Foley's Catheter as a Simple Adjunct for Membrane Reduction in Late Rescue Cerclage: A Case Report

Advanced cervical dilatation with prolapsed membranes in the late second trimester is associated with imminent pregnancy loss or extreme prematurity. Rescue cerclage may improve outcomes in selected patients with intact membranes. We report a case of a 32-year-old G2A1 (gravida 2, abortion 1) woman at 27+4 weeks of gestation with painless cervical dilatation and bulging membranes. After excluding infection and uterine activity, emergency Shirodkar cerclage was performed under spinal anaesthesia. The prolapsed amniotic sac was reduced using a Foley catheter balloon technique prior to suture placement. The pregnancy was prolonged by six weeks and five days. She later presented with preterm prelabour rupture of membranes at 34+2 weeks and delivered vaginally a healthy male neonate weighing 2287 g following cerclage removal. Both mother and baby were discharged in stable condition. This case highlights the use of Foley catheter as a low-cost, safe technique during rescue cerclage. Even beyond 27 weeks, careful selection and meticulous surgical technique can achieve meaningful prolongation of pregnancy and a favourable neonatal outcome.