Cervical cerclage in advanced prolapsed fetal membranes - Case presentation

Area of Science:

• Maternal-Fetal Medicine
• Obstetrics and Gynecology

Background:

• Preterm birth remains a significant challenge in obstetrics.
• Cervical insufficiency is a key risk factor for preterm birth.
• Early diagnosis and intervention are critical for improving pregnancy outcomes.

Observation:

• A case of transvaginal cervical cerclage at 22 weeks gestation with 7 cm dilation successfully prolonged pregnancy to 38 weeks.
• The patient had no prior history of preterm birth, with cervical insufficiency developing in her second pregnancy.
• This highlights the potential for late-stage intervention and the need for proactive screening.

Findings:

• Transvaginal cervical ultrasound is essential for early diagnosis of cervical insufficiency.
• It allows for objective assessment of the internal cervical os, guiding treatment efficacy.
• Screening should be implemented in high-risk pregnancies and even in those without a suggestive history.

Implications:

• Routine transvaginal cervical ultrasound screening can identify asymptomatic cervical insufficiency.
• Timely cerclage placement, even with significant dilation, can prevent preterm birth.
• This approach can improve neonatal outcomes and reduce healthcare costs associated with preterm birth.