Procedures › Cervical cerclage

Anaesthesia for cervical cerclage

This page explains the anaesthetic options for cervical cerclage during pregnancy, what to expect on the day, and your recovery. Your own plan is agreed with you before the procedure.

What is a cervical cerclage?

A cervical cerclage is a procedure during pregnancy to help prevent miscarriage or very early preterm birth. A strong stitch is placed around the cervix (neck of the womb) to hold it closed. It is usually performed in the second trimester if you have had a previous mid-trimester loss, very preterm birth, or an ultrasound shows a short cervix.

Anaesthetic options

Spinal anaesthesia (recommended for most patients)

• You stay awake and a numbing injection is given in your lower back so you feel no pain from the waist down.
• Benefits include avoiding a breathing tube, less nausea and drowsiness, minimal foetal exposure to medicines, and excellent comfort during and after the procedure.
• You may feel heaviness or numbness in your legs temporarily; mild cramping afterwards is normal.
• A sedative may be given during the procedure to help you feel relaxed and comfortable. Although the spinal blocks all pain, the sedation helps the procedure feel smoother for you and is safe for your baby.

General anaesthesia

• You will be asleep during the procedure.
• May be recommended if you prefer to be asleep, if your cervix is already dilated with bulging membranes, or if a transabdominal cerclage (laparoscopic) is performed.
• Recovery may involve more cramping and need for extra pain relief.

What to expect on the day

• Before the procedure: meet your anaesthetist, review medical history, follow fasting instructions.
• During the procedure: operation typically takes 20-40 minutes; you will be closely monitored; sedation can be provided with spinal.
• After the procedure: monitored until comfortable; mild cramping is common; most women go home the same day; baby's heartbeat will be checked again.

See our fasting guidance for what to do before your procedure.

Recovery and going home

Most patients go home the same day. After a spinal anaesthetic, your legs will remain numb for several hours. You will stay in hospital for around 6 to 8 hours until the spinal has worn off, you can walk safely, and your observations are stable. A small urinary catheter is routinely inserted for the procedure. This is usually removed 4 to 6 hours after surgery. You will need to pass urine normally before you can be discharged.

Risks and side-effects

• Minor side-effects: mild nausea, light vaginal spotting, mild cramping, or temporary numbness/heavy legs.
• Less common risks: low blood pressure, headache after spinal anaesthesia, or a sore throat from airway devices if general anaesthesia is used.
• Serious complications are very rare.

Summary

Cervical cerclage is a safe, common procedure to prevent pregnancy loss and very preterm birth. Both spinal and general anaesthesia are safe for mother and baby; spinal anaesthesia is generally preferred because it offers excellent comfort and a smoother recovery, but general anaesthesia may be recommended depending on your specific situation. Your anaesthetist will work with you to determine the best option.