Emergency Cervical Cerclage

Overview

Journal J Clin Med

Specialty General Medicine

Date 2021 Apr 3

PMID 33803886

Citations 15

Authors

Magdalena Wierzchowska-Opoka

Zaneta Kimber-Trojnar

Bozena Leszczynska-Gorzelak

Affiliations

Soon will be listed here.

Abstract

Despite the progress of medicine in the last decades, recurrent pregnancy loss, premature birth, and related complications are still a vast problem. The reasons for recurrent pregnancy loss and preterm delivery are diverse and multifactorial. One of the main reasons for these complications is cervical insufficiency, which means that the cervix is weak and unable to remain closed until the date of delivery. It manifests as painless softening and shortening of the cervix without contractions. The aim of the study was to review the available literature on rescue sutures, which are an emergency treatment in pregnancies with premature cervical dilatation and protrusion of the fetal membranes in the second trimester of pregnancy. This review confirms that emergency cerclage reduces the rate of preterm birth in patients with advanced cervical insufficiency. This procedure prolongs gestational age and improves the chances of survival of the newborn without increasing the risk of chorioamnionitis and preterm premature rupture of membranes.

Citing Articles

Outcomes of emergency cervical cerclage after amnioreduction in twin pregnancies with a fully dilated cervix and amniotic membrane prolapse.

Yalinkaya A, Oglak S, Gunduz R, Yilmaz E, Bolluk G, Yayla M J Turk Ger Gynecol Assoc. 2025; 26(1):26-33.

PMID: 40077964 PMC: 11905194. DOI: 10.4274/jtgga.galenos.2024.2024-9-9.

Subsequent Pregnancy Outcomes Following Prepregnancy Cerclage in Patients with Absent Ecto-Cervix.

Lu J, Zhou L, Xu M, Yang L, Li X Iran J Public Health. 2024; 53(11):2500-2508.

PMID: 39619894 PMC: 11607163. DOI: 10.18502/ijph.v53i11.16953.

Rescue Cervical Cerclage for Previable Birth Prevention: A Comprehensive Review of Indications, Techniques, and Outcomes.

Ughade P, Shrivastava D, Chaudhari K Cureus. 2024; 16(9):e68619.

PMID: 39371694 PMC: 11450839. DOI: 10.7759/cureus.68619.

Nomogram-based risk assessment for emergency cervical cerclage failure in patients with cervical insufficiency.

Chen C, Guo S, Fan C, Gao F Heliyon. 2024; 10(13):e32923.

PMID: 39027507 PMC: 11255580. DOI: 10.1016/j.heliyon.2024.e32923.

Effectiveness and pregnancy outcomes of ultrasound-indicated and physical examination-indicated cervical cerclage: a retrospective study from a single centre.

Huang L, Wang W, Wang Y, Chen J, Jin S, Qi X BMC Pregnancy Childbirth. 2024; 24(1):467.

PMID: 38977997 PMC: 11229292. DOI: 10.1186/s12884-024-06659-w.

References

Basbug A, Bayrak M, Dogan O, Ellibes Kaya A, Goynumer G . McDonald versus modified Shirodkar rescue cerclage in women with prolapsed fetal membranes. J Matern Fetal Neonatal Med. 2018; 33(7):1075-1079. DOI: 10.1080/14767058.2018.1514378. View

Mitra A, Katz V, BOWES Jr W, Carmichael S . Emergency cerclages: a review of 40 consecutive procedures. Am J Perinatol. 1992; 9(3):142-5. DOI: 10.1055/s-2007-999307. View

Cockwell H, Smith G . Cervical incompetence and the role of emergency cerclage. J Obstet Gynaecol Can. 2005; 27(2):123-9. DOI: 10.1016/s1701-2163(16)30184-0. View

Ito A, Maseki Y, Ikeda S, Tezuka A, Kuribayashi M, Furuhashi M . Factors associated with delivery at or after 28 weeks gestation in women with bulging fetal membranes before 26 weeks gestation. J Matern Fetal Neonatal Med. 2016; 30(17):2046-2050. DOI: 10.1080/14767058.2016.1236247. View

Tita A, Andrews W . Diagnosis and management of clinical chorioamnionitis. Clin Perinatol. 2010; 37(2):339-54. PMC: 3008318. DOI: 10.1016/j.clp.2010.02.003. View

