EC Gynaecology

Objective: To ascertain and compare the gestation at delivery for high-risk women with a cervical cerclage in situ, and to report the duration of pregnancy after cerclage, by type and cerclage indication.

Methods: Retrospective case-series in a single tertiary maternity hospital preterm birth surveillance clinic (PSC), between January 2019 and December 2022.

Results: Overall, 96 women who underwent cervical cerclage met the inclusion criteria, including 81 vaginal cerclages and 15 abdominal cerclages. History-indicated cerclages were inserted at a significantly earlier median gestation than ultrasound-indicated cerclages (14+2 weeks vs 20+1 weeks, p < 0.001), and had a significantly longer duration of use (23+0 vs 16+1 weeks, p < 0.001). Women with ultrasound-indicated cerclages had significantly shorter pre-cerclage cervical lengths compared to those with history indicated cerclages (p < 0.001), but did not deliver significantly earlier than in the history-indicated group (37+6 vs 38+2, p = 0.208 or experience more preterm births (9.3% vs 12.5%, p = 0.214)). Abdominal cerclages were predominately inserted pre-conceptually (66.7%, n = 10). The median gestation at delivery was significantly later for transvaginal compared to transabdominal groups (38+2 vs 37+2, p = 0.028). There was no significant difference in preterm birth rates between transvaginal and transabdominal cerclage groups (21.0% vs 13.3%, p = 0.931).

Conclusion: In this cohort, there was no significant difference in preterm birth rates between transabdominal and transvaginal cerclages. Despite significantly shorter pre-cerclage cervical lengths, women with ultrasound-indicated cerclages also did not experience more preterm births compared to those with history-indicated cerclages.

 Keywords: Preterm Birth; Prematurity; Cervical Cerclage; High-Risk; Short Cervix; Pregnancy Outcomes

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