Strapping, what precautions?

"When is a strapping prescribed and is it risky?" Dr. François Devianne, gynecologist-obstetrician, head of the maternity ward at the Orsay hospital, answers Coralie's question.

The answer of Dr. François Devianne, gynecologist-obstetrician, head of the maternity ward of the Orsay hospital.

  • Strapping is an operation that consists of strengthening the cervix with a thread or a strip for women with a gap in the cervix that may cause premature miscarriage or premature delivery.
  • In some situations, when it should remain closed until delivery, the cervix does not perform its hermetic role of "lock". It can open well before the term and compromise the continuation of pregnancy, increasing the risk of late miscarriage (from the 4th month of pregnancy) or premature delivery. Therefore, to avoid this and allow the pregnancy to continue, the cervix is ​​reinforced and "circled" with a thick thread or a strip.
  • Given the risk of infection, this procedure takes place in the operating room, in order to benefit from optimal aseptic conditions. It lasts less than half an hour and is performed under loco-regional or general anesthesia. Most of the time, wire strapping is removed at the beginning of the 9th month to allow vaginal delivery. Strip strapping can not be removed. In this case, delivery takes place by caesarean section.
  • Overall, cerclage even if it includes as any intervention an infectious risk, presents more expected benefits than risks. Otherwise the medical team would not advocate it. Because a circled collar is more fragile, the pregnancy becomes pathological, which means that it will benefit from increased surveillance by an obstetrician when a physiological pregnancy can be performed by a midwife.
  • Pregnant women with a circled collar should avoid all physical activities, sources of contractions, without necessarily lying down. They usually stop working before the entry into force of their maternity leave, it is the pathological leave.

Interview by Frédérique Odasso


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