Lv M, Zhao B, Chen Y, Xi F, Zhan Q, Wang Y . Balloon tamponade for successful emergency cervical cerclage. J Obstet Gynaecol Res. 2020; 46(3):418-424. DOI: 10.1111/jog.14186. View

Secher N, McCormack C, Weber T, Hein M, Helmig R . Cervical occlusion in women with cervical insufficiency: protocol for a randomised, controlled trial with cerclage, with and without cervical occlusion. BJOG. 2007; 114(5):649, e1-6. DOI: 10.1111/j.1471-0528.2007.01250.x. View

Aoki S, Ohnuma E, Kurasawa K, Okuda M, Takahashi T, Hirahara F . Emergency cerclage versus expectant management for prolapsed fetal membranes: a retrospective, comparative study. J Obstet Gynaecol Res. 2013; 40(2):381-6. DOI: 10.1111/jog.12207. View

Rust O, Atlas R, Reed J, van Gaalen J, Balducci J . Revisiting the short cervix detected by transvaginal ultrasound in the second trimester: why cerclage therapy may not help. Am J Obstet Gynecol. 2001; 185(5):1098-105. DOI: 10.1067/mob.2001.118163. View

10.

Sneider K, Christiansen O, Sundtoft I, Langhoff-Roos J . Recurrence rates after abdominal and vaginal cerclages in women with cervical insufficiency: a validated cohort study. Arch Gynecol Obstet. 2017; 295(4):859-866. DOI: 10.1007/s00404-017-4315-y. View

11.

Barth Jr W, YEOMANS E, Hankins G . Emergent cerclage. Surg Gynecol Obstet. 1990; 170(4):323-6. View

12.

Goodlin R . Cervical incompetence, hourglass membranes, and amniocentesis. Obstet Gynecol. 1979; 54(6):748-50. View

13.

Debby A, Sadan O, Glezerman M, Golan A . Favorable outcome following emergency second trimester cerclage. Int J Gynaecol Obstet. 2006; 96(1):16-9. DOI: 10.1016/j.ijgo.2006.09.002. View

14.

Glass H, Costarino A, Stayer S, Brett C, Cladis F, Davis P . Outcomes for extremely premature infants. Anesth Analg. 2015; 120(6):1337-51. PMC: 4438860. DOI: 10.1213/ANE.0000000000000705. View

15.

Althuisius S, Dekker G, Hummel P, Bekedam D, van Geijn H . Final results of the Cervical Incompetence Prevention Randomized Cerclage Trial (CIPRACT): therapeutic cerclage with bed rest versus bed rest alone. Am J Obstet Gynecol. 2001; 185(5):1106-12. DOI: 10.1067/mob.2001.118655. View

16.

Tsikouras P, Anastasopoulos G, Maroulis V, Bothou A, Chalkidou A, Deuteraiou D . Comparative Evaluation of Arabin Pessary and Cervical Cerclage for the Prevention of Preterm Labor in Asymptomatic Women with High Risk Factors. Int J Environ Res Public Health. 2018; 15(4). PMC: 5923833. DOI: 10.3390/ijerph15040791. View

17.

Gimovsky A, Suhag A, Roman A, Rochelson B, Berghella V . Pessary versus cerclage versus expectant management for cervical dilation with visible membranes in the second trimester. J Matern Fetal Neonatal Med. 2015; 29(9):1363-6. DOI: 10.3109/14767058.2015.1049151. View

18.

Scheerer L, Lam F, Bartolucci L, Katz M . A new technique for reduction of prolapsed fetal membranes for emergency cervical cerclage. Obstet Gynecol. 1989; 74(3 Pt 1):408-10. View

19.

Romero R, Dey S, Fisher S . Preterm labor: one syndrome, many causes. Science. 2014; 345(6198):760-5. PMC: 4191866. DOI: 10.1126/science.1251816. View

20.

Uzun Cilingir I, Sayin C, Sutcu H, Inan C, Erzincan S, Yener C . Emergency cerclage in twins during mid gestation may have favorable outcomes: Results of a retrospective cohort. J Gynecol Obstet Hum Reprod. 2018; 47(9):451-453. DOI: 10.1016/j.jogoh.2018.08.010. View