Extending the pregnancy from pre-viable to viable, the place of emergency cerclage.

Abstract

Emergency cervical cerclage is a critical intervention performed during the second trimester of pregnancy. Unlike elective cerclage performed prophylactically in early pregnancy, emergency cerclage is placed reactively in the presence of advanced cervical changes, often with exposed membranes, aiming to prolong pregnancy beyond viability. This case series retrospectively analyzed the outcomes of five patients who underwent emergency cervical cerclage for advanced cervical dilatation between January 1, 2025, and June 31, 2025. The mean pregnancy extension was 64 days, ranging from 5 to 143 days. Outcomes depended on factors such as the timing of the intervention, the type of suture material used, and the patient's clinical presentation. Two patients required a repeat cerclage. Of the five patients who underwent emergency cervical cerclage, four resulted in live births, while one case was complicated by a second-trimester pregnancy loss despite the intervention. This case series highlights the importance of timely diagnosis, appropriate patient selection, and meticulous surgical technique in optimizing outcomes following emergency cerclage. Despite the limited sample size, early intervention is a key factor in improving gestational prolongation and neonatal survival.