During pregnancy, a condition called cervical insufficiency may develop that increases the risk of losing your baby. Dr. Anna Le and the team at Annandale Ob-Gyn treat this condition by performing a cervical cerclage, which holds the cervix closed so you can have a full-term pregnancy. If you have any questions about cerclage or cervical insufficiency, please call one of the offices in Annandale or Alexandria, Virginia, or use the online booking feature to schedule a consultation.

How does your cervix change during pregnancy?

Your cervix — the lower end of the uterus that connects to your vagina — is normally firm, long, and tightly closed. When you’re pregnant, your cervix stays in its normal state until late in the third trimester.

During the first stage of labor, your cervix begins to soften, shorten, and open. In medical terms, it effaces (decreases in length) and dilates (opens). Effacement and dilatation start when the baby’s head begins to push against the cervix.

What is cervical insufficiency?

Your cervix is composed of muscle and strong connective tissue. When these tissues weaken, the cervix can efface and dilate too early in a pregnancy. This condition, called cervical insufficiency or incompetent cervix, begins in the second trimester, often causing premature birth or miscarriage.

You may have a higher risk for an insufficient cervix if you have any of the following:

  • Cervical incompetence during prior pregnancy
  • Cervical trauma
  • Uterine abnormalities
  • Genetic disorder that affects connective tissues
  • Diethylstilbestrol (DES) exposure

What are the symptoms of an insufficient cervix?

You may not have any signs of cervical insufficiency. When symptoms develop, they’re often mild and occur over several days or weeks beginning around weeks 14-20 of your pregnancy. You may experience:

  • Light vaginal bleeding or spotting
  • Mild discomfort
  • Backache
  • Sensation of pelvic pressure
  • Mild abdominal cramps
  • Change in vaginal discharge

How does cervical cerclage treat an insufficient cervix?

Cerclage is the standard treatment for cervical insufficiency in women carrying one baby. During the procedure, your doctor at Annandale Ob-Gyn & Primary Care places a large, strong stitch in your cervix to hold it closed.

If you have a history of cervical insufficiency, your cerclage may be done between weeks 12 and 14, but the procedure can be performed up until week 24 if an ultrasound shows your cervix is weakening. Then your doctor removes the stitch near the end of your pregnancy, often around week 37, or sooner if you go into labor.

How is cerclage performed?

Your doctor at Annandale Ob-Gyn & Primary Care may perform cerclage one of two ways, choosing the option that’s best for you:

Transvaginal cerclage

The stitches are placed through your vagina, creating a “purse string” around your cervix to help hold it closed.

Transabdominal cerclage

When cerclage is performed through your abdomen, the stitch can be placed closer to the uterus at the top of the cervix.