LAPAROSCOPIC cerclage placement can be performed prior to conception or in early pregnancy. Preconception placement provides optimum exposure and reduces risks of excessive bleeding and injury to the pregnancy
Is It better than a vaginal Approach ?
DEFINITELY .Time and again laparoscopy is the best method in treatment of various disease states in this modern medicine.
When the stitch has to be removed ?
The cerclage remains inside till delivery.it is released during the caesarean section in the operation theatre.
Will it harm the fetus?-
No it is necessary for the pregnancy to go on without which patient might end up in preterm delivery.
What Are The Risks Of Having A Cerclage Placed?
The likelihood of risks occurring is very minimal, and most health professionals feel a cerclage is a life-saving procedure that outweighs the possible risks involved.
what anaesthesia is given ?
its general anaeasthesia preferably.
What will be the recovery period?
Generally 2-3 days as with all the Laparoscopy procedures depending on your ability to recover.
who are the candidates for laparoscopic cerclage?
Previous failed vaginal cerclage with scarring or lacerations rendering vaginal cerclage technically very difficult or impossible.
Absent or very hypoplastic cervix with history of pregnancy loss fitting classical description of cervical insufficiency.
Which trimester it has to be planned?
The procedure is planned at the end of the first trimester or the early second trimester, after fetal viability has been documented and initial ultrasound evaluation of the pregnancy and preliminary blood tests have ruled out any major congenital malformation.
When not to have a cerclage?
Active vaginal bleeding.
Premature rupture of membranes.
Vaginal spotting .
What Can I Expect After The Procedure?
You may stay in the hospital for a few hours or overnight to be monitored for premature contractions or labor.
Immediately after the procedure, you may experience light bleeding and mild cramping, which should stop after a few days. This may be followed by an increased thick vaginal discharge, which may continue for the remainder of the pregnancy.
You may receive medication to prevent infection or preterm labor.
For 2-3 days after the procedure, plan to relax at home; avoid any unnecessary physical activity.
Your doctor will discuss with you when would be the appropriate time to resume regular activities.
Abstinence from sexual intercourse is often recommended.
what about postoperative care?
Elective cerclage is typically an ambulatory procedure. The patient is discharged after recovery from the anesthetic and when she is able to ambulate and void.
how to follow up?
Frequent visits as informed by your doctor report immediately in case of pain or spotting or bleedind or leaking.
What is the success rate?
Cervical cerclage helps prevent miscarriage or premature labor caused by cervical incompetence. The procedure is successful in 85% to 90% of cases. Cervical cerclage appears to be effective when true cervical incompetence exists
Why Doesn't Every Woman Who Has Had A Preterm Baby Need A Cerclage?
Only women with an abnormal or "incompetent" cervix can be helped by a cerclage. However, even with the help of a cerclage, other problems can cause labor to begin too early.
What About Future Pregnancies?
Most women who need a cerclage in one pregnancy will need to have a cerclage placed in future pregnancies.