Pregnancy outcomes of twin pregnancies with cervical insufficiency undergoing cervical cerclage

Cervical cerclage is an established procedure for treating cervical insufficiency; however, its efficacy in twin pregnancies remains uncertain. This study aimed to evaluate the effectiveness of transvaginal cervical cerclage in twin pregnancies complicated by cervical insufficiency. Data were retrospectively collected from 155 women with twin pregnancies diagnosed with cervical insufficiency. Participants were divided into two groups: the cerclage group (n = 131) and the non-cerclage group (n = 24). The cerclage group was further subdivided into emergency cerclage and ultrasound-indicated cerclage subgroups for detailed analysis. The duration of gestation was found to be longer in the cerclage group compared to the non-cerclage group. Procedures performed included both emergency and ultrasound-indicated cerclage. No significant difference in gestational outcomes was observed between the ultrasound-indicated cerclage subgroup and the non-cerclage group, regardless of cervical length (< 15 mm, < 25 mm, or 15-25 mm). In contrast, a significant improvement in gestational outcomes was noted in the emergency cerclage subgroup compared to the non-cerclage group, irrespective of cervical dilation (> 1 cm or ≤ 1 cm). Overall, cervical cerclage appears to improve pregnancy outcomes in twin pregnancies under specific conditions. While ultrasonographically indicated cerclage did not significantly enhance pregnancy outcomes, emergency cerclage may be effective in improving perinatal prognosis.