Cervical Encirclage-A Boon for Mid- Trimester Pregnancy with Cervical Insufficiency
DOI:
Keywords:
Cervical cerclage, Cervical insufficiency, High-risk pregnancy., Mid-trimester pregnancy, Preterm birth prevention, Second trimester miscarriageAbstract
The human cervix is a complex structure that undergoes extensive changes throughout pregnancy and parturition to support the fetus and facilitate its expulsion. Cervical insufficiency is defined as the inability of the cervix to retain fetus, in the absence of uterine contractions owing to a functional or structural defect1. The term “Cervical insufficiency” is now replaced by “cervical incompetence”. Epidemiologic studies suggest an approximate incidence of 0.5% in the general obstetric population and 8% in women with a history of previous mid-trimester miscarriages.
References
M Thakur, S M Jenkins, K Mahajan (2025) Cervical insufficiency. https://www.ncbi.nlm.nih.gov/books/NBK525954/
L Temming, E Mikhail (2023) Society for Maternal-Fetal Medicine Consult Series #65: Transabdominal cerclage. 228(6), B2-B10. https://doi.org/10.1016/j.ajog.2023.02.018
D James, P J Steer (2011) High risk pregnancy: management options.
K B Bieber, S M Olson (2025) Cervical cerclage. https://www.ncbi.nlm.nih.gov/books/NBK560523/
Shilpi S, Kumari C, Prasad A (2025) Pregnancy outcomes and determinants of cervical cerclage effectiveness: a retrospective analysis. 17(5), 1216–1222.
Shilpa M N Shilpa MN, Kavyashree G, Pooja R, Sandyashree P K PK (2024) Pregnancy outcome in cervical cerclage patients — a retrospective study in a tertiary care center, Mandya. 6(1), 1732–1735. https://academicmed.org/Uploads/Volume6 Issue1/342.%20%5B2287.%20JAMP_MOGA%5D%201732-1735.pdf
C Lu, B Lim, S J Robson (2016) Increasing incidence rate of cervical cerclage in pregnancy in Australia: a population-based study. 4(3), 68. https://doi.org/10.3390/healthcare4030068
C Golbasi, H Golbasi, B Bayraktar, B Sever, T Vural, A Ekin (2022) Effectiveness and perinatal outcomes of history-indicated, ultrasound-indicated and physical examination-indicated cerclage: a retrospective study. 22(1), 217. https://doi.org/10.1186/s12884-022-04557-7
The outcome of preterm births in pregnant women with hypertensive disorders: an observational study. https://ijogr.org/archive/volume/9/issue/2/article/13458/pdf
Shruthi S, T S Kaviyapriya, V G Poorani, S Anjani Devi (2025) Pregnancy outcomes following cervical cerclage: a prospective observational study from a tertiary care centre in Tamil Nadu. 14(32S), 5048–5053. https://www.jneonatalsurg.com/index.php/jns/article/view/8241
C A Bigelow, M Naqvi, A G Namath, M Ali, N S Fox (2020) Cervical length, cervical dilation, and gestational age at cerclage placement and the risk of preterm birth in women undergoing ultrasound or exam-indicated Shirodkar cerclage. 33(15), 2527-32. https://doi.org/10.1080/14767058.2018.1554050
A Suhag, N S Seligman, I Bianchi, V Berghella (2010) What is the optimal gestational age for history-indicated cerclage placement?. 27(6), 469-74. https://doi.org/10.1055/s-0030-1247601
H Diamant, S A Mastrolia, A Y Weintraub, B Sheizaf, T Zilberstein, D Yohay (2019) Effectiveness and safety of late mid-trimester cervical cerclage. 32(18), 3007–11. https://doi.org/10.1080/14767058.2018.1454426
V Berghella, S M Keeler, M S To, S M Althuisius, O A Rust (2010) Effectiveness of cerclage according to severity of cervical length shortening: a meta-analysis. 35(4), 468-73. https://doi.org/10.1002/uog.7547
R K Song, H H Cha, M Y Shin, S J Choi, S Y Oh, J H Kim, C R Roh (2016) Post-cerclage ultrasonographic cervical length can predict preterm delivery in elective cervical cerclage patients. 59(1), 17-23. https://doi.org/10.5468/ogs.2016.59.1.17
