Pregnancy 16 weeks. At 15 weeks, a suture was placed on the cervix. Because I had a miscarriage in the past. IVF pregnancy - twins. I really want to save it. What actions are carried out after suturing the cervix: medications, ointments, sanitation?
The fact is that after the stitches were put in, I was given a magnesium system for 6 days, and now for the third day I’m just lying in a hospital bed. After asking the doctor whether the vagina needed to be treated somehow, she received the answer: no. I asked, maybe at least Hexicon candles for prevention, the answer: well, if you want, put it in. I put the candles on. On the 6th day after suturing, mucous discharge appeared from the vagina (when I went to the toilet to urinate). The doctor said that most likely the discharge had just accumulated. On this day I received the last magnesium system.
Three days later, i.e. Today, again on a napkin there is either mucous or purulent discharge of a yellow-brown color. I called the guard nurse and showed her the discharge. She asked to call the doctor on duty. The doctor refused to come, citing the arrival of a large number of women and operations. I don't know what to do next. The attending physician will return to work in a day. I'm afraid that this discharge may harm the pregnancy. Tell me what I can do myself?

Sometimes a long-awaited pregnancy is complicated by the threat of not bringing the baby to term. Various pathologies of the cervix can cause istic-cervical insufficiency. In some cases, the expectant mother is recommended to have suturing on the cervix. We will talk about why this is done and how this manipulation takes place in this material.

What is it?

Putting sutures on the cervix is ​​a necessary necessity, which gives a real chance to preserve and prolong pregnancy if the cervix for some reason cannot cope with its direct responsibilities. After conception has taken place, the cervix closes tightly. The cervical canal closes and fills with mucus. The task facing this part of the female reproductive organ is large and important - keep the growing fetus in the uterine cavity and prevent it from leaving it prematurely.

In addition to retention, the cervix with a mucus plug prevents pathogenic bacteria, viruses, and other unpleasant uninvited “guests” from entering the uterine cavity from the vagina, which can cause intrauterine infection of the baby. This is dangerous, because infections suffered in the embryonic and later periods usually result in developmental defects and severe congenital pathologies, and intrauterine death of the baby.

If the cervix does not provide adequate protection to the growing baby, the likelihood of miscarriage and premature birth increases. If by this time the baby is not yet able to survive on his own in this world, then such a birth will end tragically. In order to strengthen a weak neck, doctors recommend in certain situations to sutured it so that the mechanical barrier in the form of sutures prevents it from opening prematurely.

Indications

For this type of surgical intervention during pregnancy there must be strict indications and clear recommendations from the attending physician. These factors include:

• high risk of miscarriage or premature birth due to the presence of similar cases in the anamnesis;
• recurrent miscarriage in the 1st and 2nd trimesters of pregnancy;
• miscarriage in the third trimester;
• earlier shortening and opening of the cervix, expansion of the internal or external pharynx;
• dubious scars left as “memories” from previous births in which cervical ruptures occurred;
• any destructive changes in the cervix during the process of bearing a child, which are prone to further development.

The doctor cannot make a decision that there is a need for such an extreme measure as suturing based on an examination on the gynecological chair alone. He needs comprehensive information about the condition of the lower segment of the uterus, which is the cervix. For this purpose it is assigned full biometric examination, which includes colposcopy and ultrasound diagnostics, as well as laboratory smear testing.

Only after all risk factors have been identified, the length and width of the cervix have been measured, the condition of the cervical canal inside it has been assessed, as well as the patient’s personal history, can a decision be made to suture the cervix.

Contraindications

Suturing this organ during pregnancy is possible only if, apart from a weak cervix, no other global problems have been identified in this pregnancy. If some concomitant pathologies are detected, the operation will have to be abandoned. Contraindications include:

• diseases of the heart and blood vessels, kidneys, which have worsened in the expectant mother due to pregnancy, the risk of death of the woman in the event of mechanical prolongation of pregnancy;
• bleeding, increasing in strength and character, as well as recurrent bleeding when there is a threat;
• gross malformations of the baby;
• hypertonicity of the uterine muscles, which cannot be reduced with medical conservative treatment;
• chronic inflammation of the female reproductive organs, the presence of sexually transmitted infections, STDs;
• late detection of cervical pathologies - after the 22nd week of pregnancy (the best time for successful intervention is considered to be the period from 14 to 21 weeks).

How is the operation performed?

