Perinatology.  2024 Jun;35(2):27-37. 10.14734/PN.2024.35.2.27.

Cervical Cerclage: What Is the Current Evidence?

• Oh Sy

• KMID: 2557566
• DOI: http://doi.org/10.14734/PN.2024.35.2.27

Abstract

During pregnancy, cervical incompetence has an incidence of approximately 0.5%, accounting for about 8% of mid-trimester miscarriages or stillbirths. Cervical cerclage is a crucial intervention to save fetuses at the periviable period, but it remains a contentious area due to insufficient evidence and susceptibility to selection bias. The American College of Obstetricians and Gynecologists’ guidelines from 2014 were not revised, while the United Kingdom updated its recommendations in 2022 based on the 2011 guidelines, and Canada revised its guidelines in 2019 from those issued in 2013. In 2021, the International Federation of Gynecology and Obstetrics emphasized the importance of evidencebased medicine and released recommendations for cervical cerclage surgery. This review aims to examine the evidence for cervical cerclage, focusing on indications, timing of the procedure, its application in twin pregnancies from the four international guidelines, and to update recent metaanalyses and clinical research results about cervical cerclage.

Keyword

Cervical incompetence; Cerclage; cervical; Guideline; Indication