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Published on: September 13, 2022
Successful Late Emergency Cerclage for Painless Cervical Dilation in Triplet Gestation
Zagdon Keidar Shir1, Spiegel Efrat1, Silberstein Tali1
1Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel, bgu.ac.il.
Introduction:
The efficacy of emergency cerclage placement in triplet pregnancies remains controversial. This case describes a favorable outcome following such an intervention in prolonging gestation and improving neonatal outcomes in high-risk multiple gestations complicated by cervical insufficiency.
Case Presentation:
We report a bichorionic triamniotic (BCTA) triplet pregnancy in a primigravida admitted at 21 + 5 weeks gestation with asymptomatic cervical dilation and bulging membranes. After thorough counseling regarding risks and benefits, an emergency McDonald cerclage was placed at 22 + 4 weeks. The pregnancy was prolonged until 29 + 3 weeks, when the patient underwent cesarean delivery of three healthy neonates following preterm premature rupture of membranes and suspected chorioamnionitis. Informed consent was obtained from the patient for publication.
Discussion:
Despite the inherent risks, emergency cerclage may be considered in highly selected triplet pregnancies with cervical insufficiency. This case underscores the importance of individualized decision-making and may contribute to the existing literature and generate hypotheses for future research.
