Cerclage During Pregnancy: Risks, Benefits, and What to Expect After Cervical Procedures

Question
I had 2 d&c(s) almost 3 years ago.  I also had a LEEP procedure about 10 years ago.  I also had a laparascopic myomectomy about 5 months ago.  I am not sure if that one went through the cervix.  I am now 14 weeks pregnant after two early losses (3 years ago).  No one has mentioned a cerclage (RE or OB).  After googling and my previous surgeries especially the latest one, that may or may not have gone through the cervix, I am wondering if I should investigate this furhter.  I am also 40 years old.  Don't know if this makes a difference or not.  With the info I have provided just wondering whether you think I would be a cantidate for a cerclage?  Why or why not?  I am also on Heparin for FVL. Writing from SC

Answer
Hello Jamie from the U.S.,

Cerclage is a procedure used to suture the cervix closed in cases of incompetent cervix.  Incompetent cervix is a disorder where the cervix dilates prematurely without any contractions.  Having had a LEEP, you are at risk for incompetent cervix so it is not a bad idea to see if that is something that you need.  Also, because of your age, you have a genetic risk of chromosomal abnormalities in the fetus so for both reasons you might want to have a consultation with a Perinatologist (Ob subspecialist, specializing in high risk pregnancies).  As you doc for a referral.  The Perinatologist will then decide if a cerclage is indicated or not. Do it soon because a cerclage is usually done by 20 weeks gestational age, and amniocentesis for genetic testing is done at 16 wks.

Good Luck,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf, and follow me on Facebook at http://bit.ly/9Iw9oV