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The cerclage stitch and what it does | CION Cancer Clinics
A cerclage is a strong, permanent stitch tied around the lower end of the womb during a trachelectomy. It takes over part of the cervix's job, helping keep the womb closed during a future pregnancy so the baby is less likely to arrive too early. Most women never notice it. This page explains why it is placed, what problems it can occasionally cause, and what it means for pregnancy. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What is the cerclage stitch after a trachelectomy?
- What happens to the stitch from surgery to delivery?
- What problems can the stitch cause?
- What do the words in your notes mean?
- What do women often worry about with the stitch?
- Who might not get a stitch, and what can this page not tell you?
- Common questions about the cerclage stitch
The short answer
What is the cerclage stitch after a trachelectomy?
A cerclage is a strong, permanent stitch tied around the lower end of the womb during a trachelectomy. It does part of the job the cervix used to do: it helps keep the womb closed during a future pregnancy, so the baby is less likely to come too early.
Why it is needed
The cervix is normally a firm, closed neck at the bottom of the womb. It stays shut for most of a pregnancy and opens only in labour. A trachelectomy removes it. Without that neck, the growing weight of a pregnancy can open the womb too soon, leading to a late miscarriage or a very early birth. The stitch acts as a supporting ring.
What it is made of
It is a non-dissolving tape or thread, placed while you are already asleep for the main operation. You do not usually feel it. It is left in place for years, often for good, and it is one reason a baby is usually delivered by caesarean after a trachelectomy.
What it does not do
The stitch does nothing to treat the cancer. It does not affect your hormones, your ovaries or your chance of conceiving. Its only job is support, later, if you become pregnant.
Not every surgeon places a stitch in every case. Ask yours whether they plan to, and why.Over time
What happens to the stitch from surgery to delivery?
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During the operation
After the cervix is removed, the surgeon ties the stitch around the lower womb, then joins the womb to the top of the vagina.
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While you heal
Some discharge or light bleeding is common in the first weeks as the join heals. The stitch itself is buried and usually causes no symptoms.
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Trying to conceive
The stitch does not stop sperm reaching the womb or periods flowing out. Your team will usually advise waiting a while after surgery and checking follow-up results before trying.
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During a pregnancy
An obstetric team that knows about the trachelectomy watches the pregnancy closely. Sometimes an extra stitch is advised, either early in pregnancy or before trying.
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At delivery
The baby is usually delivered by planned caesarean. The stitch is often left in place so it can support another pregnancy.
Not sure whether this applies to you?
Ask an oncologistWhen it causes trouble
What problems can the stitch cause?
Most women never notice it. These are the problems that do occasionally happen, and all of them can be looked at.
The stitch working through
Over time the stitch can come to the surface inside the vagina. This can cause a watery or stained discharge, or spotting. It can often be trimmed or removed in a short procedure.
A narrowed opening
The new opening of the womb can scar and tighten, called stenosis. The stitch can add to this. Periods may become painful or stop, and it may need gentle stretching under anaesthesia.
Spotting after sex
Bleeding after sex can come from the stitch or from healing tissue at the join. It should still be checked, because follow-up after cancer surgery must rule out other causes.
Infection
Rarely, the area around the stitch becomes infected.
Signs to report
- A foul-smelling discharge
- Fever with pelvic pain
On your notes
What do the words in your notes mean?
- Cerclage
- A stitch placed around the lower womb or cervix to help keep it closed during pregnancy.
- Isthmus
- The narrow lower part of the womb, just above where the cervix was. This is where the stitch usually sits.
- Abdominal cerclage
- A stitch placed from above, through a cut or keyhole surgery on the tummy, sometimes used when a stitch is needed later.
- Preterm birth
- A baby born well before the expected date. This is the main risk the stitch is meant to lower.
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Commonly believed
What do women often worry about with the stitch?
"The stitch will stop my periods coming out."
It does not close the womb completely. Periods pass through the new opening. If periods stop or become very painful, the usual cause is scarring of the opening, and that can be treated.
"With the stitch in, a normal delivery is still possible."
