EFFECT OF RESCUE CERVICAL CERCLAGE ON PREVENTION OF PRETERM BIRTH AND PERINATAL OUTCOMES

Abstract

Background: Preterm birth is a leading cause of neonatal morbidity and mortality worldwide, and cervical insufficiency is an important contributor to mid-trimester pregnancy loss and spontaneous preterm delivery. Rescue cervical cerclage is performed in women presenting with advanced cervical dilatation to prolong pregnancy and improve neonatal outcomes. This study evaluated the effect of rescue cervical cerclage on prevention of preterm birth and perinatal outcomes.

Methods: This prospective quasi-experimental study was conducted at the Department of Obstetrics and Gynaecology, Ayub Teaching Hospital Abbottabad, Pakistan, from January to December 2025. A total of 137 women with singleton pregnancies between 16–24 weeks of gestation presenting with painless cervical dilatation ≥1 cm underwent rescue cervical cerclage using the McDonald technique. Maternal and neonatal outcomes were recorded and analyzed using SPSS version 26, with p ≤ 0.05 considered statistically significant.

Results: The mean gestational age at cerclage was 20.4 ± 2.1 weeks and the mean cervical dilatation was 2.1 ± 0.6 cm. The mean cerclage-to-delivery interval was 14.8 ± 4.6 weeks, while the mean gestational age at delivery was 35.2 ± 3.9 weeks. Term delivery occurred in 32.8% of cases. The neonatal survival rate was 87.6% with a mean birth weight of 2.32 ± 0.61 kg. Cervical dilatation at the time of cerclage showed a significant association with gestational age at delivery (p < 0.001) and neonatal survival (p = 0.003).

Conclusion: Rescue cervical cerclage can significantly prolong pregnancy and improve neonatal survival in women with mid-trimester cervical dilatation. Early intervention is associated with better perinatal outcomes, although prematurity-related complications remain common.