Suture on the cervix during pregnancy: indications, possible complications and consequences. Stitches on the cervix during pregnancy

During pregnancy, the cervix of the reproductive organ holds the fetus inside the mother's body and closer to the due date it gradually opens. In some cases, this process begins much earlier, when the child is not yet ready to exist outside the womb. This pathological condition of the uterus is called isthmic-cervical insufficiency (ICI) and is considered one of the main causes of miscarriages and premature labor activity. Caesarean section is performed if there are certain indications, and one of them is considered to be incompetence of the uterine muscles. Many mothers are concerned about the question of when the sutures are removed from the cervix during a caesarean section, whether it is possible to cut them, how long it lasts recovery period after the operation and can such an operation affect life in the future?

During pregnancy, the cervix of the reproductive organ is a kind of closure, thanks to which the child is held inside the mother's body. In some situations, there is an increased risk that it may open prematurely in a pregnant woman. In order to prevent such a pathological condition, a woman undergoes an operation - tightening the neck of the reproductive organ with sutures.

There are several reasons that can provoke dilatation of the cervix, and if identified, the doctor will decide to apply sutures. In some patients, the tissues of the cervix of the reproductive organ are too weak and this is due to their genetic feature body. As the unborn child grows, the load on the tissues increases significantly and at a certain point they may simply not be able to cope with it.

The risk of cervical dilatation also increases in women who have irregular shape organ s, so during pregnancy they are warned about their condition. Cause of ICN often there is damage to the reproductive organ, its changes hormonal levels female body. Those expectant mothers who have already encountered problems during a previous pregnancy should be attentive to their health. Put correct diagnosis and it is possible to identify such a pathology after a vaginal examination by a gynecologist and an ultrasound scan. In some cases, to confirm the ICN, it is necessary special examinations which must be completed from 12 to 25 weeks. How will a woman with such a pathology give birth? naturally or by caesarean section is determined only by the doctor.

Surgical treatment of ICI in expectant mothers is usually used in the following cases:

Detection in the patient after gynecological examination and ultrasound of the following pathological conditions of the body:

incompetent cervix of the reproductive organ;
softening and shortening of the uterine pharynx;
disclosure cervical canal or internal pharynx by 20-30 mm;

Presence in the woman’s history of premature labor and spontaneous miscarriages at a long term;
The patient is pregnant with twins.

In some cases, suturing the cervix will have to be abandoned, since there are some contraindications to such an operation:

detection of developmental defects in fetuses;
pregnancy, which is complicated by bleeding;
suspicion of frozen pregnancy;
increased excitability of the reproductive organ, which cannot be eliminated with the help of medications;
complicated somatic pathologies in which further continuation of pregnancy is simply impossible;
genitals;
pathogenic microflora in the cervical canal.

Important: If the cervix begins to open prematurely ahead of schedule, the membranes containing the baby may rupture. With a short period of up to 22 weeks, the pregnancy is terminated, and after 28 weeks the baby is born prematurely.

The procedure for suturing the neck is carried out in inpatient conditions. After a woman's admission to medical institution over the course of several days, specialists carry out some preparatory procedures before surgery:

relieving tension in the reproductive organ using tocolytic treatment;
sanitation of the vagina using antibiotics.

Immediately before the elective surgery blood work is prescribed. In addition, it is shown general research urine and a smear to determine the sensitivity of microflora to antibiotics, and if indicated, an ultrasound is performed.

The operation of suturing the cervix of the genital organ can be carried out in the following ways:

Suturing the external pharynx. IN medical practice A widely used method involves joining the posterior and anterior lips of the uterine pharynx using silk or kengut threads. However, suturing the reproductive organ in this way can negatively affect the course of pregnancy. The fact is that during the operation a closed space is formed, which can provoke an exacerbation of hidden infections. In addition, such suturing is considered ineffective if the expectant mother has a pathology such as.
Mechanical narrowing of the internal os of the reproductive organ. This method of suturing is most often used in medical practice, since it is considered the most favorable. The peculiarity of this operation lies in the fact that after it is performed, a hole for drainage is left in the cervical canal. Suturing of the cervix of the reproductive organ can be carried out according to MacDonald, that is, the woman is given a circular purse-string suture. In addition, such surgical treatment is often performed according to the method of Lyubimova and Mamedalieva.

