Stenosis of the cervical opening during pregnancy does not affect the development of the fetus and is carried out quite quickly. The method of stitching the cervical opening to prevent miscarriage such as: pregnant women with cleft uterus, pregnant women with a history of premature birth due to cleft of the uterus in previous pregnancies, a history of cervical stitches …
1. What is cervical stenosis?
Cervical stenosis or cervical stitching is a procedure to stitch the uterus waist with Mercilene only to prevent miscarriages such as: pregnant women with cleft uterus, pregnant women with a history of premature birth due to cleft of the uterus in previous pregnancies, a history of cervical stitches …
Sewing of the uterus waist is performed when there is a cleft of the uterus through imaging (ultrasound sees the length of the cervical canal ≤ 25mm, the diameter of the cervical hole is ≥ 8mm wide); have pre-miscarriage with the special nature of the waist opening (consecutive miscarriages 2-3 times or more, gestational age lying 3 months between pregnancy, the age of miscarriage the next time is smaller than the previous one, rapid miscarriage, pregnancy when miscarriage is alive but because it is too young to lose) or miscarriage is large, premature birth before 28 weeks ≥ 2 consecutive times with the characteristics of fast labor without causing pain.
This method of narrowing the cervical opening is contrained in case the uterus has a contraction; bleeding from the uterus; inflammation of the amniotic membrane, young ruptured amniotic fluid; fetal abnormalities; inflammation of the vagina, cervical.
The time of stitching the uterus waist is 14-18 weeks gestational and it is recommended to have stitches before the final miscarriage age.
2. Cervical stenosis process
- Implementer: The implementer is a trained obstetrician and gynecologist and the assistant team will explain the purpose of stitches, accidents that may occur after stitching the uterus for the maternity and the family before the decision on stitches
- Means and tools: Betadine solution; specialized sutures (Perlon, Mercilen 5mm wide…); vaginal valve
- Patient: Sanitation; lying in a gynecology position
2.2. Steps to take
Step 1: Reveal the cervical. Disinfection, clamps pull the cervical to the outside.
Step 2: Stitch the ring
- Poke the needle at 11:30, come out at 9:30, then poke at 8:30 to 7:30, poke at 5:30 and up at 3:30; Finally, poke at 2:30 up at 12:30. Forced only at position 12 hours
- Cut the head just 1cm from the fastener
Step 3: Check the only button
- Vaginal, cervical disinfection
- Check the only button, the two noses will only narrow the cervical opening to two vertical and horizontal directions
2.3. Follow-up after the procedure
- Let the patient stay in bed for 12-24 hours
- Follow-up after uterus mound, abdominal pain, vaginal water bleeding
- Withdrawal of gauze after 4-6 hours
- Antibiotic (oral) and anti-contraction treatment of the uterus
- Pregnant women discharged after 24 – 48 hours without uterus mounds, abdominal pain, vaginal bleeding
- Instructions for non-intersable maternity, not to stand for long, without exertion
- Instructions for maternity signs of hospitalization
- Ultrasound of the length of the cervical uterus every regular examination
- Take Progesterone continuously up to 36 weeks gestational age
- Instructions for pregnant women to re-hospitalize when available: uterus contraction, vaginal bleeding, amniotic fluid
- Cut only at ≥ 38 weeks or during labor
2.4. Possible accidents
- Bleeding: usually bleeding (except in case of unsym detected blood disease) after inserting hem bleeding gauze for 3-4 hours
- Infection: due to the procedure carried out in conditions that do not guarantee the hygiene of the instrument, or the pregnant woman has a definitively unequivocal genital tract infection
- Breaking the needle into the cervical neck: it is recommended to use a large round needle with a small curvature
- Bladder damage
- Amniotic rupture,or amniotic fluid leakage
- Premature labor
- Cervical tearing
- Difficult birth due to cervical fibrosis, fibrous scars
- Rupture of the uterus
3. What should be done after stitching the cervical waist?
Stitching the waist of the uterus during pregnancy does not affect the development of the fetus and is carried out quite quickly so the mother does not need to worry too much. What you need to worry about is how to take care of your uterus waist to ensure your safety later on through some of the following notes:
- Minimize movement and movement at least within the first week, it is best to lie in bed only, especially in cases where there has been a history of miscarriage, premature birth before.
- In addition, proper nutrition for pregnant women (with a full range of essential nutrients such as protein, starch, grease, vitamins and minerals) should also be taken care of and implemented.
- Absolute abstinence from sex during pregnancy at this time.
- Pregnancy and ultrasound examinations to measure cervical length regularly and additional progesterone can be taken continuously until the 36th week of gestation.
- When the date of birth is near (approximately greater than 38 weeks), the mother must have a suture before signs of labor to avoid a cervical rupture. However, in cases of majeure such as early labor, early stitches will be cut to avoid tearing and cervical rupture due to sutures during labor.
The method of preterm birth or consecutive miscarriage at Share99 International Health Hub applies to pregnant women with a diagnosis of cervical waist opening; have a history of cervical stitches and some special cases such as twin pregnancies, multiple pregnancies with a cervical length of less than 25 mm … Advantages of shrinking the cervical opening at Share99 include:
- Professional services: Modern civilized disease prevention system, comprehensive care, meals, rest, exercise, health education, each room is equipped with the same facilities as a 5-star hotel apartment, patient information is confidential.
- Share99's Hybrid Operating Room is the most modern operating room system in the world today, integrating operating rooms and advanced diagnostic imaging facilities (CT scans, MRI scans, ultrasounds …) to help reduce surgical time and bring the best surgical efficiency to patients.
- In resuscitation anesthesia, Share99 adheres to anesthesia regimens, anesthesia safety guidelines, anaesthesia checkboards for 100% of surgeries to minimize incidents and undesirable effects
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- How many weeks of pregnancy is considered sufficient months to give birth?
- Can a 25-week pregnant woman with a cervical opening fly?
- The first time pregnant with the waist of the uterus, does the third time have to be stitched?