In what cases to ask it?

What is the surrounding of the cervix?

(Update of March 21, 2022). During a normal pregnancy, the cervix ensures The function of “mechanical barrier”. It remains completely closed, then gradually relaxes at the end of the pregnancy to prepare childbirth. On the other hand for certain pregnancies, it may happen that The cervix runs short and expands too earlybefore the term, which considerably increases the risk of miscarriage or premature delivery. This spontaneous opening phenomenon of the collar is called “collar“. The strapping of the cervix thus makes it possible to provide mechanical support to the cervix and to maintain it closed. How? By placing a thick suture in the thickness of the cervix. The cause of this early opening of the collar is mainly congenital due to a malformation of the uterus, but it can happen following an operation or a voluntary termination of pregnancy.

When to have a strapping placed during pregnancy?

This intervention can be “cold” Between the 16th and 17th week of amenorrhea To prevent collar or “hot”, after 17 weeks of amenorrhea when the cervix is already open. A strapping can be placed in women who have undergone several late abortions or having experienced a tear of the cervix or premature delivery. The strapping makes it possible to limit recurrences.

The strapping technique is practiced by a doctor-cutter under General or epidural anesthesia. There are different techniques for laying a strapping:

• Cervico-vaginal strappingthe most used technique: it consists in “sneaking” a non -absorbable nylon thread in the wall of the cervix in order to keep it closed. At the end of pregnancy, generally between 36 and 37 weeks of amenorrhea, the wire is removed during a gynecological consultation using a speculum. The withdrawal is painless and very fast. When the wire is removed, the collar reopens and allows the baby’s passage by low way.
• Cervico-isthmic strappingtechnique carried out when the cervix is very short and the cervico-vaginal technique has failed: it consists in incising the uterine mucosa and placing a non-absorbable strip, vaginal, in the supravaginal portion of the cervix.
• Abdominal strappingtechnique used when the vaginal strapping is impossible: it consists in opening the abdomen (laparotomy) in order to place a strip to close the cervix. In this case, childbirth can only be done by cesarean.

The strapping remains a classic intervention and is generally not linked to complications. However, Light genital bleeding and uterine contractions may appear after the operation. Moreover, whatever the technique used, regular monitoring The risk of infection or premature delivery is essential throughout pregnancy. Depending on the doctor’s decision, some women are stopped and must remain in bed after laying a strapping, others must simply limit their activity. Sex are generally not recommended in the weeks following the operation. The ideal is to ask your doctor for advice.

Can we make love with a strapping of the cervix?

The strapping does not bother to have sex during pregnancy. However, it is advisable to wait several weeks after the operation to make love again. You have to be vigilant, and it goes smoothly. In addition, as this device is posed when there is a risk of premature delivery, if making love causes uterine contractions, it is advisable to avoid reports before childbirth.

Can a strapping break?

It is very rare for a uterine strapping to be broken. Despite everything, after pose, you can have undesirable effects which can, in some cases, indicate that it broke. It is therefore advisable to consult if you have contractions or cramps, abdominal or back pain that arrives in waves, vaginal bleeding, fever at more than 37.8 ° C or chills, nausea and vomiting, vaginal losses that smell bad, or a break in the pocket of total or partial waters.

Sources: Cochrane: strapping of the cervix for the prevention of premature delivery

Dr. Benchimol site, gynecologist-obstetrician