Name of the Procedure:

Removal of Cerclage Suture under Anesthesia (other than local)

Summary

This procedure involves removing a cerclage suture, which is a stitch placed around the cervix to keep it closed during pregnancy. The removal is performed under anesthesia other than local, such as regional or general anesthesia, to ensure patient comfort and safety.

Purpose

Cerclage suture removal is performed to prevent cervical damage or preterm labor once the pregnancy reaches a point where the baby can be safely delivered. The goal is to remove the stitch to allow for natural labor or to prepare for a planned delivery.

Indications

• Completion of pregnancy to term (usually around 37 weeks)
• Preterm labor to prevent any complications
• Infection or other complications involving the cerclage
• Elective removal before a planned C-section

Preparation

• Fasting may be required for a certain period before the procedure if general anesthesia is used.
• Medication adjustments as advised by the healthcare provider.
• Pre-procedure assessments, including an ultrasound or cervical examination.

Procedure Description

1. The patient will be positioned appropriately, usually in a lithotomy position.
2. Anesthesia will be administered by an anesthesiologist or nurse anesthetist.
3. A speculum is inserted into the vagina to visualize the cervix.
4. Surgical instruments are used to carefully cut and remove the cerclage suture.
5. The area is inspected for any signs of bleeding or complications.
6. Post-removal monitoring is conducted to ensure no immediate complications.

Duration

The procedure typically takes about 15-30 minutes.

Setting

The procedure is performed in a hospital or an outpatient surgical center.

Personnel

• Obstetrician or Gynecologist
• Anesthesiologist or Nurse Anesthetist
• Surgical Nurse

Risks and Complications

• Infection
• Bleeding
• Preterm labor
• Cervical injury

Benefits

• Prevents cervical damage
• Allows for natural labor or planned delivery
• Reduces risk of complications associated with the cerclage remaining in place

Recovery

• Monitoring in a recovery area until the effects of anesthesia wear off.
• Instructions on activity restrictions, if any.
• Follow-up appointments to monitor cervical status and pregnancy progression.

Alternatives

• Waiting until the onset of labor for natural removal, if medically advisable.
• Other surgical techniques or methods of labor induction, depending on the individual case.

Patient Experience

During the procedure, the patient will not feel pain due to anesthesia. After the procedure, there might be minor discomfort or cramping. Pain management will be provided as necessary to ensure comfort.