The suturing procedure lasts about 10-15 minutes, and during the procedure the patient is under anesthesia, so she is not in pain at all. After the operation, the patient may complain that the lower abdomen is severe, and small bloody issues, which usually disappear after a few days without special treatment.

Indications for suture removal

Prevention of ICN

If, while waiting for the child, ICN is detected, then when planning next pregnancy It is imperative to consult a gynecologist. He examines the woman and, based on the results obtained, prescribes the necessary treatment for the patient.

When a woman is diagnosed with ICI, there is no need to be upset, since today such a pathology can be successfully treated. To do this, it is necessary to comply with the treatment regimen and maintain psychological attitude, which will allow you to carry your baby to term and have a successful birth. Caesarean birth is used for certain indications and is considered quite complex operation. For quick recovery You must follow all doctor’s recommendations and take care of yourself.

Many women claim that they were able to successfully carry their child to term while following all the doctor’s recommendations. Usually, with timely suturing, pregnancy ends successfully, but cases of its termination due to weakness of the uterine pharynx still occur.

Video: Suture after caesarean section

Video: Scar and suture after cesarean section

The cervix, at the time when the child is being carried, performs very important function. Thanks to it, the fetus is retained. Its closed state throughout the entire pregnancy helps to retain the embryo in the mother’s body, and, in addition, protect it from infections from the outside. Timely opening of the cervical (cervical) canal should occur after 37 weeks. But if this process begins prematurely, doctors recommend an operation such as suturing the cervix.

The reason is factors that contribute to the onset of labor at a time when the fetus is not yet viable outside the womb. This situation occurs when the uterine muscles fail, called isthmic-cervical insufficiency, or ICI for short. The consequence of the disease is the premature birth of a non-viable baby.

What treatment methods are there for ICI?

Most often, doctors recommend a suturing method performed in a hospital. He has proven himself to be the best. For a week, women are instructed to stay in the hospital under the supervision of a gynecologist, and then they can move on to their normal lifestyle with minor restrictions.

Surgical method of suturing the uterus in a woman

Conservative treatment of uterine incompetence

This method consists of using obstetric unloading pessaries to prevent the threat. They help keep the growing fetus in the womb by reducing the load on the cervix. With their help, the ability to maintain a pregnancy increases significantly.

Obstetric pessary- This is a specially shaped structure made of plastic or silicone. It fits in early dates pregnancy in the vagina, and is removed after 37 weeks.

Method of surgical correction

This type of treatment is carried out by placing suture material on the cervix. After its implementation, the frequency of premature birth, which usually occur before 33 weeks of pregnancy. Surgical method in the treatment of ICI is considered the most effective. Most often, with such a correction, the following methods of applying suture materials are used: U-shaped, performed according to Lyubimova, and suturing according to McDonald and Shirodkar, which has various modifications.

They give the greatest effect when they prevent gaping of the pharynx. To be achieved best results, the operation is performed no later than 18 weeks of pregnancy. Removed suture material just before birth, at 37 weeks.

Signs of ICI for which surgery is indicated

A disease such as incompetence uterine cervix, which occurs during gestation, can occur completely without symptoms. However, when its image becomes progressive, the woman exhibits the following symptoms:

The urge to urinate becomes significantly more frequent, and discomfort and a feeling of unpleasant pressure appear in the lower abdomen;
The vagina feels soft foreign body;
Begin watery discharge, which are harbingers of rupture of membranes.

A gynecological examination shows that the amniotic sac begins to rupture, the length and consistency of the cervix changes, it smoothes out, and the cervical canal expands. If such signs appear, it is necessary to urgently suturing the uterine cervix. After the operation, the threat to the life of the unborn child completely disappears.

Additional information about such a sign as rupture of membranes can be found by watching this video:

Conditions required for surgical correction of ICI

For patients diagnosed with cervical incompetence, it is recommended surgery. To carry it out successfully, several prerequisites are required:

Good viability of the fetus, absence of any developmental defects;
The amniotic sac is undamaged;
Pregnancy period not exceeding 25 weeks;
The uterus is in normal tone;
Absence of bloody discharge from the genital tract;
Absence of vulvovaginitis and any signs of chorioamnionitis.

