Visible fetal membranes in cervical insufficiency: Biological severity or emergency cerclage salvageability?

Yoneda et al. recently reported distinct inflammatory, microbiological, and clinical characteristics between cervical-type and vaginal-type visible fetal membranes in cervical insufficiency. We discuss the potential influence of operative management, particularly emergency cervical cerclage, on interpretation of the reported outcome differences. We suggest that anatomical classification, biological severity, and operative feasibility should be considered complementary dimensions when evaluating visible fetal membranes in cervical insufficiency.