The timing of the operation is of great importance. From 14 to 21 weeks, the child is not so large as to greatly stretch the walls of the uterus and the muscles of the cervix; at later stages, suturing is not recommended due to the fact that highly stretched tissues may not be able to withstand and the sutures will cut through with subsequent rupture.

The operation, which in medical language is called "cervical cerclage", carried out only in a hospital. It is not considered painful or excruciating because the woman is given an epidural or intravenous anesthesia.

There is no need to be afraid of it, because experienced anesthesiologists will calculate the dosage of drugs solely taking into account the gestational age, physique, weight and health status of the expectant mother herself and the developmental characteristics of her baby. The dose will be safe for mother and fetus.

The duration of the entire manipulation does not exceed a quarter of an hour. Depending on the condition of the cervix, the doctor will suture either the external or internal os of the cervix. The external one will not be touched if there is erosion, dysplasia, or pseudo-erosion on the neck. The technique is very simple - surgeons suture the edges of the outer part of the neck together with strong surgical threads.

This method requires careful preparation. If there is an infection in the uterus, the consequences will be more than dire. Stitching will create a closed space inside the female reproductive organ in which any microbe can begin to multiply quickly. The woman is first treated with antibiotics, and the vagina is thoroughly sanitized. However, this does not always help.

There will be no closed space if the doctor decides to sew up the internal os of the cervix. In this case, specialists leave a small drainage hole. The sutures themselves are applied in different ways, each surgeon has his own favorite, and much depends on the anatomical characteristics of the patient.

The cerclage itself can be performed laparoscopic method. It has many advantages - speed, fairly easy postoperative period, low blood loss, lower risk of complications.

Laparoscopic cerclage is indicated for women with congenital shortening of the cervix and those who have had unsuccessful vaginal suturing surgery.

Possible problems and complications

Like any surgical procedure, cerclage can also have its complications. The most dangerous are considered to be the addition of an infection, the development of an inflammatory process and an increase in the tone of the uterine muscles. Inflammation may develop due to an internal infection that could not be “defeated” in the preoperative period. Sometimes a woman has an individual allergic reaction to the suture material used by doctors.

Possible problems can be discussed prolonged discharge after surgery, burning sensation, mild pain. Moreover, inflammation can appear not only immediately after surgery, but also several weeks after suturing. This is why it is important to visit your doctor more often and monitor any changes.

Hypertonicity is also a reaction of the uterus to surgery and suture material foreign to its structures. Some heaviness in the abdomen, slight tugging sensations may be quite normal in the first time after surgery, but subsequently they should disappear. If this does not happen, you should inform your doctor.

It’s not often, but it also happens that a woman’s body categorically refuses to accept a foreign body, which is surgical threads, and a violent immune process of rejection begins, which can be accompanied by high fever, atypical discharge, and pain.

In the later stages, cerclage can have another unpleasant consequence - the sutured cervix can be seriously damaged if labor has already begun and the stitches have not yet been removed. Therefore, it is important not to ask the doctor to “stay at home for another week,” but to go to the hospital in advance.

After the intervention, the woman needs to remain under 24-hour medical supervision in the hospital for several more days. She is prescribed antispasmodic drugs to reduce the muscle tone of the uterus, as well as strict bed rest. The vagina is sanitized daily to avoid infection. After this, the pregnant woman can be sent home. Discharge after the intervention continues for approximately 3-5 days.

Stitches on the cervix will require the expectant mother to reconsider her lifestyle until the birth. Physical activity, prolonged standing in an upright position, and prolonged walking are contraindicated. Under no circumstances should you lift heavy objects. You should also abstain from sexual activity so as not to provoke hypertonicity of the uterus, which can lead to the cutting of sutures.

Until childbirth, a woman will have to monitor her stool - constipation is extremely undesirable, since pushing is prohibited. Therefore, you will have to go on a diet, introduce more fresh vegetables and fruits, juices into your diet, limit salt, an abundance of protein foods, as well as baked goods.

You will have to go to the doctor more often, than women in an “interesting position” usually do. The doctor will monitor the condition of the sutures, take smears for the vaginal microflora, and, as necessary, prescribe unscheduled ultrasound examinations, the purpose of which will be to measure the parameters of the cervix and evaluate its internal structures.

A woman with stitches on her uterus will have to go to the maternity hospital at 36-37 weeks. Around this time, the sutures are removed. Labor can begin at any time after this, even on the same day.

It is not painful to remove the sutures; there is no need to use anesthesia or other anesthesia methods.

