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Updated: Jul 18, 2026
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Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse
Published on: September 13, 2022
Favorable outcome following emergency second trimester cerclage.
A Debby1, O Sadan, M Glezerman
1Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel. debby@nashim.net
Summary
Emergency cerclage for cervical incompetence in the second trimester is effective, even with bulging membranes. This procedure can lead to favorable neonatal outcomes and prolonged pregnancy.
Area of Science:
- Maternal-Fetal Medicine
- Obstetrics
- Surgical Gynecology
Background:
- Cervical incompetence is a significant cause of second-trimester pregnancy loss.
- Midtrimester emergency cerclage is a procedure to prevent preterm birth.
- The presence of bulging membranes may affect the success of cerclage.
Purpose of the Study:
- To evaluate the outcomes of midtrimester emergency cerclage.
- To compare outcomes with and without bulging membranes during cerclage placement.
Main Methods:
- Retrospective cohort study of 99 women undergoing emergency cerclage (16-27 weeks).
- Two groups: no bulging membranes (n=75) and bulging membranes (n=24).
- McDonald cerclage technique used in all cases.
Main Results:
- Pregnancy prolonged significantly longer in the no-bulging group (14.3 weeks vs. 9.3 weeks).
- Higher gestational age at delivery in the no-bulging group (34.6 weeks vs. 29.5 weeks).
- Neonatal survival was high (83%) and similar between groups, despite higher chorioamnionitis in the bulging group.
Conclusions:
- Emergency cerclage can achieve favorable neonatal outcomes in the second trimester.
- The procedure is beneficial even when membranes are bulging.
- Cervical suturing is a viable option for cervical incompetence with bulging membranes.
