Position: Lithotomy, Trendelenburg, arms extended
Time: 30-60 min (short)
Blood Loss: Very Low (5-10 ml)
Post-op Pain: Minimal (1-3)
Maintenance Paralytic: No

Position – The surgeon generally likes the patient in slight Trendelenburg and the bed raised approximately to eye-level.

Pregnancy – These patients are pregnant.

Cervical softening and dilation are a normal part of pregnancy. However, a premature weakened cervix (incompetent cervix or cervical insufficiency) can be caused by cervical damage or an abnormally shaped uterus. Congenital disorders affecting collagen can cause cervical insufficiency. In addition, Past surgical procedures such as a LEEP may also weaken the cervix. Past miscarriages indicate the possibility that the patient has a weak or weakened cervix. Diethylstilbestrol (DES), an estrogen synthetic, if taken before birth has also been linked to this condition. African-American women are at higher risk.

This procedure is designed to help reinforce a weak cervix. If not reinforced, the pressure on the weakened cervix can cause premature delivery. The cervix is reinforced by placing sutures at the opening.