How cervical cerclage is performed

The uterus is a very important organ for women. It can give birth to new hope. Someone once said that without a uterus, a woman would not be a complete woman. Although the uterus is very important to women, due to its complexity, changes inside it will have certain impacts on women. For example, if the cervix is ​​too small, it is not easy to get pregnant. If the cervix is ​​too large, miscarriage will easily occur. In this case, a cervical cerclage surgery is needed. Let’s learn more about cervical cerclage surgery.

Treatment method

1. Anesthesia

8-20ml of 1% lidocaine, 4-5ml is injected on each side of the cervix, to a depth of 1+cm. Before injecting the anesthetic, the needle must be aspirated to empty it, and the injection can only be performed when there is no blood after aspiration to avoid injecting the anesthetic into the blood vessels. For patients with nervousness, 50 to 100 mg of pethidine should be injected intramuscularly. For those with narrow vagina and difficult to expose cervix, sacral anesthesia or intravenous anesthesia can be used.

2. Procedure

MacDonald procedure or modified MacDonald procedure. The surgical method is simple, less damaging, easy to perform and has good results.

(1) Empty the bladder on its own.

(2) Routinely disinfect the vulva and vagina, and moisten the gauze with 20 ml each of 10% potassium chloride and 3% hydrogen peroxide. Insert the gauze into the vagina and remove it during surgery. Lay a disinfected towel.

(3) Use a single-leaf vaginal retractor to expose the cervix, and use an oval forceps to clamp the anterior lip of the cervix and gently pull it downward. Use a large triangular needle or round needle, No. 10 silk thread or No. 4 nylon thread to approach the internal cervical os at the vaginal vault. Insert the needle from the cervix at 11 o'clock and remove the needle at about 9 o'clock, reaching deep into the cervix. Then insert the needle at 8 o'clock, remove the needle at 6 o'clock, insert the needle at 5 o'clock, remove the needle at 3:30, and finally insert the needle at 3 o'clock and remove the needle at 1 o'clock. Insert a 1+cm long rubber tube into the thread, gradually tighten the suture, and tie a circular knot at the anterior vaginal fornix to tighten it.

The most significant feature of this procedure is that it does not require any tissue to be cut. Instead, sutures are inserted into and out of the vaginal cervical wall, surrounding the entire cervix to shrink the internal cervical os. If the cervix is ​​short, the bladder needs to be pushed up to suture the internal opening. Obviously old cervical lacerations should be sutured throughout the entire thickness, and cervical laceration repair should be performed after delivery.

The internal os of the cervix tightens to prevent it from expanding as the pregnancy progresses, causing the fetal sac to become wedged in and leading to late miscarriage or premature birth. It also delays the formation of the lower uterine segment and prevents partial placenta previa from causing little or no bleeding.

The above is the relevant knowledge about cervical cerclage surgery that we have prepared for our female friends. I believe that through our introduction everyone should have a deeper understanding of this surgery. Therefore, when you are preparing to become a mother, you must go to the hospital for a check-up in time to understand the condition of your uterus and prepare for welcoming the baby.