A cerclage is the placement of a stitch usually around the cervix during pregnancy. This is done to prevent premature dilatation of the cervix and premature birth in cases where the cervix is thought to be weak.

A cerclage is uaully done through the vagina as a "vaginal cerclage". Occasionally, the cerclage is placed as a transabdominal or abdominal cerclage.

Potential advantages of transabdominal over transvaginal cerclage are

  • more proximal placement of the stitch (at the level of the internal os),
  • decreased risk of suture migration,
  • absence of a foreign body in the vagina that could promote infection, and
  • the ability to leave the suture in place for future pregnancies [

An abdominal cerclage is relatively complicated and not done in many institutions. One disadvantage of the abdominal cerclage is the need to open the abdomen twice, once during placement of the cerclage, and another time when it is being removed. In addition patients require a cesarean delivery after a transabdominal cerclage. Most experts recommend a transabdominal cerclage only if the traditional vaginal cerclage has failed two or more previous times or when a vaginal cerclage is technically impossible to perform such as when the cervix was removed or operated on previously.