Factors associated with success of emergent second-trimester cerclage

Abstract

Nulliparity, the presence of membranes prolapsing beyond the external cervical os, and gestational age less than 22 weeks at cerclage placement are associated with decreased chance of delivery at or after 28 weeks after emergent cerclage; these factors may be used to help counsel patients considering the procedure.

Emergency cervical cerclage: Predictors of success

“…Nevertheless, failure was not universal where limited vaginal bleeding or abdominal discomfort were present, suggesting that such risk factors are not entirely reliable. In contrast to Terkildsen et al [15] we did not find earlier gestation to be associated with increased risk but we did confirm their finding that membranes through the cervix, as opposed to at the level of the external os, increased the risk of failure.…”

A single‐center retrospective study of pregnancy outcomes after emergency cerclage for cervical insufficiency

“…Most women in the emergency cerclage group had cervical shortening but not dilation. Several studies have showed that membrane prolapse beyond the external os and/or a cervical dilation of 1.5 cm are independent predictors of cerclage failure . In the present study, seven patients had cervical dilation at the time of the cerclage procedure, and most of these women had poor outcomes.…”

Outcomes of Mid-Trimester Emergency Cerclage in Twin Pregnancies

“…The time interval between procedure and delivery was statistically increased for patients without bulging membranes as opposed to patients with shortening of the cervix only, being 14.3 versus 9.3 weeks, respectively. In fact, factors associated with successful mid-trimester placement of cerclage have also been studied [9]. Nulliparity, the presence of membranes protruding beyond the external os and gestational age of less than 22 weeks at the procedure were associated with a decreased chance of delivery at or beyond 28 gestational weeks.…”