Is my wife's vaginal delivery possible after a cerclage?

Question

Hi doctor,

My wife had cervical cerclage at 20 weeks of pregnancy. Now, she is at almost 38 weeks, and the doctor is resisting the removal of the cerclage. Last time, the cervical length measured in the 24th week was 37 mm. We suspect that she is doing this to encourage C-section delivery.

Should we get a second opinion in this case?
My wife does not like to go in for a C-section unless it is extremely necessary. What to do now?

Please assist.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your query.

Once the cervical cerclage (cervical stitch to prevent pregnancy loss or premature birth) has been placed, then the guideline is to remove it once the woman goes into the latent phase or active labor in the labor room. There is no indication of removing it earlier and letting the woman go back home, as this shall precipitate labor.

Again, labor pain has nothing to do with cervical cerclage. If the baby is in cephalic presentation and if she goes into labor with an adequate pelvis, then vaginal delivery shall definitely be undertaken. But in case there is any asynclitism (shoulder first) or non-progress of labor or any fetal distress at the time of labor or there is a tight loop of cord around the neck as seen on ultrasound and based on NST readings (non-stress test), it is only then the cesarean section is planned and not due to cervical cerclage. So, she is right in not removing it now and allowing her to go into labor first. One can actually wait till the completion of 40 weeks plus 3 days for labor pain to start naturally.

I hope I have answered your queries.

Please let me know if I can assist you any further.

Thank you.