Before this operation it is necessary to carry out microbiological examination discharge from the cervical canal of the uterus and vagina. In addition, according to certain indications tocolytic therapy is prescribed. After surgery, antibiotic therapy is necessary.

Available contraindications and indications for surgery

If during pregnancy, according to ultrasound and visual examination, signs of ICI are detected, correction of the cervix will be prescribed using suture materials. This is a fairly simple operation that does not harm either the mother or the child.

Additional information about ultrasound during pregnancy can be found in this video:

Indications for suturing surgery

The entire cervical canal has practically opened;
The external pharynx is shortened, its gaping is noticeable;
The consistency of the cervix has changed and become softer.

When such symptoms appear, you should not hesitate to agree to surgical intervention, because the life of the unborn baby is in question.

Contraindications to the procedure

But there are also signs in which the operation is categorically not permitted. These include:

Somatic diseases, after which it becomes impossible to continue pregnancy. This infectious processes and various pathologies, both genetic and internal organs;
Any defects in the development of the fetus;
Pathogenic microflora present in the cervical canal;
Increased excitability of the uterus that cannot be removed by medication;
Complication of pregnancy - bleeding;
Suspicion of a frozen, undeveloped pregnancy;
Vaginal flora, having 3–4 degrees of purity.

If the presence of at least one of them is detected, you should consult your doctor about further actions.

Surgical intervention, its features

If a woman has symptoms of a threatened miscarriage, she is recommended to surgical procedure, like suturing the uterine cervix, necessary in order to save the child.

Only thanks to her will it be possible to save the fetus. In addition, if you follow all the doctor’s recommendations after it, last weeks Pregnancies will proceed smoothly.

Preparatory activities being carried out

Cervical correction surgery is performed only in a hospital. The first 3 days are allotted for the doctor to conduct preparatory activities before a planned procedure. They involve sanitizing the vagina antibacterial drugs, and, in addition, in the use of tocolytic therapy, which effectively relieves uterine tone.

In addition, the woman will need to undergo an ultrasound and undergo laboratory tests. This is a smear that determines the sensitivity of the vaginal flora to antibiotics, a urine test, and a complete blood test. After all their results are obtained, the patient is prescribed a planned correction of the uterine cervix, which makes it possible to avoid spontaneous miscarriage.

How is the operation performed?

To correct the cervix during pregnancy surgically, one of two methods is usually used. The first is the Czendi method, which received greatest distribution and consists of suturing the lips of the cervix. With it, the front and back lips are fastened together using catgut or silk threads.

But this method has a significant disadvantage. It consists in the fact that after such an intervention further development pregnancy may have pathologies. After all, the closed space that is created in the uterus when it is used becomes the cause of exacerbation of any existing hidden infection. Its effectiveness is also quite low when there is erosion on the cervix.

The second, more favorable type of manipulation is to reduce the internal cervical os mechanically. At the same time, the hole necessary for drainage is preserved in the cervical canal. Most Applications Here they found such methods as the purse-string circular suture according to MacDonald and the circular suture according to Lyubimova’s method. Also common is the U-shaped one, according to Lyubimova and Mamedalieva.

The operation time does not exceed 15 minutes. It is performed under anesthesia and is completely painless. Normal manifestations that occur after surgery are considered to be scanty bleeding and mildly expressed nagging pain, which pass quickly.

Postoperative period, features of its management

This correction operation, prescribed depending on certain medical indicators during pregnancy, is atraumatic and completely safe for the unborn child. There are usually no complications after it. The postoperative period, spent in a hospital, lasts no more than a week. Doctors do not practice mandatory bed rest. You can get up immediately after the correction.

During the entire period of hospitalization, antibacterial and hormone therapy, and if necessary, if the tone of the uterus is increased, tocolytic is added to them. In addition, antispasmodics are prescribed. Those places where surgery was performed are treated with antibacterial compounds.

The lifestyle recommended for women after surgery and until the time when the sutures are removed must be specific to avoid the occurrence of any adverse consequences and maintain the pregnancy. Any emotional turmoil should be avoided physical exercise limited to a minimum.

It is also necessary to observe a gynecologist with strict adherence to all his recommendations. Sexual intercourse should be excluded for the entire period of pregnancy.

