# Late Cervical Cerclage at 30 Weeks of Gestation: A Case Report

## TL;DR

A woman received a late cervical cerclage at 30 weeks during her fourth pregnancy to prevent preterm birth, resulting in a successful full-term delivery.

## Contribution

The paper presents a case where late cervical cerclage beyond the typical 28-week cutoff was successfully used to avoid neonatal complications.

## Key findings

- Late cerclage placement at 30 weeks gestation was effective in prolonging pregnancy.
- The patient delivered a healthy baby at 35.5 weeks after cerclage removal.
- The case supports individualized assessment for cerclage placement beyond standard guidelines.

## Abstract

A 34-year-old woman was experiencing her fourth pregnancy, which was totally normal till she arrived at 29.1 weeks of gestation, beginning with uterine activity, which required hospitalization and was controlled with intravenous (IV) medication. Once discharged, in her follow-up appointment a week later, when she was 30.3 weeks, a cervical shortening was observed when the transvaginal ultrasound was made. This, in conjunction with her previous history of preterm birth, led to the decision to place a McDonald-type cerclage even when guidelines usually recommend the procedure before 28 weeks. When she was 35.5 weeks pregnant, she started with uterine activity, so it was decided to remove the cerclage and expect a natural delivery. She gave birth to a female baby without complications. What we want to highlight from the following clinical case is that it is valid to place a cerclage after week 28. Each case should be assessed individually; weeks of gestation do not appear to be an absolute contraindication, but signs of infection should be considered. Late cerclage placement should be considered in specific cases with the purpose of avoiding days at the neonatal intensive care unit, as neonatal comorbidities in well-selected cases.