Investigating the Successful Emergency Cerclage by Double-suture Method in the Presence of Prolapsed Amniotic Membrane: Case Series

Background: premature childbirth is the most common cause of neonatal morbidity and mortality. cervical insufficiency is not an all-or-none phenomenon; however, it is a continuous variable that can contribute to preterm deliveries at different gestational ages. an emergency cerclage is recommended for those suffering from cervical incompetence with prolapsed membranes before 24 weeks of gestation. objective: the objective of this study is to assess the efficacy and outcomes of emergency cervical cerclage using the double-suture technique in women with advanced cervical insufficiency and prolapsed amniotic membranes, presenting in the late second trimester, with the aim of providing insights into its effectiveness in preventing preterm deliveries and improving neonatal outcomes. methods: this is a case series study on eight women treated with cervical cerclage presented in the late second trimester with advanced cervical insufficiency for whom the emergency cervical cerclage by a double-suture technique was conducted from september 2021 to february 2022 in kowsar and mehregan hospitals in qazvin city, iran. women with a gestational age of 18 to 24 weeks, a prolapsed amniotic membrane, and cervical dilatation (greater than 3 to 4 cm) on the speculum test met the inclusion criteria. the exclusion criteria were pregnancy with twins, previous failure cerclage, preterm rupture of membrane, and clinical or biological signs of infection. this study aimed to report the outcome with emergency cerclage by double-suture method. findings: cerclage was placed in eight women at a mean gestational age of 19.4 weeks. the average gestational age of delivery was 36.4 weeks of gestation by normal delivery. conclusion: the findings demonstrated that the double-suture method provides better cervical support in high-risk women for preterm birth and second-trimester loss. nevertheless, this procedure requires a trained surgical team and operator. given the small sample size of our study, it would be more informative if this study was carried out on a wider population sample and compared to other procedures of rescue cerclage.