of preterm premature rupture of membranes.

Your health care provider will recommend removing the cervical cerclage early if you have preterm premature rupture of membranes or if you have symptoms that suggest a uterine infection. Your health care provider might take a swab of your cervical secretions or do amniocentesis — a procedure in which a sample of amniotic fluid is removed from the uterus — to check for infection. Ideally, a history-indicated cervical cerclage is done between weeks 12 and 14 of pregnancy. However, cervical cerclage can be done up until week 23 of pregnancy if a pelvic exam or ultrasound shows that your cervix is beginning to open.

Cervical cerclage is typically avoided after week 24 of pregnancy due to the risk of rupturing the amniotic sac and triggering premature birth.

What you can expect Cervical cerclage is typically done as an outpatient procedure at a hospital or surgery center under regional or general anesthesia. Most cervical cerclage procedures are done through the vagina. Cervical cerclage might be done through the abdomen if transvaginal cerclage is unsuccessful or anatomically difficult due to an extremely short, lacerated or scarred cervix.

During the procedure During transvaginal cervical cerclage, your health care provider will insert a speculum into your vagina and grasp your cervix with ring forceps. He or she might use ultrasound for guidance. Your health care provider will likely use the McDonald operation or the Shirodkar operation.

Data suggests no significant difference in outcomes between the two methods. During the McDonald operation, your health care provider will use a needle to put stitches around the outside of your cervix. Next, he or she will tie the ends of the sutures to close your cervix. During the Shirodkar operation, your health care provider will use ring forceps to pull your cervix toward him or her while pulling back the side walls of your vagina.

Next, he or she will make small incisions in your cervix where it meets your vaginal tissue. Then, he or she will pass a needle with tape through the incisions and tie your cervix closed.

Your health care provider might use stitches to reposition vaginal tissue affected by the incisions. During transabdominal cervical cerclage, your health care provider will make an abdominal incision. He or she might elevate your uterus to gain better access to your cervix. Next, your health care provider will use a needle to place tape around the narrow passage connecting the lower part of your uterus to your cervix and tie your cervix closed.

Then he or she will set your uterus back into place and close the incision. The procedure also can be done laparoscopically. You might experience some spotting, cramps and painful urination for a few days. Acetaminophen Tylenol, others is recommended for pain or discomfort. If your health care provider used stitches to reposition vaginal tissue affected by incisions in your cervix, you might notice passage of the material in two to three weeks as the stitches dissolve.

As a precaution, your health care provider might recommend avoiding sex for a few weeks or more, depending on the reason for the cerclage. If you had cervical cerclage because your cervix had already begun to open or an ultrasound showed that your cervix is short, you might need to remain in the hospital for observation. As a precaution, your health care provider might recommend limiting physical activity and sex until delivery.

Your health care provider will continue to monitor you closely for signs or symptoms of preterm labor. Cervical cerclage removal A transvaginal cervical cerclage is typically removed at around week 37 of pregnancy — or at the start of preterm labor.

If you expect to have a C-section and plan to have children in the future, you might choose to leave a Shirodkar cerclage in place throughout your pregnancy and after the baby is born. Consult your health care provider about your options. As a result, a C-section is typically recommended. Your baby will be delivered through an incision made above the cerclage. During the C-section, you can choose to have the cerclage removed or leave it in place for future pregnancies.

Results The effectiveness of cervical cerclage is a topic of debate. Research suggests that cervical cerclage reduces the risk of premature birth in women with proven cervical insufficiency. However, the timing of cervical cerclage can also affect the outcome.

Emergency cervical cerclage done in the presence of advanced cervical change and prolapsed membranes has a poorer outcome.

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Cervical cerclage

The procedure is performed under local anaesthesia , usually by way of a spinal block. It is typically performed on an outpatient basis by an obstetrician-gynecologist. Usually the treatment is done in the first or second trimester of pregnancy, for a woman who has had one or more late miscarriages in the past. A cerclage is considered successful if labor and delivery is delayed to at least 37 weeks full term. After the cerclage has been placed, the patient will be observed for at least several hours sometimes overnight to ensure that she does not go into premature labor. The patient will then be allowed to return home, but will be instructed to remain in bed or avoid physical activity including sexual intercourse for two to three days, or up to two weeks.

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Cerclaje Cervical

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