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Updated: May 4, 2026
Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
A review of the contemporary evidence on rescue cervical cerclage
Hatem Abu Hashim1, Hesham Al-Inany2, Zaid Kilani3
1Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Background:
Rescue cervical cerclage (RCC) is essentially a salvage procedure to prolong pregnancy in women with advanced cervical changes and prolapsed membranes in the second trimester. However, its effectiveness and safety remain controversial.
Objectives:
To provide a comprehensive review of the contemporary evidence on RCC and evaluate which treatment modalities can be offered to pregnant women based on the best available evidence.
Search Strategy:
A PubMed search of published studies on RCC and perinatal outcome was conducted using defined keywords.
Selection Criteria:
Clinical studies were included with priority for level I evidence (randomized controlled trials [RCTs]) followed by other evidence levels.
Data Collection And Analysis:
Abstracts of 141 articles were screened and 40 articles were selected.
Main Results:
Evidence from retrospective and nonrandomized prospective trials shows a benefit of RCC. It may prolong pregnancy by an average of 4-5 weeks, with a 2-fold reduction in the chance of preterm birth before 34 weeks. A higher chance of failure is expected if cervical dilatation exceeds 4 cm or if membranes are bulging into the vagina.
Conclusions:
The decision for an RCC should be individualized after comprehensive counseling by a senior obstetrician. Further research in the form of robust RCTs is recommended.