Sometimes long-awaited pregnancy complicated by the threat of not bringing the baby to term. Various pathologies cervix can cause ischemic cervical insufficiency. In some cases to the expectant mother suturing of the cervix is recommended. We will talk about why this is done and how this manipulation takes place in this material.

What it is?

Suturing the cervix - forced necessity, which gives a real chance to preserve and prolong pregnancy if the cervix for some reason cannot cope with its direct responsibilities. After conception has taken place, the cervix closes tightly. The cervical canal closes and fills with mucus. The task before this part of the reproductive female organ stands big and important - keep the growing fetus in the uterine cavity and prevent it from leaving it prematurely.

In addition to retention, the cervix with a mucus plug prevents pathogenic bacteria, viruses, and other unpleasant uninvited “guests” from entering the uterine cavity from the vagina, which can cause intrauterine infection of the baby. This is dangerous, because infections transmitted in embryonic or later late periods, usually result in developmental defects and severe congenital pathologies, intrauterine death crumbs.

If the cervix does not provide adequate protection to the growing baby, the likelihood of miscarriage and premature birth increases. If by this time the baby is not yet able to survive on his own in this world, then such a birth will end tragically. In order to strengthen a weak neck, doctors recommend in certain situations to sutured it so that the mechanical barrier in the form of sutures prevents it from opening prematurely.

Indications

For this type of surgical intervention during pregnancy there must be strict indications and clear recommendations from the attending physician. These factors include:

high risk of miscarriage or premature birth due to the presence of similar cases in the anamnesis;
recurrent miscarriage in the 1st and 2nd trimesters of pregnancy;
miscarriage in the third trimester;
earlier shortening and opening of the cervix, expansion of the internal or external pharynx;
dubious scars left as “memories” from previous births in which cervical ruptures occurred;
any destructive changes in the cervix during the process of bearing a child, which are prone to further development.

Decide that there is a need for such at least, like suturing, the doctor cannot do it based on an examination alone in a gynecological chair. He needs comprehensive information about the condition lower segment the uterus, which is the cervix. For this purpose it is assigned full biometric examination, which includes colposcopy and ultrasound diagnostics, as well as laboratory test smear

Only after all risk factors have been identified, the length and width of the cervix have been measured, the condition of the cervical canal inside it has been assessed, as well as the patient’s personal history, can a decision be made about suturing the cervix.

Contraindications

Suturing this organ during pregnancy is possible only if, in addition to a weak neck, other global problems not detected in this pregnancy. If some concomitant pathologies are detected, the operation will have to be abandoned. Contraindications include:

diseases of the heart and blood vessels, kidneys, which have worsened in the expectant mother due to pregnancy, the risk of death of the woman in the event of mechanical prolongation of pregnancy;
bleeding, increasing in strength and character, as well as recurrent bleeding when there is a threat;
gross malformations of the baby;
hypertonicity of the uterine muscles, which cannot be reduced with medical conservative treatment;
chronic inflammation reproductive organs women, presence of sexually transmitted infections, STDs;
late detection of cervical pathologies - after 22 weeks of pregnancy ( best time The period from 14 to 21 weeks is considered for successful intervention).

How is the operation performed?

The duration of the operation is great importance. From 14 to 21 weeks, the baby is not large enough to stretch the walls of the uterus and the muscles of the cervix, more later suturing is not recommended due to the fact that highly stretched tissues may not be able to withstand and the seams will cut through with subsequent rupture.

The operation, which medical language is called "cervical cerclage", carried out only in a hospital. It is not considered painful or excruciating because the woman is given an epidural or intravenous anesthesia.

There is no need to be afraid of it, because experienced anesthesiologists will calculate the dosage of drugs solely taking into account the gestational age, physique, weight and health status of the expectant mother herself and the developmental characteristics of her baby. The dose will be safe for mother and fetus.

The duration of the entire manipulation does not exceed a quarter of an hour. Depending on the condition of the cervix, the doctor will suture either the external or internal os of the cervix. The external one will not be touched if there is erosion, dysplasia, or pseudo-erosion on the cervix. The technique is very simple - surgeons suture the edges of the outer part of the neck together with strong surgical threads.

This method requires careful preparation. If there is an infection in the uterus, the consequences will be more than dire. Stitching will create a closed space inside the female reproductive organ in which any microbe can begin to multiply quickly. The woman is first treated with antibiotics, and the vagina is thoroughly sanitized. However, this does not always help.

