In order to avoid the possible and sudden incidents that may be faced by pregnant women, which may lead to the stimulation of early labor or premature birth, the non-surgical procedure has proven to be effective in avoiding this problem. This procedure is based on the tightening of the cervix, which is one of the therapeutic methods recommended by gynecologists and obstetricians in cases of short or weak cervix, which promotes the establishment of pregnancy. In the medical reason of this article, we will review  Dalili Medical,  the important precautions that must be observed after putting on a cervical collar for pregnant women.

**What is cervical tightening?**

Circumcision of the cervix is ​​considered a recommended procedure for pregnant women who have a history of cervical insufficiency. In this case, the cervix begins to open early, which may lead to premature birth or pregnancy loss. This procedure is usually performed during the second trimester of pregnancy, and it can be preventive or emergency.

**Why is cervical girdling performed?**

This procedure aims to reduce the risk of premature birth in women with a history of cervical insufficiency or other risk factors.

**When is it usually recommended to circumcise the cervix?**

This procedure is usually considered if you have a history of miscarriage in the second trimester, or premature births, or if a short cervix is ​​discovered during pregnancy.

**How ​​to perform the procedure of cervical tightening?**

Suturing the cervix for closure using different techniques, such as Shirodkar or McDonald's method, with the aim of strengthening the cervix and preventing premature dilatation.

**Will the operation be completed under anesthesia?**

Yes, the cervical cerclage is usually performed under general, regional, or local anesthesia.

**What is cervical tightening?**

Circumcision of the cervix is ​​considered a recommended procedure for pregnant women who have a history of cervical insufficiency. In this case, the cervix begins to open early, which may lead to premature birth or pregnancy loss. This procedure is usually performed during the second trimester of pregnancy, and it can be preventive or emergency.

**Why is cervical girdling performed?**

This procedure aims to reduce the risk of premature birth in women with a history of cervical insufficiency or other risk factors.

**When is it usually recommended to circumcise the cervix?**

This procedure is usually considered if you have a history of miscarriage in the second trimester, or premature births, or if a short cervix is ​​discovered during pregnancy.

**How ​​to perform the procedure of cervical tightening?**

Suturing the cervix for closure using different techniques, such as Shirodkar or McDonald's method, with the aim of strengthening the cervix and preventing premature dilatation.

**Will the operation be completed under anesthesia?**

Yes, the cervical cerclage operation is usually performed under general, regional, or local anesthesia.

**. Does it guarantee cervical ligation for the entire pregnancy period?**

Although cerclage can reduce the risk of premature birth, it does not guarantee the continuation of the pregnancy until the end. Regular prenatal care and following medical guidelines are considered essential.

**Types of cervical ring**

There are several types of cervical cerclage:

. **Preventive or optional circumcision**: It is performed in the early stages of pregnancy, usually between the 12th and 14th weeks, for women with a history of cervical insufficiency and no current signs of changes in the cervix.

. **Al-Tawaiq al-Tari or El-Savvi**: It is performed when there are signs of changes in the cervix, such as shortening or dilation, in the advanced stages of pregnancy. This is often the most dangerous situation, but stretching is still a long way from reducing the risk of premature birth.

. ** Circumcision through the abdomen**: It is used in cases where the traditional methods are ineffective or failed, and involves placing a band around the cervix through the incision in the abdomen.

**What happens during the cervical collar procedure?**

During the cervical girdling process, stitches or sutures are placed around the cervix in order to provide support and help in preventing premature dilatation (stretching) of the cervix during pregnancy. This procedure is usually performed to reduce the risk of premature birth in women with a history of cervical insufficiency or other risk factors. Here is an overview of what happens during cerclage:

Preparation before surgery:

- You will be admitted to the hospital or surgical center on the day of the operation.

- You can change your clothes to hospital clothes and your vital signs will be checked.

- The length of the IV line to deliver fluids and drugs.

**Anesthesia:**

Cervical banding can be performed under general anesthesia, or local anesthesia (such as epidural anesthesia or spinal anesthesia), or local anesthesia, based on the recommendations of the health care provider and his preferences.

**Patient condition:**

You will be placed on the operating table, and usually you will be lying on your back with a foot on your legs.

**Sterilization and preparation:**

The genital area will be cleaned and sterilized to reduce the risk of infection.

Procedure:

The surgeon will insert a scope through the vagina to image the cervix.

The cervix will be gently fixed using special tools to ensure stability.

The surgeon will place a stitch (suture) around the cervix to strengthen it and prevent it from stretching before the appropriate time.

The type of device used (such as Shirodkar, McDonald, or other techniques) depends on the specific condition and preferences of the health care provider.

**Closing the incision:** After placing the sutures in the positions, the surgeon will make sure that it is securely positive and that the cervix is ​​properly supported. Al-Manzar will be removed and the area of ​​Al-Mahabal will be cleaned.

