International Journal of Clinical Obstetrics and Gynaecology

Objective: To share my experience of the five patients with cervical insufficiency, open cervix, and bulging membranes into the vagina, which I had between 2015 and 2019. All managed with a Rescue Cervical Cerclage (RCC) procedure.
Methods: The study includes anonymous brief information about the five patients with the above condition, covering their ethnicities, ages, body mass index (BMI), previous obstetrical and medical histories, laboratory and ultrasonography results, physical examination findings, rescue cervical cerclage procedures, and their care during the index pregnancy, as well as the outcome of this pregnancy.
Results: The average age of patients in this study was 28.8, ranging from 20 to 34 years. One patient had a significant obstetrical history with a previous cervical surgery and a previous pregnancy loss. The rescue cervical cerclage procedure was performed at an average age of 20 weeks of gestation and 3 days. The cerclage suture was removed at an average age of 34 weeks and 3 days of gestation. The average time of delivery was 35 weeks and 2 days of gestation. Sadly, one patient experienced an intra-uterine foetal demise (IUFD) at 32 weeks and 2 days of gestation. On average, rescue cervical cerclage prolonged pregnancy by 109 days (15 weeks and 4 days). The longest duration was 138 days (19 weeks and 5 days), and the shortest duration was 89 days (12 weeks and 5 days). The take-home baby rate was 80%, with the rescue cervical cerclage being successful in bringing the foetus to viability and beyond extreme prematurity in all cases.
Conclusion: Rescue cervical cerclage is a recommendable option for patients with cervical insufficiency, open cervix and bulging membranes into the vagina, provided there are no clear contraindications like active labour, bleeding, premature Preterm Rupture of Membranes (PPROM) and infection. These pregnancies remain at high risk and should receive ongoing specialist care.