After a trachelectomy, a planned caesarean is the usual route. The stitch is not meant to stretch open in labour, and labour against it can cause damage.
"The stitch means the pregnancy will be safe."
It lowers a risk, it does not remove it. Pregnancies after a trachelectomy still carry a higher chance of an early birth, so they need closer care throughout.
"My husband will feel it during sex."
The stitch sits above the top of the vagina and is usually not felt. If a knot has come to the surface, a partner occasionally notices it. Mention it at follow-up, as it can be dealt with.
!
If you are pregnant with a stitch, do not wait
If you have a stitch after a trachelectomy and are pregnant, go to your maternity unit the same day if you have fluid leaking from the vagina, bleeding, regular tightening or cramping, or a feeling of pressure low down. Say that you have had a trachelectomy and a cerclage. Do not wait for your next scan, and do not travel a long distance first if a nearer maternity unit can see you.
Being straight with you
Who might not get a stitch, and what can this page not tell you?
Some surgeons place a stitch only in some cases, for example after a simple trachelectomy where more cervix may remain, or where they plan to add one later if a pregnancy happens. Others place one routinely. There is no single agreed rule, and the evidence comparing the approaches is small.
Questions worth asking
Ask whether a stitch will be placed, what material it is, and whether it will stay in for good. Ask what would lead them to remove it. Ask who should look after a future pregnancy, and whether an extra stitch might be advised.
What this page cannot do
It cannot tell you how likely a pregnancy is, or how early a baby might come. It cannot tell you whether a symptom you have is from the stitch or from something else. Only an examination can do that.
If you are helping a wife, sister or daughter
Keep a copy of the operation notes, which record whether a stitch was placed and what kind. Years later, a maternity team or a fertility clinic in another city may need them, and the details are easily forgotten. If a pregnancy happens, make sure the first doctor she sees knows about the trachelectomy and the stitch.
Questions we are asked
Common questions about the cerclage stitch
Can I feel the stitch?
Most women cannot. It is buried in the tissue at the lower end of the womb. If you notice a new discharge, spotting, or a feeling of something sharp inside, the stitch may have come to the surface. Tell your surgeon, who can check with a simple examination.
Will the stitch ever need to come out?
Often it stays for good. It may be removed if it causes repeated discharge or bleeding, infection, or a blocked opening that stretching does not settle. If it is removed and you later want a pregnancy, your team may discuss placing a new one.
Does the stitch affect my smear tests or check-ups?
It can make samples from the new opening a little harder to take, and it may be visible on MRI scans. Your follow-up team expects this. Keep every follow-up appointment, because after a trachelectomy those checks matter as much as the stitch does.
Can I have sex with the stitch in place?
Yes, once the wound has healed and your surgeon agrees. The stitch sits above the vagina and should not get in the way. Bleeding after sex, or pain that is new, should be checked rather than put down to the stitch without an examination.
Can IVF be done with a stitch in place?
Usually yes. The embryo transfer tube has to pass through the new opening, which can be harder if it has narrowed. Tell the fertility clinic about the trachelectomy and the stitch at the first visit, and ask them to talk to your surgeon.
Why might I need another stitch in pregnancy?
If there was no stitch placed, if it was removed, or if the lower womb looks short on scans, an obstetrician may advise one. Sometimes it is placed from the tummy side before or early in pregnancy. This is a specialist decision, so ask to be referred early.
Will the stitch cause a miscarriage early in pregnancy?
The stitch is not known to cause early miscarriage. The risks it is meant to reduce come later, when the pregnancy is heavier. Any bleeding or pain in pregnancy should still be checked quickly by your maternity team.
Who should look after my pregnancy?
An obstetrician experienced in high-risk pregnancy, working with your surgical team. Ask for this referral before you try to conceive, or as soon as a test is positive. Bring your operation notes, which record the stitch, to the first antenatal visit.
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Sources
- American Cancer Society — Surgery for cervical cancer
- NHS — Cervical cancer: treatment
- Cancer Research UK — Treatment for cervical cancer
- Macmillan Cancer Support — Cervical cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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