Predictions and consequences

The pregnancy rate after cerclage is quite high - more than 80%. Prognosis depends on the degree of cervical insufficiency and the reasons why the woman underwent surgery. If after the operation she follows all the doctor’s recommendations, then the chances of carrying a baby to 36-37 weeks are significantly increased.

Pregnancy is an important and responsible period in the life of every woman. Unfortunately, health problems are not uncommon at this time. And in some cases, the doctor recommends a special procedure to the patient, during which a suture is placed. Sutures are needed on the cervix during pregnancy to prevent miscarriage or premature birth.

On the other hand, surgery during pregnancy frightens women. So in what cases is such a procedure prescribed? What risks does it involve? What is the surgical procedure and how is the rehabilitation period? The answers to these questions are of interest to many patients.

Suturing the cervix during pregnancy: why is it necessary?

The uterus is an important organ of the reproductive system. This is where implantation of the fertilized egg and further development of the embryo occurs. Normally, the cervix begins to dilate slowly starting at the 36th week. But in some patients the discovery occurs in the early stages.

This is fraught with extremely dangerous consequences for the child, because the growing organism may not yet be viable. Miscarriage or premature birth are consequences that an expectant mother may face. It is in such situations that doctors prescribe suturing the cervix during pregnancy - such a procedure can save the child’s life.

Main indications for the procedure

Of course, there are situations when stitches on the neck are simply necessary. Indications for the procedure are as follows:

• Isthmic-cervical insufficiency is a pathology that is accompanied by expansion or shortening. A similar phenomenon develops with anatomical defects of the cervix, which in turn can be associated with mechanical damage, previous inflammatory diseases, cancer, etc.
• Hormonal imbalances, because it is hormones that control the condition of the walls of the reproductive organ. A change in the amount of certain hormones in the blood can cause relaxation or contraction of the muscles of the uterus, and early opening of the cervix.
• If the patient’s history includes information about previous miscarriages or premature births, then the doctor will probably closely monitor the patient’s health and, if necessary, prescribe surgical intervention.

A suture on the cervix during pregnancy can ensure the normal development of the child. However, only an experienced obstetrician-gynecologist is able to decide on the procedure.

What preparation does suturing require?

Applying a suture to the cervix during pregnancy is not a very complicated procedure. However, the doctor can decide to perform surgery only after passing all the necessary tests.

Starting from the 12th week of pregnancy, women are sent for an ultrasound examination, during which a specialist can determine the early dilatation of the uterus. An ultrasound may be repeated to confirm the diagnosis. Naturally, as before any other operation, it is necessary to take blood and urine tests, check the level of hormones in the blood of a pregnant woman and conduct other tests. Immediately the day before the operation, the vagina is sanitized.

Features of surgery

Naturally, patients are interested in questions about how exactly the surgical intervention occurs. In fact, this is not such a complicated procedure, and it lasts no more than 15-20 minutes. Suturing is carried out under general anesthesia. To strengthen the uterus, strong nylon threads are usually used.

The doctor may place a suture on the outer or inner edges of the pharynx. Access to the tissue is usually through the vagina, but in some cases a laparoscopic procedure (through small punctures in the abdominal wall) is required. The number of stitches depends on how far the cervix has dilated.

When are stitches removed?

Already placed sutures on the cervix during pregnancy help preserve the fetus inside the mother's womb. As a rule, they are removed at 37 weeks. Naturally, before this, the woman undergoes an examination and an ultrasound examination, during which it is possible to find out whether the child is developed enough to be born.

Removal of suture material is carried out without anesthesia - this procedure may not be very pleasant, but it is painless and quick. In most cases, birth occurs on the same day. But even if there are no contractions, the woman should be in a hospital setting.

It is worth saying that in some (rare) cases, a suture on the cervix during pregnancy, unfortunately, cannot prevent early labor. Then the stitches are removed as an emergency. If the procedure is not carried out on time, the suture threads can severely damage the pharynx, complicate childbirth and create problems in the future (if the woman wants another child).

Postoperative period: rules and precautions

Sutures on the cervix during pregnancy provide the child with normal intrauterine development. However, the success of the procedure largely depends on how the rehabilitation period goes. The woman spends the first 3-7 days after surgery in a hospital setting, under the constant supervision of doctors. She is prescribed strict use of antibacterial agents (to prevent inflammation) and antispasmodics (to prevent contraction of the uterine walls). In addition, the seams are regularly washed with antiseptic solutions.