**Resuscitation and monitoring:**After the procedure is completed, you will be transferred to the recovery area to recover consciousness after anesthesia. The health care team will monitor your vital signs and make sure there are no immediate complications.

**Our care after surgery:** If you feel some mild spasms, tail cramps, or discomfort after surgery. You will receive instructions on how to care for yourself after surgery, including any restrictions on physical activity, necessary medications, andYou should check with your health care provider.

It is important to note that although cerclage is considered a safe procedure in general, there are potential risks and complications associated with any surgery. You will talk to your health care provider about these risks before the operation and take the necessary measures to reduce them.

**I need to contact you to perform a cervical collar surgery**

Obstetrician consultation: The first step should be a visit to the obstetrician you usually interact with. The doctor will evaluate your medical history and perform the necessary tests to determine if cervical collar is suitable for your condition.

High-risk pregnancy specialist: If you have a history of repeated miscarriages, or premature births, or any other factors that indicate a high-risk pregnancy, the gynecologist and obstetrician may refer you to a maternal and fetal medicine specialist or a perinatal medicine specialist. These specialists are trained to deal with complicated pregnancy situations and can provide specialized care, including cervical cerclage.

Surgical center or hospital: When making an appointment for cervical cerclage, it is likely that the health care provider will schedule the surgery in a hospital or surgical center equipped with the necessary facilities. We will provide you with information about the procedure, the necessary skills before the operation, and what can be expected during the recovery period.

Followers of medical recommendations: It is important to adhere to the instructions of the health care provider regarding the necessary preparations before the operation, including the required tests, fasting periods, and any other instructions.

Recovery and care after surgery: After the surgery, it is necessary to follow the instructions of the aftercare provided by the health care provider. These instructions often include restrictions on physical activity, instructions on medications, and follow-up appointments.

** How to prepare for the operation of cervical ringing **

**Advice and education:** Make an appointment with an obstetrician or maternal and fetal medicine specialist to discuss the necessity of cervical cerclage.

During the visit, the healthcare provider will explain the purpose of the procedure, as well as possible risks and benefits.

**Medical history and tests:**Medical history includes previous pregnancies, abortions, surgeries, and other health conditions.

Make sure to carry out the necessary examinations, such as ultrasound, to evaluate the length of the cervix and the general state of pregnancy.

**Discussion and decision:**Participate in a comprehensive discussion with your health care provider to make an informed decision regarding the need to circumcise the cervix.

Make sure you understand the reasons behind the recommendation, and don't hesitate to ask any questions you may have.

Our pre-surgery instructions: Please adhere to the fasting instructions provided by the health care provider. You may be asked to refrain from eating or drinking for a certain period before the surgery.

If you are taking medication, please discuss the matter with your healthcare provider to find out if you should continue taking it before surgery.

Arrangements and support: Make sure to arrange my transportation to the hospital or surgical center on the day of the procedure.

If that is possible, it is preferable to arrange for a person to accompany you, as long as you need help after surgery.

Cleanliness and comfort: On the day of surgery, it is recommended to take a bath and follow any special health instructions provided by the health care provider.

Wear comfortable clothes when going to the hospital or surgical center.

Personal belongings: Avoid bringing essential items only, such as ID, insurance information, and any documents provided by your health care provider.

**Questions required for designs:**

Before the operation, do not hesitate to ask any final questions about the surgery, the recovery process, and what can be expected later.

**Emotional and mental capacity:** Be aware that undergoing surgery may be an emotional challenge. Use relaxation techniques, meditation, or any activities that help you manage stress and anxiety.

** Follow the instructions of the provider: ** Adhere to the additional instructions provided by the health care provider regarding the necessary care and skills before the surgery.

**How ​​to diagnose cervical dilatation?**

Diagnosing cervical dilatation is an essential part of pregnancy follow-up, especially for women with a history of repeated miscarriages or premature births. There are several methods for diagnosing cervical dilatation, and below are some of the methods used in Noor Al-Hayat Hospital for Fertility:

. **ultrasound examination (ulsonar)**

 - **Vaginal ultrasound**: This is the most accurate way to diagnose cervical dilatation. A small probe is inserted into the vagina to measure the length of the cervix and to make sure it is closed. It is also possible to evaluate the state of the amniotic membrane and amniotic fluid.

 - **transabdominal ultrasound**: This method is used to evaluate the cervix in some cases, but it is less accurate than vaginal ultrasound.

. **Hysterosalpingography** The injection of dye into the uterus and imaging using X-rays. This method is usually used to evaluate the shape of the uterus and tubes, but it can also detect the presence of problems in the cervix such as distortion or dilatation.