There will be no closed space if the doctor decides to sew up the internal os of the cervix. In this case, specialists leave a small drainage hole. The stitches themselves are applied different ways, every surgeon has his own favorite, besides, a lot depends on anatomical features of this patient.

The cerclage itself can be performed laparoscopic method. It has many advantages - fast, quite lightweight postoperative period, low blood loss, lower risk of complications.

Laparoscopic cerclage is indicated for women with congenital shortening of the cervix and those who have undergone unsuccessful operation for suturing using the vaginal method.

Possible problems and complications

Like any surgical intervention, cerclage can also have its complications. The most dangerous are considered to be the addition of an infection, the development of an inflammatory process and an increase in the tone of the uterine muscles. Inflammation can develop due to internal infection, which could not be “defeated” in the preoperative period. Sometimes a woman has an individual allergic reaction on the suture material used by doctors.

ABOUT possible problems can talk prolonged discharge after surgery, burning sensation, weak pain syndrome . Moreover, inflammation can appear not only immediately after surgery, but also several weeks after suturing. This is why it is important to visit your doctor more often and monitor any changes.

Hypertonicity is also a reaction of the uterus to surgery and suture material foreign to its structures. Some heaviness in the stomach, small pulling sensations may well be normal occurrence at first after surgery, but subsequently they should disappear. If this does not happen, you should inform your doctor.

It’s not often, but it also happens that a woman’s body categorically refuses to accept a foreign body, which is surgical threads, and a violent immune process of rejection begins, which may be accompanied high temperature, atypical discharge, pain.

In later stages, cerclage may have one more unpleasant consequence– a sutured cervix can be seriously damaged if labor has already begun and the stitches have not yet been removed. Therefore, it is important not to ask the doctor to “stay at home for another week,” but to go to the hospital in advance.

After the intervention, the woman needs to remain under 24-hour medical supervision in the hospital for several more days. She is prescribed antispasmodic drugs to reduce muscle tone uterus, as well as strict bed rest. The vagina is sanitized daily to avoid infection. After this, the pregnant woman can be sent home. Discharge after the intervention continues for approximately 3-5 days.

Stitches on the cervix will require the expectant mother to reconsider her lifestyle until the very birth. Physical activity, prolonged exposure to vertical position, long walking. Under no circumstances should you lift heavy objects. You should also refrain from sex life so as not to provoke hypertonicity of the uterus, which can lead to the cutting of sutures.

Until childbirth, a woman will have to monitor her stool - constipation is extremely undesirable, since pushing is prohibited. Therefore, you will have to go on a diet, introduce more fresh vegetables and fruits, juices into your diet, limit salt, an abundance of protein foods, as well as baked goods.

You will have to go to the doctor more often, than women usually do in " interesting position" The doctor will monitor the condition of the sutures, take smears for vaginal microflora, and, if necessary, prescribe unscheduled ultrasound examinations, the purpose of which will be to measure the parameters of the cervix and evaluate its internal structures.

A woman with stitches on her uterus will have to go to the maternity hospital at 36-37 weeks. Around this time, the sutures are removed. Labor can begin at any time after this, even on the same day.

It is not painful to remove the sutures; there is no need to use anesthesia or other anesthesia methods.

Predictions and consequences

The pregnancy rate after cerclage is quite high - more than 80%. Prognosis depends on the degree of cervical insufficiency and the reasons why the woman was indicated for surgery. If after the operation she follows all the doctor’s recommendations, then the chances of carrying a baby to 36-37 weeks are significantly increased.

The treating gynecologist diagnosed you with isthmic-cervical insufficiency and sent you to put a suture on the cervix? Don't be alarmed. Pull yourself together, because now is the time when you can seriously harm yourself with worries. Let's look into the situation together.

When does a neck need to be hemmed?

In non-medical terms, ICI is when the cervix is very short and very loose. That is, it cannot “hold” the fetus inside the uterus. By the way, a little less than half of miscarriages in the second trimester occur precisely because of such a cervix - in cases where the peculiarity was either not diagnosed in time, or due to a medical error or disobedience of the pregnant woman, was not resolved in a timely manner.