In the first few days, patients feel mild pain in the lower abdomen. Vaginal discharge may appear in the form of ichor, mixed with blood. Such phenomena are considered normal and go away on their own. Gradually the woman returns to her usual way of life.

There are some requirements that should be followed until the end of pregnancy. In particular, the expectant mother should not lift weights, engage in physical labor, or overexert herself (physically or emotionally). Sexual life is also contraindicated. Rest and healthy sleep are important for women and children. Proper nutrition (will help prevent constipation) and walks in the fresh air will have a positive effect on your health.

Suture on the cervix during pregnancy: complications

Like any surgical procedure, suturing involves some risks. The procedure may cause some complications, in particular inflammation. Such a pathology can have different causes - sometimes pathogenic microorganisms penetrate the tissue during the procedure, sometimes even during rehabilitation. In addition, it is possible to develop an allergic inflammatory reaction when tissue comes into contact with suture material. These complications are usually accompanied by the appearance of uncharacteristic vaginal discharge, pain in the lower abdomen, and increased body temperature.

The cervix may become hyperactive after suturing during pregnancy. Due to hypertension, women feel a tugging in the lower abdomen. As a rule, the patient’s condition can be returned to normal with the help of special medications and bed rest.

We should not forget that premature dilatation of the uterus is a consequence, and not an independent problem. It is necessary to conduct a thorough diagnosis, find out what exactly caused the pathology, and eliminate the primary cause. For example, in case of hormonal disorders, the patient is prescribed to take special hormonal medications. Chronic inflammation also requires specific therapy.

Contraindications to the procedure

It is worth noting that this procedure cannot be carried out in every case. A suture on the cervix during pregnancy is contraindicated in the following cases:

• The presence of a sluggish inflammatory process in the organs of the reproductive system.
• Increased excitability of the uterus (this refers to cases when it cannot be eliminated with medication).
• Bleeding.
• Blood clotting disorders, as massive blood loss is possible.
• Severe chronic diseases, including damage to the kidneys, heart or liver.
• Frozen pregnancy, death of a child in the womb.
• The presence of certain anomalies in the process of child development (if this is confirmed through diagnostic procedures and tests).
• Suturing has a time limit - the intervention is not performed after the 25th week of pregnancy.

It is worth saying that if for some reason the surgical procedure is impossible (for example, if the problem was diagnosed too late), then a special pessary made of durable plastic is placed on the uterus. It not only keeps the cervix closed, but also partially relieves the load on the uterine walls. In addition, the patient is recommended to undergo strict bed rest.

Bloody discharge after stitches on the cervix during pregnancy

Asked by: Victoria

Gender: Female

Age: 37

Chronic diseases: not specified

Hello, I am worried about bloody, pink discharge 8 days after getting stitches on the cervix at 19 weeks. Since the previous pregnancy ended with the dilatation of the cervix and the rupture of water at 18 weeks, in this pregnancy I have been monitoring the cervix since 12 weeks. She was hospitalized as planned at 18 weeks; upon admission, the cervix was closed, 3.7 cm (in 2013 there was conization of the cervix), rather soft. Examination on a chair the day after the operation - the condition is satisfactory, vaginal ultrasound 7 days later - the cervix is ​​closed, 3.4. During the operation, the doctor noted that the neck was plump, but short. Recommendations upon discharge: ginipral 0.5 every 6 hours with verapamil, utrozhestan to drink 3 times 200 times, sanitation with miramistin once every 2 weeks. Tell me, how long can the pink discharge last? Thank you!

Can the combination of Isoprinosine, Superlymph and Uro-Vaxom cause bleeding? Bleeds for 2 days I have been suffering from heavy vaginal discharge for 2 years now. They are white, transparent, dark brown all the time, regardless of the day of the cycle. The gynecologist tried everything she could, nothing helped, there wasn’t even a slight remission. She diagnosed cervical erosion (0.5 mm) 4 years ago. The tests were always consistently bad, with leukocytes and inflammation. The last time the smear for flora was good, but the cytogram showed inflammation of the cervix. Before this, I was tested for STDs, and only Ganderella was found. I went to another doctor. She said that there was no erosion at all, applied something and immediately diagnosed HPV. She prescribed me a course of treatment for HPV: 1) Superlymph suppositories at night for 20 days. 2) Immunomodulator Isoprinosin (I bought Groprinosin, they said it was the same thing). 28 days, 2 tablets. 3 times a day In addition, I visited a urologist because I have problems with urination. A urine culture tank showed E. coli 1x10 in 2 tbsp. The urologist supplemented the treatment with the drug URO-VAXOM (take it for at least a month). A simple analysis showed bacteria +++ and red blood cells unchanged 3-4 in the PZR. Before this, I was treated with Suprax-solutab, which gave temporary relief. On the 3rd day of taking these drugs together, I started bleeding. I continued therapy. On the 4th day I started bleeding more heavily, almost the same as during menstruation, with clots. Your period should come only in 2 weeks. Tell me, please, what could have caused such a reaction? Which drug should be discontinued? Or continue treatment? It also happened before that there was bleeding, but not so much. I'm very afraid of bleeding. Thanks in advance for the information provided!