**Medical history and clinical evaluations** The doctor of Noor Al-Hayat Hospital relies on the patient's medical record, including any previous conditions such as repeated miscarriages or premature births. Symptoms such as pain or pressure in the pelvic area, as well as any changes in vaginal secretions, are also evaluated.

**Cervical pressure tests** Techniques such as the "Falsalfa test" can be employed, where the patient is asked to hold her breath and then breathe.

Are there any side effects of cervical ligation?

Yes, like any other medical procedure, cervical ligation may be associated with some possible side effects and complications. It is necessary for the patient to be aware of these effects beforehandundergo surgery Here are some possible side effects and complications:

**Common side effects:**

- **Convulsions and pain:** The patient suffers from pain or mild convulsions in the abdomen or pelvis after the operation.

- **Light bleeding:** It is possible to have slight vaginal bleeding after the operation, which is considered normal.

- **Vaginal secretions:** The height of the patient increases in the amount of vaginal secretions.

**We should avoid it after the cervical collar procedure**

While it is important to maintain a positive and proactive attitude towards health after the procedure, there are some things that you must avoid to avoid any possible risks.

**Avoid sexual activity** Usually, we advise you to avoid sexual activity after cervical circumcision. Although each case is unique, doctors usually recommend abstaining from sex for a certain period after the procedure, in order to reduce the risk of infection and avoid pressure on the cervix.

**Avoid strenuous exercises and lifting weights** Strenuous exercises can lead to increased pressure on the cervix, which may lead to negative results after the procedure. Similarly, lifting weights can increase intra-abdominal pressure, which may weaken the contractions or cause contractions.

**Do not ignore the signs of infection** If you notice any signs of infection, such as fever, chills, foul-smelling vaginal discharge, or severe pain, you must seek medical attention immediately. Failure to treat the infection can have harmful effects on both the mother and the child and may affect the effectiveness of vaccination.

** Avoid fullness of the bladder ** A full bladder can lead to unnecessary pressure on the cervix, so it is preferable to empty the bladder regularly. Although it may seem simple, maintaining healthy bladder habits can make a big difference in reducing the risk of complications.

**Beware of the symptoms of early labor** Watch for any signs of early labor, such as regular contractions, changes in vaginal secretions, pressure in the pelvic area, pain in the lower back, or convulsions. If you notice any of these symptoms, you should contact your healthcare provider immediately.

**Don't ignore the importance of mental health** The stress and anxiety associated with high-risk pregnancy can affect your mental health, especially in the presence of cervical mucus. If you feel overwhelmed, don't hesitate to ask for support from friends, family or special counseling.

**Avoid unrecommended medications or nutritional supplements** It is necessary to consult a health care provider before taking any new medications or supplements. Some materials may interfere with the success of the wrapping process or pose risks to the shipment.

Circumcision is a surgical procedure performed during pregnancy with the aim of strengthening the cervix (the lower part of the uterus) and preventing premature dilatation. This procedure is considered necessary, usually in cases where the woman suffers from a previous history of cervical dysplasia or pregnancy loss as a result of cervical dilatation.

Here is an overview of the cervical collar surgery:

**Preparation for the operation:** Before the surgery, the medical team reviews the patient's medical history and conducts a comprehensive physical examination. It is also possible to perform imaging tests such as ultrasound to evaluate the condition of the cervix and the health of the pregnancy in general.

**Anesthesia:** Cervical tightening can be performed using different types of anesthesia, such as local anesthesia, or regional anesthesia (such as epidural anesthesia or spinal anesthesia), or general anesthesia. The choice of sedation depends on the patient's health condition and preferences.

**Surgical Techniques:** There are several techniques to perform cervical cerclage, and the selection of the appropriate method depends on factors such as the stage of pregnancy and the experience of the surgeon. Among the main types of cervical ligation, "McDonald's Cerclage" is the most common.

**McDonald's Cerclage**: This is considered to be the most common type of tightening procedure. In this procedure, the surgeon places a strong, non-absorbable suture around the cervix, just below the level of the bladder. It is necessary to connect the sutures to keep the cervix closed and support the uterus during labor.

**Circlage surgeon**: This technique involves making a small incision in the wall of the vagina, where the suture is inserted deeper into the cervix, usually near the junction of the cervix and the uterus. This method requires a higher surgical skill and is often used in cases where the cervix is ​​shorter or more fragile.

**Care after surgery**: After the surgery, the patient is usually monitored in the recovery area to make sure that the effect of the anesthesia is deteriorating and that there are no immediate complications. Depending on the technology used and the patient's condition, he may be discharged from the hospital at the same time or kept for observation.

**Follow-up**: Regular appointments with the health care provider are essential after the cervical cerclage procedure. These appointments include ultrasound examinations to monitor the length of the cervix and the progress of the pregnancy in general. Usually, we remove the placenta in the 7th and 30th week of pregnancy, approximately, to allow birth.