The cervix begins to be observed at approximately 12-16 weeks. If a suture is necessary, this is done from approximately 17 to 21 weeks. When time is lost for some reason and the period has passed the 22nd week, the expectant mother is offered a pessary - a special ring that holds the cervix.

The suture is removed depending on the situation. Some are at 36 weeks of pregnancy, others are closer to 39.

Two stitches

The cervix is sutured in the hospital, after which the pregnant woman remains in the hospital for a couple of days. However, exceptions are possible - it all depends on the institution, the doctor and, in fact, the specific cervix. My friend was allowed to go home 2 hours after the intervention. I spent about a week in the hospital after the procedure.

Actually, the procedure itself takes place under general anesthesia and lasts no more than 15 minutes. Doctors assure that this anesthesia is absolutely harmless for the baby: firstly, it is a special anesthesia, shallow, and secondly, it is really short-lived. And it is much easier to recover from it than after a deeper anesthesia. The feeling can be compared to waking up. Some people open their eyes, get up and can already go about their business, others need to lie down for an hour.

What can and cannot be done after the procedure?

Usually after surgery you are not allowed to sit for 24 hours. Just stand and lie down. This means that you need to roll out of bed, as it were, and go to the toilet almost standing up. By the way, don’t be alarmed if you find droplets dark discharge on panties. A day or two after the suture is applied, there may be some bleeding.

Depending on your situation, your doctor may either allow you to live full life with virtually no restrictions, or will recommend that you adhere to semi-bed rest. Be sure to check this issue with your doctor.

Follow intimate hygiene you will have to be even more careful than before. While washing in the shower, did you feel a thread in your vagina? Don't even try to pull on it!

But the most important thing is that from now on you need to make every effort to prevent the occurrence of uterine tone. The tension of this organ increases the load on the cervix and is fraught with cutting through the tissue by the thread. This means, firstly, you should never have sex. Let me clarify: strictly contraindicated and oral sex, and masturbation. In medicine this is called complete sexual rest. You should not get excited and have an orgasm, because at such moments the uterus becomes very tense. However, if you dreamed erotic dream, which led to an orgasm, don’t be upset. Try to relax - and the tone will go away.

Secondly, women who have had a suture placed on the cervix are not allowed to be nervous, since worries can provoke strong tone. Try to control yourself. Do not neglect the sedative therapy prescribed by your doctor - herbal sedatives. If your treating gynecologist has not prescribed you such medications, check with him - it may be worth taking them. It's not just about them sedative effect, but also that such drugs relax the muscles of the uterus.

And, of course, give up foods that provoke tone. This includes coffee, green and strong black tea, and various sweet carbonated drinks containing caffeine. I won’t dwell on the fact that you can’t run, jump, dance or lift heavy things.

Suture vs pessary

“I am offered to put a suture on the cervix, but my friend was given a pessary, why is that?” is a question often heard on forums. Let's figure it out.

A pessary is a special ring that is placed on the neck. The pessary prevents it from opening and supports the uterus. It is usually placed when it is too late to apply a suture. This is done in 5 minutes in a gynecological chair, after which the pregnant woman can be free. It would seem that the ideal option: no anesthesia, no week in the hospital, no “sewing” on the neck... a logical question arises: why then does the practice of suturing still exist if the problem can be solved much faster and easier? However, not everything is so simple.

Firstly, the pessary is usually perceived by the body as a foreign body. The process of its rejection begins - that is, a sluggish inflammatory process. It must be constantly treated with medications prescribed by a doctor. After all, inflammation near the uterus and amniotic fluid is completely unnecessary.
Secondly, experienced women in labor say that the pessary can fall out. Of course, you won’t be able to put it back on yourself, which means you’ll need to urgently run to the doctor.

By the way, it’s not at all painful to shoot both. It's just a little unpleasant. The removal procedure lasts from one to several minutes.

What if childbirth?

Regardless of whether you have a pessary or a suture, you need to see a doctor periodically. Moreover, the closer to the PDR, the more often. Gynecologist leaning on Current state cervix, will set a date for you to remove the “lock” from the uterus.

Of course, at the first suspicion of contractions, you need to run to the doctor. Otherwise, the consequences can be disastrous: up to cervical rupture. At the same time, worry about every wasted minute It’s also not worth it, especially if it’s your first birth.

