Rescue Cerclage by McDonald’s Technique at 18 Weeks for Cervical Insufficiency With Intravaginal Amniotic Sac: A Case Report

TL;DR

A woman with cervical insufficiency at 18 weeks underwent a rescue cerclage and had a successful pregnancy outcome.

Contribution

This case report demonstrates the effectiveness of emergency cerclage in managing advanced cervical insufficiency with intravaginal amniotic sac.

Findings

Rescue cerclage at 18 weeks extended gestational age and improved neonatal survival chances.

The procedure did not increase risks of chorioamnionitis or preterm rupture of membranes.

Successful pregnancy outcome was achieved following the intervention.

Abstract

Recurrent pregnancy loss, premature birth, and associated complications exhibit a multifactorial etiology and persist as substantial challenges during pregnancy, despite the notable advancements in the medical field. Among several factors, cervical insufficiency or incompetence emerges as a prominent causal factor, characterized by painless softening and shortening of the cervix associated with absent contractions. The implementation of emergency cerclage represents a pivotal intervention in mitigating preterm birth among individuals with advanced cervical insufficiency. By extending gestational age, this procedure increases the likelihood of neonatal survival without elevating the risk of chorioamnionitis or preterm rupture of the membranes. In this study, an antenatal woman presented with advanced changes in the cervix along with intravaginal bulging amniotic membranes at 18 weeks and underwent a rescue cervical cerclage, resulting in a successful pregnancy.

Figures