McDonald Cervical Stitch

Cervical Cerclage Procedure for Cervical Incompetence

During transvaginal cervical cerclage, your health care provider will insert a
speculum into your vagina and grasp your cervix with ring forceps. He or she might
use ultrasound for guidance. Your health care provider will likely use the McDonald
cerclage or the Shirodkar cerclage. Research suggests no significant difference in
outcomes between the two methods.

To place the McDonald cerclage, your health care provider will use a needle to put
stitches around the outside of your cervix. Next, he or she will tie the ends of the
sutures to close your cervix.

After the procedure

After cervical cerclage, your health care provider will do an ultrasound to check your
baby’s well-being.

You might experience some spotting, cramps and painful urination for a few days.
Parasetamol or TRAMACET is recommended for pain or discomfort.
If you had history-indicated cervical cerclage, you’ll likely be able to go home the
next day after the procedure. As a precaution, your health care provider might
recommend avoiding sex for at least one week and, afterward, using condoms
during sex.

If you had cervical cerclage because your cervix had already begun to open or an
ultrasound showed that your cervix is short, you might need to remain in the hospital
longer for observation. As a precaution, your health care provider might recommend
limiting physical activity and sex until up to week 34 of pregnancy.
Your health care provider might recommend weekly or biweekly visits to examine
your cervix until you give birth.

Cervical cerclage removal

A transvaginal cervical cerclage is typically removed at around week 37 of
pregnancy — or at the onset of preterm labor.

A McDonald cerclage can usually be removed in a health care provider’s office
without anesthetic, but sometimes needs to be removed in theatre in a hospital.
After having a transvaginal cervical cerclage removed, you’ll typically be able to
resume your usual activities as you wait for labor to begin naturally.