Cervical suture – indications, complications, preterm labor

Cervical suture – indications

Circumferential suture to the cervix is a procedure used in gynecology as a prevention of preterm labor. In addition to sutures, pessaries and progesterone are also used in practice. Cervical suture has a proven effect, among other things. For patients with risk factors such as a history of preterm labor and a shortening cervix (<25mm before 24. tyg).

Prophylactic cervical suture

Prophylactic cervical suture is used in patients with a history of a minimum of 3 late miscarriages (after the 16th week) or preterm births. Those pregnant women who have had a cervical conization, for example, may also qualify for the placement of a prophylactic cervical suture. It is usually inserted in the first trimester of pregnancy (around the 14th week of pregnancy) and is aimed at reducing the risk of preterm labor. Most often, in addition to the cervical suture, the pregnant woman then uses intrapartum progesterone in a dose of 200ug.

Emergency cervical suture

Emergency cervical suture is an emergency procedure performed when there is active shortening of the cervix or even dilation. Doctors place an emergency cervical suture even when the fetal bladder is visible in the speculum. The emergency suture is usually placed before 26. week of pregnancy. On the other hand, it is removed when contraction activity begins, amniotic fluid drains out or when the 36th is over. One week of pregnancy.

Cervical suture – what does the insertion look like

Qualification for cervical suture placement is carried out by a gynecologist. The procedure itself takes place in the hospital. The patient usually receives antibiotic prophylaxis beforehand due to the fact that cervical shortening is often associated with intrauterine infection. In addition, if there is an insertion of the fetal bladder in some situations, a so-called “fetal bladder” is performed. amnioreduction to reduce the process and thus facilitate the technical conditions for suture placement. The cervical suture itself is placed transvaginally in most cases and involves temporarily “suturing” the external orifice of the cervix with an insoluble suture. The procedure is performed under subarachnoid or general anesthesia under sterile conditions.

Cervical suture – complications

Like any medical procedure, the placement of a cervical suture can carry complications. Among the most commonly mentioned, but rarely encountered, are: amniotic fluid drainage or intrauterine infection.

Read more:
Preterm labor – can it be prevented?