Research progress on the complications related to cervical cerclage failure

Area of Science:

• Reproductive Medicine
• Maternal-Fetal Medicine
• Gynecologic Surgery

Background:

• Cervical cerclage (CC) is a procedure to prevent preterm birth in women with cervical insufficiency.
• CC failure can result in severe complications, necessitating a better understanding of risk factors and predictive markers.

Purpose of the Study:

• To systematically review severe complications, clinical risk factors, and predictive biomarkers of cervical cerclage failure.
• To inform individualized clinical decisions for managing cervical insufficiency.

Main Methods:

• A narrative review of English-language studies was conducted using PubMed and Web of Science.
• Evidence on surgical complications, risk factors, and inflammatory biomarkers was synthesized.

Main Results:

• Preterm premature rupture of membranes (PPROM) and chorioamnionitis (CAM) are more common with physical examination-indicated cerclage (PEIC).
• Advanced cervical dilatation, fetal membrane protrusion, and vaginal dysbiosis are key risk factors for CC failure.
• Maternal inflammatory markers (SII, SIRI), amniotic fluid markers, and vaginal Lactobacillus abundance show potential as predictive biomarkers.

Conclusions:

• Cervical insufficiency is increasingly viewed as an inflammation-related condition.
• Novel biomarkers show promise for predicting CC outcomes but require validation in large-scale, prospective studies.