(National) June 21, 2006 - Pregnant women who have "cervical insufficiency" tend to have a premature birth or miscarriage. Here's how an improvement on an old procedure could help these women have healthy babies.
For Angela Norton, the news of a second pregnancy brought both joy - and anxiety. "Because with Kayla, she was in the hospital for four and a half, four months."
Firstborn Kayla, now five, was premature, weighing only 1.5 pounds at birth. Norton says, "I had gone to my doctor when I was pregnant with Kayla and he had told me at four months I'd need a cerclage."
Angela had an insufficient cervix, too weak to support a baby. In a cerclage, doctors stitch up the bottom tip of the cervix to strengthen it. Dr. Abdullah Al-Khan explains, "You're just taking a string, like a shoelace, and you're just putting it all around the cervix and just tying it in the front."
Angela's first cerclage was done through the traditional route, vaginally.
Because it failed, doctors did the cerclage for her next pregnancy through her abdomen. Dr. Al-Khan talks about that procedure, "The rationale for abdominal cerclage is placement of the suture, it's as high as possible."
"Because putting the stitch at the tip of the cervix may not really do the job. If you want to do it, you need to do it right at the base."
The procedure can be done with traditional open surgery or laparoscopically through four small incisions. There are pros and cons to both approaches, according to Dr. Al-Khan, "If you do the laparoscopic route, it can be a little longer, so you're exposing the patient to long anesthesia, but also it's minimally invasive."
This time Angela's pregnancy was closer to full term. Baby Nathaniel weighed a healthy six pounds.
Norton was thrilled, "To have Nathaniel at the month that I did, it was, it was wonderful."
Women who have the abdominal cerclage deliver by Caesarean section. If they want to have more children, the cerclage sutures stay in place. If not, they're removed.
A cerclage is typically placed near the end of the first trimester.
Posted 5:00pm by Chantelle Janelle
WISTV License Subsidiary, LCC
1111 Bull St.