**Precautions after cervical collaring**
After the cervical cerclage procedure, it is necessary to take additional precautions to ensure your and your baby's health. Here are some general care tips that must be followed:

- Strict adherence to the doctor's instructions, including attending all follow-up appointments to monitor the effectiveness of the treatment and the presence of any signs of infection or other complications.

- Participating in light activities according to the instructions of the health care provider, avoiding lifting weights or doing strenuous exercise.

- Keeping the body hydrated and following a balanced diet to support the healing process and the child's growth.

- Pay attention to the body and inform the health care provider immediately about any abnormal symptoms.

**The importance of comfort in bed**
Mostly weIt is recommended to rest in the bed after the cervical tightening procedure, but the duration and degree of rest varies from one patient to another. The purpose of this comfort is to reduce the pressure on the cervix and enable the body to heal better.

**Recovery after cervical ligation**
The recovery after the cervical cerclage procedure varies from person to person, as it depends on several factors such as the type of procedure, your general health, and any complications that may occur. Here is an overview of what we can expect during the recovery period:

**Our period immediately after the surgery:**After the operation, you will spend some time in the recovery area until you regain consciousness. The healthcare team will monitor your vital signs to make sure your condition is stable.

**Pain and discomfort:**some women may feel mild to moderate spasms, or after relief, or pressure in the pelvic area during the days following the procedure. A health care provider prescribes painkillers or recommends the use of non-prescription painkillers to relieve discomfort.

**Vaginal discharge:** It is normal to notice some vaginal spots or light bleeding for a few days after the operation. However, if you experience heavy bleeding, severe pain, or foul-smelling discharge, you should contact your healthcare provider, as these symptoms may indicate complications.

**Activity restrictions:** It is likely that the health care provider will advise you to avoid strenuous physical activities during the recovery period.

**Follow-up appointments:** You will have specific follow-up appointments with the health care provider to monitor the progress of recovery and evaluate the effectiveness of the treatment.

During these appointments, the cervix will be examined to make sure that the sutures are well connected and that there are no signs of complications.

**Monitoring:** Pay attention to any changes in symptoms, such as increased pain, abnormal secretions, high temperature, or contractions.

If you notice anything that causes concern, do not hesitate to contact the health care provider immediately.

**Relief and self-care:** Take care to get enough of my comfort and take care of your general health.

Make sure to drink enough water, eat nutritious foods, and use relaxation techniques to reduce stress.

**Return to daily activities:** Your health care provider will guide you about the appropriate time to gradually resume daily activities, including working out and exercising.

**Possible complications:** Although complications are rare, it is important to know the warning signs that may indicate the existence of a problem. These symptoms include increased pain, heavy bleeding, fever, or discharge.

**Changes in lifestyle after the procedure of cervicectomy**
After the cervical cerclage procedure, the health care provider may recommend certain lifestyle changes to ensure the best pregnancy results and reduce the risk of complications. We must keep in mind that these recommendations may vary depending on individual circumstances, so it is important to adhere to the advice provided by your health care team. Here are some general changes that have been suggested:

** Restrictions on comfort and pleasure: ** It is recommended to reduce vigorous physical activities and avoid lifting weights during the recovery period. It can contribute to comfort and avoid excess stress in reducing the pressure on the cervix and enhancing the healing process.

**Avoid sexual contact:** The health care provider recommends abstaining from sexual intercourse for a certain period after the procedure, which helps to reduce the risk of infection and other complications.

**Moisturization and nutrition:** Make sure to drink enough water daily to keep your body hydrated. It is also preferable to follow a balanced and nutritious diet to support your general health and the health of your baby.

**Stress Management:**Participate in stress relief techniques such as relaxation exercises, reflection, and deep breathing.

**Avoid smoking and alcohol**: If you smoke, it is preferable to quit this habit, as smoking may negatively affect the results of pregnancy. It is also recommended to avoid drinking alcohol, because it can have harmful effects on the body.

**Regular prenatal care**: Make sure to attend all prenatal follow-up appointments with your health care provider. Careful monitoring of the property allows detecting any problems early and providing the necessary interventions at the right time.

**Pay attention to symptoms:** Pay attention to any changes or symptoms that occur to you, such as increased pain, bleeding, fluid leakage, or contractions. If you notice anything abnormal, do not hesitate to contact your healthcare provider immediately. .

**Stay informed:** Learn about the signs of premature birth and what you should do if you have doubts about it

Understanding the warning signs that may indicate a problem in pregnancy and knowing when you should seek medical care.

**Maintaining your positivity:** Maintaining a positive outlook and focusing on your health and your child's health can contribute to a healthier pregnancy.