An open abdominal cerclage is a surgery that involves making a cut on the skin of the lower abdomen in order to place a stitch on the bottom of the uterus, at the top of the cervix. This can be either before pregnancy or around the twelfth week of the pregnancy. It will be recommended after a careful review of your obstetric and general medical history.
Before the procedure, some tests will be done to check your blood level, heart and kidney functions, blood group, and blood clotting function. If an abnormality is detected or if you have been known to have a previous illness, you might need to be seen by another doctor to be cleared for surgery.
For this surgery, you will have the choice of either being put to sleep (general anaesthesia), or being numbed from the waist down (spinal anaesthesia), as long as there are no other medical contraindications involved.
A cut is made on the lower abdomen, below the bikini line. A stitch is carefully placed at the bottom part of the uterus, with a special kind of suture. Once the stitch has been secured tightly, the uterus is placed back and the skin is closed. The procedure lasts for about 45 minutes to 1 hour.
Afterwards, you will need to be on admission for 3 to 4 days, to allow your wound to heal and to monitor you and your baby (if you are pregnant) for a while. It is not uncommon to experience some vaginal bleeding (spotting), and mild cramps after the procedure, which will stop in a day or two. You will be placed on oral antibiotics, analgesics, and tocolytics (a drug to prevent the uterus from contracting). Subsequently you will be seen after a few days to check that the stitch is intact, then either weekly or every two weeks.