There is a belief among women in labor: if after removing a suture or pessary, labor occurs within a period of a couple of hours to three days, then it was really necessary to carry out the procedure of “closing” the cervix. If later, it means that the suture or pessary was a reinsurance measure. However, if you give birth a week after removal, do not rush to blame your gynecologist. Perhaps your cervix itself has undergone changes.

Dear girls:) For 3 years I’ve been here honestly answering questions about poop, colostrum, breastfeeding, threats, who’s age, whether the dress is good and whether the world will end. I understand that it’s more interesting to discuss mothers-in-law and fights on sites, I’m a sinner myself, but now I kindly ask everyone who is “in the know” to respond to a question that’s very important to me important question.

During my first pregnancy I had ICI - isthmic-cervical insufficiency, which is when the cervix softens, shortens and tends to open long before the due date. They discovered it at 9 weeks, kept it until 18, and put a ring on it. This time, everything I drank and did to prevent the diagnosis, at 19 weeks my cervix was just beautiful - 37 mm, but yesterday, at 23 weeks, it was already 26. And it needs to be corrected in any case.

All four of me are in favor of a ring or a pessary, but the doctor (paid, I haven’t gone to a consultation yet and don’t want to yet) suggests stitches on the cervix. The argument is my symphysitis (symphysitis is inflammation of the symphysis pubis, separation of the pubic bones, it is painful and it threatens to rupture the symphysis during childbirth, which is what I had last time). He says that the ring will put pressure on the bones, and they will diverge even more.

So - attention - question!

Who had cervical stitches stitched - was a ring offered as an alternative? Have you asked yourself? What were the arguments for the stitches? Or simply no one mentioned rings and pessaries, and you didn’t know?

Who had the ring put on - were there any complications from the pelvis or pubic symphysis? Was it painful to put it on? On the forum I read the opinion of girls (not doctors) that it hurts especially those who have symphysitis. It hurt me the first time.

The experience of friends and relatives is also suitable if the information is reliable, and not “my mother’s friend said about the daughter-in-law of her godfather’s brother.”

Below is background information for those who are interested:

Obstetric pessary

An obstetric pessary is a small plastic or silicone medical device that is inserted into the vagina to hold the uterus in a certain position. An obstetric pessary is used in obstetrics to prevent premature birth in pregnant women with isthmic-cervical insufficiency (ICI) and to prevent the development of this pathology. The effectiveness of this method of correcting ICI is 85%. The obstetric unloading pessary has been used in a number of countries (Germany, France) for more than 30 years, in the CIS countries (Russia, Belarus, Ukraine) for more than 18 years.

Mechanism of action of the obstetric pessary

The mechanism of action of the obstetric unloading pessary is based on reducing the load on the cervix due to a decrease in the pressure of the fertilized egg.

Indications for use of an obstetric pessary

functional and organic isthmic-cervical insufficiency;
prevention of isthmic-cervical insufficiency in pregnant women;
prevention of suture failure during surgical correction of ICI.

Obstetric pessary

Meyer ring

Suturing the cervix

Indication To surgical treatment serve as progression of ICI: change in consistency and shortening of the cervix, gradual increase(“gaping”) of the external pharynx and opening of the internal pharynx.

Contraindications For surgical treatment of ICI in pregnant women, the following are considered: diseases and pathological conditions which are a contraindication to continuing pregnancy (severe forms of disease of cardio-vascular system, liver, kidney, infectious, mental and genetic diseases), symptoms of threat of interruption, birth defects fetal development, non-developing pregnancy, III-IV degree of purity of vaginal flora, presence pathogenic microflora in the discharge of the cervical canal. In the last 2 cases, preliminary sanitation of the genital tract is necessary.

It was recognized as the most effective for prolonging pregnancy at the 17th Congress of the International Federation of Obstetricians and Gynecologists (FIGO). surgical correction ICN using a circular suture in the area of the internal os according to the Shirodkar method (the suture is almost completely immersed in the mucous membrane of the cervix). If they produce caesarean section, the suture is usually not removed.

The second method of suturing the neck is the Mac Donald method - a simple procedure that involves less blood loss and is less traumatic for the neck compared to the Shirodkar method. A simple purse-string suture is placed on the cervix.

Suturing the cervix for ICN