Complications after uterine cerclage to prevent premature birth

Ms. Thuy had two miscarriages before 8 weeks. This time, when she was 18 weeks pregnant, a doctor at a private clinic prescribed uterine cerclage to prevent premature birth. After the procedure, when she was 22 weeks pregnant, she had abdominal pain and went to Tam Anh General Hospital in Ho Chi Minh City for examination and discovered that her cervix showed signs of infection.

On January 11, M.D. Nguyen Thi Quy Khoa, Deputy Department of Obstetrics and Gynecology, Center for Obstetrics and Gynecology, Tam Anh General Hospital, Ho Chi Minh City, explained that normally the cervix is ​​closed to protect the amniotic sac and fetus. Cervical cerclage is the use of special sutures to sew around the cervix, helping to prolong pregnancy until adulthood. In the unfortunate case of Ms. Thuy, 1/3 of the cervix was severely torn and the amniotic sac prolapsed deep into the vagina, causing infection.

“This is a serious obstetric accident,” Dr. Khoa said, adding that the tear in the cervix was quite large, extending to the uterine waist, creating a hole that caused the amniotic sac to fall out.

Ms. Thuy was monitored for fetal heart rate and contractions, and used birth control medication but did not respond to the medication and her uterus began to have contractions. The doctor removed the cervical sutures. Ms. Thuy then gave birth naturally at 22 weeks, and the baby died a few minutes after birth.

Cervical cerclage is performed at 14-18 weeks gestation or in some cases considered at older gestational ages. According to Dr. Quy Khoa, the uterine cerclage procedure is quite safe, but complications still occur such as bleeding, infection, chorioamnionitis, premature rupture of membranes, bladder damage, cervical tear, and uterine rupture. , premature labor or early miscarriage.

This procedure should only be applied to women with a history of more than two major miscarriages over 14 weeks or premature birth before 28 weeks with rapid, painless labor, according to Dr. Khoa. People with risk factors on the cervix such as cone cutting, sectioning, cervical damage due to dilation and curettage with a history of premature birth before 36 weeks, cervical length shorter than 25 mm at a gestational age of less than 24 weeks or if the length of the cervix gradually decreases over time, the doctor will also consider prescribing this method.