Emergency Cerclage Placement in Multifetal Pregnancies with a Dilated Cervix and Exposed Membranes: Case Series

Abstract

Pregnancies complicated by midtrimester painless cervical dilation are known to have associations with preterm birth. In situations where fetal amniotic membranes are exposed, the risk of perinatal morbidity and mortality increases dramatically in this particularly high-risk population. Multifetal gestations further increase the risk of preterm birth, yet there remains a paucity of data supporting therapeutic intervention for these patients. We report a case series of 12 multifetal gestations with painless cervical dilation and exposed fetal membranes that underwent emergency cerclage placement. Pregnancy prolongation was achieved on average 60.25 days with 76.9% neonatal survival. These findings are suggestive that emergency cerclage may be a beneficial treatment in this unique patient population.