Is cerclage safe and effective in preventing preterm birth in women presenting early in pregnancy with cervical dilatation

### What you need to know Preterm birth and its complications account for nearly one million neonatal deaths each year globally.1 Women who present with a dilated cervix in the second trimester are at increased risk of pregnancy loss and preterm birth (fig 1). They generally have no or minimal preceding symptoms such as change in discharge or mild abdominal pain and are detected to have a dilated cervix on examination. Cervical dilatation may also be detected in the anomaly scan. Fig 1 Premature cervical dilatation and exposed unruptured fetal membranes International guidelines from the US, UK, and Canada suggest considering emergency cervical cerclage, or rescue cerclage, to prevent preterm birth in women presenting with cervical dilatation and exposed fetal membranes between 16 and 28 weeks of gestation if there are no signs of bleeding, infection, or uterine activity (see box 1).2 Box 1 ### NICE guidelines for management of preterm labour and birth (NG25)2 #### Women with a closed cervixRETURN TO TEXT