Last updated: 02/17/2009

Diagnosis of an incompetent cervix is usually done by medical history and/or by examination (manually during a pelvic exam or using ultrasound technology). Some symptoms of an incompetent cervix used to decide if a cerclage is necessary are:

• cervical...
  
  dilation
• shortening of the cervix
• funneling of 25% or more (when the internal opening of the cervix has begun to dilate but the external opening remains closed)

Women who are more than 1.5 in (4 cm) dilated, who have already experienced rupture of membranes, or whose fetus has died are ineligible for cerclage.

Before the procedure may be performed, there are a number of preparatory steps that must be taken. A complete medical history will be taken. A cervical exam will be necessary to assess the state of the cervix; usually a transvaginal (through the vagina) ultrasound will be performed. No food or drink will be allowed after midnight before the day of surgery to avoid nausea and vomiting during and after the procedure. The patient will also be instructed to avoid sexual intercourse, tampons, and douches for 24 hours before the procedure. Before the procedure is performed, an intravenous (IV) catheter will be placed in order to administrate fluids and medications.