Rescue Cervical Cerclage in a Twin Pregnancy With Short Cervical Length or Cervical Dilatation: A Case Report

Preterm birth is a leading cause of neonatal morbidity and mortality worldwide, with the risk being substantially higher in multiple pregnancies. Twin gestations are associated with several maternal and foetal risk factors that contribute to spontaneous preterm birth. Although cervical cerclage is an established intervention for cervical insufficiency in singleton pregnancies, its role in preventing preterm birth in twin pregnancies remains controversial, and its use continues to be the subject of ongoing research. This case report details the management of a woman with a twin pregnancy who presented with abdominal pain. She had one anterior wall and one fundal fibroid; however, they did not cause any compression effects on the endometrial cavity. Rescue cerclage was performed at 17 weeks and three days of gestation following thorough counseling on potential risks and benefits. The patient chose to have the cerclage, received continuous multidisciplinary antenatal care, and ultimately delivered at 27 weeks and three days via emergency caesarean section due to premature rupture of membranes. Throughout her care, informed discussions supported shared decision-making.