1 answer

Don't forget to rate the doctors' answers, help us improve them by asking additional questions on the topic of this question.
Also, don’t forget to thank your doctors.

Hello. Pink discharge may periodically bother you. The main thing is that there is no bright scarlet bleeding.

If you don't find the information you need among the answers to this question, or your problem is slightly different from the one presented, try asking additional question doctor on the same page, if he is on the topic of the main question. You can also ask a new question, and after some time our doctors will answer it. It's free. You can also search for the information you need in similar questions on this page or through the site search page. We will be very grateful if you recommend us to your friends in social networks.

Medical portal website provides medical consultations via correspondence with doctors on the website. Here you get answers from real practitioners in your field. Currently on the website you can get advice in 49 areas: allergist, anesthesiologist-resuscitator, venereologist, gastroenterologist, hematologist, geneticist, gynecologist, homeopath, dermatologist, pediatric gynecologist, pediatric neurologist, pediatric urologist, pediatric surgeon, pediatric endocrinologist, nutritionist, immunologist, infectious disease specialist, cardiologist, cosmetologist, speech therapist, ENT specialist, mammologist, medical lawyer, narcologist, neurologist, neurosurgeon, nephrologist, nutritionist, oncologist, urological oncologist, orthopedist-traumatologist, ophthalmologist, pediatrician, plastic surgeon, proctologist, psychiatrist, psychologist, pulmonologist, rheumatologist, radiologist, sexologist-andrologist, dentist, urologist, pharmacist, herbalist, phlebologist, surgeon, endocrinologist.

We answer 96.7% of questions.

Stay with us and be healthy!

Good afternoon

At week 17, the cervix was sutured (there had been a miscarriage in the past at this time, dynamic shortening of the cervix and opening of the internal os). I re-read everything on the site about ICN and suturing and tocalytic therapy, and I still have a number of questions regarding which (due to great worries) I would really like to receive an additional answer. (The brains give in to panic in anxiety)

Do I understand correctly that after stitching:

1) there is no particular point in lying down, because according to research this does not affect the situation (except for multiple births)

2) there is no point in using any tocalytics, because there are no effective ones anyway (or are there some that are still justified? Do I need to take any special pills after stitching?

3) is it necessary to inject and drink antibiotics immediately after stitching? How many days? (It’s not healthy for a child, so it worries me a lot, I’ve been injected for 5 days now)

4) do the seams need to be rehabilitated? If yes, how often? Only immediately after application for a couple of days or then too?

5) is it true that the tone of the uterus during sutures is not dangerous, because whether it was tone at all was unknown (it is often misdiagnosed on ultrasound) and it is not a constant phenomenon. In addition, in fear, fighting tone is a useless path, since this is what it appears from. Is this correct? If not, then what about the tone at the sutures? How should we approach this issue? Is he dangerous at all?

6) Do I understand correctly that after suturing every 2 weeks, smears and chair examinations and ultrasound are recommended? What exactly is being checked during these procedures? The strokes are still somewhat clear, but the rest is not so clear. On smears they look primarily at leukocytes, right?

7) And in light of the question above. What dynamics of the neck length and opening of the internal pharynx should be after suturing (ultrasound)? Should everything lengthen and close? How fast? What if it shortens and opens further? Or is this an unimportant factor? Why then regular ultrasounds?

I beg your pardon for the number of questions, but I know the official answers of traditional gynecologists to them (even many options), but I don’t really trust them, because no one can really explain anything and they prescribe “because”. At the same time, sometimes even I can understand that the logic in the answers is broken and the person most likely does not understand what he is talking about. I got myself into trouble with this.

I really trust your site! I'll be looking forward to your answer!

THANK YOU IN ADVANCE!!!