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Dynamic Systemic Inflammatory Markers for Predicting Perinatal Outcomes After Emergency Cerclage in Women With
Büşra Tsakır1, Gül Alkan Bülbül1, Elif Ayan Avcı1
1Department of Perinatology, Antalya Training and Research Hospital, Antalya, Turkey.
The Journal of Obstetrics and Gynaecology Research
|June 4, 2026
Summary
Postoperative neutrophil-to-lymphocyte ratio (NLR) effectively predicts emergency cerclage failure in women with prolapsed membranes. Higher postoperative NLR indicates a greater risk of cerclage failure, aiding in patient management.
Area of Science:
- Obstetrics and Gynecology
- Inflammatory Markers
- Pregnancy Complications
Background:
- Preoperative inflammatory markers are linked to cerclage outcomes.
- The prognostic value of postoperative inflammatory markers and their changes is not well understood.
Purpose of the Study:
- To assess postoperative inflammatory markers and their dynamic changes as predictors of outcomes in women with prolapsed membranes undergoing emergency cerclage.
Main Methods:
- Retrospective cohort study of 34 singleton pregnancies with prolapsed membranes treated with emergency McDonald cerclage.
- Measured neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) preoperatively and 48-72 hours postoperatively.
- Primary outcome was cerclage failure (delivery before 28 weeks).
Main Results:
- Postoperative inflammatory markers were significantly higher in the cerclage failure group.
- Postoperative NLR showed good predictive performance (AUC=0.825) with a cutoff of ≥5.78 (sensitivity 80.0%, specificity 84.2%).
- Postoperative NLR negatively correlated with pregnancy prolongation, birth weight, and gestational age at delivery.
Conclusions:
- Postoperative NLR is a promising predictor of cerclage failure in women with prolapsed membranes.
- This marker can enhance risk stratification and support individualized patient management.
- Larger prospective studies are recommended for validation.