Abdominal Cerclage Specialist

What is an incompetent cervix?

A healthy cervix stays tightly closed throughout pregnancy and begins to open as the due date nears. In women with cervical insufficiency or incompetence, the weight of the fetus causes the cervix to open much earlier – between 16 and 24 weeks gestation – causing pregnancy loss in the second trimester.

How common is it?

The condition is uncommon but devastating. Because many women who have experienced pregnancy loss due to an incompetent cervix don't attempt to have children again, the number of women affected is unknown.

What causes cervical insufficiency or cervical incompetence?

An incompetent cervix can be the result of a congenital disability. A previous D & C (dilation and curettage), LEEP procedure, or cold knife conization can put women at higher risk of cervical incompetence.

How is it diagnosed?

Dr. Swainston often discovers cervical insufficiency after a second-trimester loss. Women who have a known incompetence or women who are at high risk of incompetence can be monitored closely via ultrasound during the first and second trimester. Perinatologists normally make the determination if abdominal cerclage should be offered during first trimester or prior to pregnancy.

What treatment options are available?

Transabdominal cerclage is the treatment of choice for cervical incompetence if vaginal cerclage has failed in past pregnancy. It's inserted near the top of the cervix through laparoscopic incisions in the abdomen and prevents the cervix from opening prematurely. Once Dr. Swainston inserts the cerclage, it stays throughout the pregnancy and can even remain to protect future pregnancies. The child must be born via cesarean section.

The most encouraging news is that Dr. Swainston can perform transabdominal cerclage before conception when cervical insufficiency is known in advance. This improves the chances of a positive result for women who have a history of second-trimester loss without performing a surgical pregnancy during pregnancy. Many times patients are pregnant prior to having this surgery which requires the procedure to be done in first trimester of pregnancy.

Why should women consider robotic-assisted surgery for cervical incontinence?

Robotic-assisted surgery is both minimally invasive and highly effective in treating cervical incontinence and preventing preterm birth. Sometimes there is no bed rest required after robotic-assisted surgery for cervical incompetency, and it can dramatically improve the lives and outcomes of women with this condition. Dr. Swainston has over 20 years of experience in the treatment of cervical incontinence and is an expert in the use of robotics in gynecologic surgery.

We offer Minimally Invasive Surgery, Robotic Surgery, and Fibroids. Call us to book your appointment today.