Everything you need to know about strapping

Strapping, what is it?

 Strapping consists of tighten the cervix using a thread or a strip, in case of threat of late miscarriage or premature delivery. The gynecologist passes a thread or a band, non-absorbable, around and inside the cervix, then he tightens and makes a knot so that it holds. Depending on the length of the neck and the practitioner’s habit, two methods can be used: the Mac Donald technique (the most widespread and the simplest) or that of Shirodkar.

 This intervention is not systematic, even quite rare! It is decided on a case-by-case basis, depending on the risk estimated by the doctor. 

Why practice strapping?

Cerclage can be recommended for mothers-to-be with “Cervical open bite”, or “cervical incompetence”. Clearly, when the cervix no longer fulfills its role as a barrier, preventing the baby from coming out.

As a precaution, a cerclage may be considered in pregnant women who have already suffered several late miscarriages (beyond the 1st trimester of pregnancy) or premature deliveries. The objective: to avoid a recurrence …

At what stage of pregnancy is cerclage performed?

Cerclage arises at the end of the first trimester of pregnancy (between 14 and 16 weeks of amenorrhea) or “in emergency”, if a threat of late miscarriage presents itself.

How does the strapping work take place?

The most common method is to tie a thread non-absorbable around the cervix to keep it closed until the end of pregnancy. This “sewing” exercise is performed vaginally and lasts about fifteen minutes. It requires general anesthesia or spinal anesthesia (drowsiness of the abdomen and lower limbs). The future mother must then stay for a few hours under observation. Note that in certain cases (very shortened neck, for example), the gynecologist prefers to use strips instead of the thread.

Rhesus negative blood group mothers receive an injection of anti-Rhesus positive antibodies. The goal: to prevent the body from producing anti-Rhesus antibodies that could harm the child during a future pregnancy.

Are there any contraindications to strapping?

To give the strapping all its chances of success, precautions are taken. In particular, we make sure that the mother does not have an infection. It is also contraindicated if the mother is bleeding, has lost water, or has uterine contractions.

Cerclage: the rest of the pregnancy

Cerclage of the cervix does not exclude 100% the risk of miscarriage or premature delivery. It is therefore necessary to spare ! The doctor does not ask the mother-to-be to lie down until the end of the pregnancy, but no question of staying up for 8 hours in a row either! It is also better to avoid long car journeys, shopping days, moving house, etc.

Usually, the pregnant woman stops labor a little earlier than expected.

Strapping = sexuality on “stand by”?

Still happy, the strapping does not prevent mothers-to-be from having sex ! Nevertheless, these gentlemen are advised to take it easy … Ditto with the use of sextoys.

On the other hand, since semen can trigger contractions, some doctors advise you to take a few precautions (it’s up to you to guess which ones!).

After strapping, what signs should prompt me to consult?

Moms who have a strapping are more supervised. Between two visits to the doctor, do not delay going to the maternity ward if you have stomach pain or lower back pain. But also if bleeding occurs, if you have a fever or notice a smelly vaginal discharge or discharge of fluid.

Cerclage removal and delivery

The cerclage is removed around the 37th week of amenorrhea, about three weeks before the due date or before, if labor begins. The gynecologist simply cuts the threads. The intervention is, in principle, painless.

Baby’s arrival will then proceed normally, by natural means, if possible.