Insertion of a cerclage is done as a therapeutic measure to prevent preterm delivery.
Women with 3 or more previous preterm births <34 weeks (not twin/ triplets)
– Cervical stitch should be done at 12–14 weeks of gestation after first trimester ultrasound scan and screening for aneuploidy to ensure both viability, singleton pregnancy, and the absence of lethal/major fetal anomaly.
Women with 1 or more previous preterm birth or second trimester loss (16–34 weeks’ gestation) / not twin/ triplets
– Consult by Preterm prevention specialist by 12 weeks where possible, or with the dating scan whichever is sooner, and transvaginal cervix scanning as a secondary screening test every 2–4 weeks between 16 and 24 weeks.
– If cervical length 25mm or less, cerclage may be considered.
The insertion of cerclage in women with above conditions in multiple pregnancies is not recommended.
For women with a singleton pregnancy and no other risk factors for preterm birth, insertion of cervical cerclage is not recommended in women who have an incidentally identified short cervix.