K E Mountain, S Ng, T Elger, H Judah, R Akolekar, H V Lewis, D A MacIntyre, V Terzidou, P R Bennett, T G Teoh, L Sykes, K H Nicolaides (2025) Predictive value of cervical length for spontaneous preterm birth in women with cervical cerclage. 66(2), 210-216. https://doi.org/10.1002/uog.29281
A C S Binsted, L Nehme, A Z Abuhamad, T Kawakita (2024) Outcomes of Ultrasound or Physical Examination-Indicated Cerclage according to the Degree of Cervical Dilation. 41(6), 684-689. https://doi.org/10.1055/a-2203-3696
K B Fortner, C B Fitzpatrick, C A Grotegut, G K Swamy, A P Murtha, R P Heine, H L Brown (2012) Cervical dilation as a predictor of pregnancy outcome following emergency cerclage. 25(10), 1884-8. https://doi.org/10.3109/14767058.2012.668582
A Sundaresan, S De (2015) A Systematic Review of Elective, Urgent and Emergency Cervical Cerclage and Pregnancy Outcomes. 6(10), 1016–1024. https://doi.org/10.9734/BJMMR/2015/15574
S Gupta, G Kumari, V Taralekar (2023) Effect of elective cerclage versus rescue cerclage in pregnancy and its pregnancy outcome. 12(1), 240–243. https://doi.org/10.18203/2320-1770.Ijrcog202235
F Lugowski, J Babińska, K Jasak, K Pastwa, E Litwińska-Korcz, M Litwińska (2025) Comparison of Perinatal Outcomes Following Elective and Emergency Cerclage Insertion: A Ten-Year Retrospective Cohort Study. 14(10), 3515. https://doi.org/10.3390/jcm14103515
A Jaworowski, J Jurga, H Huras, A Gałaś, G Mierzwa, A Stasiak, M Kołak (2025) Pregnancy outcomes following history- and ultrasound-indicated cervical cerclage: a 10-year retrospective cohort study from a tertiary center. 24(2), 113-119. https://doi.org/10.5114/pm.2025.152085
A Jafarzade, S Aghayeva, T M Mungan, A Biri, E Jabiyev, O U Ekiz (2024) Perinatal outcomes of emergency and elective cervical cerclages. 21, 100276. https://doi.org/10.1016/j.eurox.2023.100276
D He, D Zhao (2022) Analysis of the timing of cervical cerclage treatment in pregnant women with cervical insufficiency and the effect on pregnancy outcome. https://doi.org/10.1155/2022/8340009
M N Han, B E O'Donnell, M M Maykin, J M Gonzalez, K Tabsh, S L Gaw (2019) The impact of cerclage in twin pregnancies on preterm birth rate before 32 weeks. 32(13), 2143-2151. https://doi.org/10.1080/14767058.2018.1427719
C Li, J Shen, K Hua (2019) Cerclage for women with twin pregnancies: a systematic review and metaanalysis. 220(6), 543-557.e1. https://doi.org/10.1016/j.ajog.2018.11.1105
M Barbosa, R Bek Helmig, L Hvidman (2019) Twin pregnancies treated with emergency or ultrasound-indicated cerclage to prevent preterm births. https://doi.org/10.1080/14767058.2019.1570119
S Sultan, S S Fatima, Khubroo (2024) Mode and success rate of delivery of live births following emergency cervical cerclage. https://doi.org/10.54112/bcsrj.v2024i1.850
Wafi A, Faron G, Parra J, Gucciardo L (2018) Influence of cervical cerclage interventions upon the incidence of neonatal death: a retrospective study comparing prophylactic versus rescue cerclages. 10(1), 29-36.
Shalini, Meena U, Malsri R (2021) Obstetric outcome after emergency cervical cerclage: A prospective observational study performed in CSI Kalyani hospital, Chennai. 8(1), 66-69. https://doi.org/10.18231/j.ijogr.2021.013
Hulshoff CC, Bosgraaf RP, Spaanderman MEA, Inthout J, Scholten RR, Van Drongelen J (2023) The efficacy of emergency cervical cerclage in singleton and twin pregnancies: a systematic review with meta-analysis. 5(7), 100971. https://doi.org/10.1016/j.ajogmf.2023.100971
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Authors and Global Journals Private Limited
This work is licensed under a Creative Commons Attribution 4.0 International License.
