Expectant management vs. cerclage in cases with prolapsed or visible membranes in the second trimester: is 24 weeks gestation threshold critical?

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dc.authorid0000-0002-4940-8862
dc.authorid0000-0002-6799-5909
dc.contributor.authorKole, Emre
dc.contributor.authorAkar, Bertan
dc.contributor.authorDogan, Yasemin
dc.contributor.authorYalcinkaya, Leylim
dc.contributor.authorDoger, Emek
dc.contributor.authorCaliskan, Eray
dc.date.accessioned2026-01-24T12:29:13Z
dc.date.available2026-01-24T12:29:13Z
dc.date.issued2024
dc.departmentAlanya Alaaddin Keykubat Üniversitesi
dc.description.abstractObjectives: The aim of this study was to compare the efficacy of cervical cerclage with spontaneous follow-up strategy on pregnancy duration and neonatal outcomes in women with visible or prolapsed fetal membranes. Methods: Patients who were referred to a single tertiary care centre between 1st January 2017 and 31st December 2022 were included in this comparative, retrospective cohort study. Patients were divided into two groups, those undergoing cerclage and those followed with no-cerclage. The range of pregnancy weeks for cerclage is between 18th and 27+6 weeks. Results: A total of 106 cases were reviewed and nine were excluded. Based on shared decision making, cervical cerclage was performed in 76 patients (78.3 %) and 21 patients (21.6 %) were medically treated in no-cerclage group if there was no early rupture of the fetal membranes. The gestational age at delivery was 29.8 +/- 6 [Median=30 (19-38)] weeks in the cerclage group and 25.8 +/- 2.9 [Median=25 (19-32)] weeks in the no-cerclage group (p=0.004). Pregnancy prolongation was significantly longer in the cerclage group compared to the no-cerclage group (55 +/- 48.6 days [Median=28 (3-138)] vs. 12 +/- 17.9 days [Median=9 (1-52)]; p<0.001). Take home baby rate was 58/76 (76.3 %) in cerclage group vs. 8/21 (38 %) in no-cerclage group. In the post-24 week cerclage group the absolute risk reduction for pregnancy loss was 50 % (95 % CI=21.7-78.2). Conclusions: Cervical cerclage applied before and after 24 weeks (until 27+6 weeks) increased take home baby rate in women with visible or prolapsed fetal membranes without increasing adverse maternal outcome when compared with no-cerclage group.
dc.identifier.doi10.1515/jpm-2024-0049
dc.identifier.endpage711
dc.identifier.issn0300-5577
dc.identifier.issn1619-3997
dc.identifier.issue7
dc.identifier.pmid38890768
dc.identifier.scopus2-s2.0-85196496275
dc.identifier.scopusqualityQ2
dc.identifier.startpage706
dc.identifier.urihttps://doi.org/10.1515/jpm-2024-0049
dc.identifier.urihttps://hdl.handle.net/20.500.12868/5214
dc.identifier.volume52
dc.identifier.wosWOS:001250317400001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherWalter De Gruyter Gmbh
dc.relation.ispartofJournal of Perinatal Medicine
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WoS_20260121
dc.subjectcervical incompetence
dc.subjectcervical cerclage
dc.subjectcervical dilatation
dc.subjectpreterm labor
dc.subjectprolapsed fetal membranes
dc.titleExpectant management vs. cerclage in cases with prolapsed or visible membranes in the second trimester: is 24 weeks gestation threshold critical?
dc.typeArticle

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