Incompetence Cervix is Associated to 2nd Trimester Pregnancy Losses

Question: Please what your view on cervical cerclage for IVF pregnancies. I am 13w pregnant with twins and I am being asked to have a cervical cerclage. I have had my cervix measured and it was 3.2cm. Do I really need a cerclage?

Doctors Response:

Cervical cerclage is a surgical procedure for managing incompetent cervix. A cervix is said to be incompetent if it can not carried pregnancy to term. In other words, incompetent cervix is a associated with preterm delivery and 2nd trimester pregnancy losses. So to avoid this, cervical cerclage is done.

Evidence based medicine says that a cerclage is needed only if there is an indication viz-a-viz a cervix less than 2.5cm or previous mid trimester pregnancy loss which was associated with painless rupture fetal membrane. However, most gynecologists and fertility experts in our region will carry out the procedure for twin gestation as a prophylactic step to prevent such occurrence.

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