It is a problem that continues in the cervical canal
(cervix), which usually appears suddenly without pain and bleeding, and with
the introduction of pregnancy material into the vagina, causing repeated
pregnancy losses.
The exact cause is unknown. Causes such as births,
lacerations, previous surgical interventions (conization, cervical dilation),
which may lead to cervical trauma, exposure to diethylstilbestrol in
intrauterine life, are accused in the development of cervical insufficiency.
Although interventions such as bed rest, intravaginal
pessaries, some pharmacological agents and cervical electrocauterization have
been used in spite of low success rates in the past, the method preferred in
treatment today is surgery. With a procedure called cerclage (there are methods
such as McDonald or Shirodkar), the cervix is strengthened and the opening is
prevented by the band-shaped peripheral suture placed at the level of the
internal os. Cerclage is usually done at 13-14 weeks of pregnancy.
No cerclage
can be performed in the presence of the following conditions:
-Active vaginal bleeding
-Fracture of fetal membranes, chorioamnionitis suspicion or
presence
-Presence of uterine contractions
-4 cm. having openness above
-Presence of polyhydramnios and fetal anomalies
Although there are several different types of cerclage, the
most commonly used technique is called McDonald method cerclage. It is put
under general anesthesia. In patients who have started labor, who have signs of
infection, or who have ruptured fetal membranes, cerclage should be removed. If
vaginal delivery is planned, the stitch is removed at 37 weeks of gestation.
-QUESTIONS ABOUT ABORTION
-RISKS OF ABORTION
-PIECES THAT ARE LEFT IN THE WOMB DURING ABORTION
-MENSTRUATION AND MENSTRUAL DELAY AFTER AN ABORTION
-BLEEDING AFTER AN ABORTION
-MISCARRIAGE
-RECURRENT MISCARRIAGES
-ABDOMINAL PREGNANCY
