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Published on: September 12, 2025
Emergency cerclage: literature review
Shirin Namouz1, Shay Porat, Nan Okun
1Department of Obstetrics & Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Obstetrical & Gynecological Survey
|April 30, 2013
Summary
Emergency cerclage (cervical stitch) can improve pregnancy outcomes for women with a dilated cervix in the second trimester. Key predictors of poor outcomes include infection and significant cervical dilation.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Emergency cerclage is a procedure for women presenting with a dilated cervix in the second trimester.
- Identifying predictors of successful outcomes is crucial for patient management.
Purpose of the Study:
- To review the use and effectiveness of emergency cerclage.
- To identify predictors of favorable emergency cerclage outcomes.
- To compare emergency cerclage with bed rest.
Main Methods:
- Systematic review of 34 studies involving transvaginal emergency cervical cerclage.
- Searched PubMed and Cochrane Library (January 1995 - April 2012).
- Included studies of women with a dilated cervix in the second trimester.
Main Results:
- Emergency cerclage was associated with a longer latency period and better pregnancy outcomes compared to bed rest.
- Predictors of poor outcomes included prolapsed membranes, infection, symptomatic presentation, cervical dilation >3 cm, or cerclage after 22 weeks.
- The cerclage group showed significant improvements in delivery interval and reduced preterm delivery and neonatal morbidity.
Conclusions:
- Emergency cerclage appears to offer better outcomes than bed rest for selected women.
- Evidence of inflammation or infection is strongly associated with adverse outcomes.
- Further research, including randomized controlled trials, is needed to fully establish effectiveness.
