{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T12:52:47Z","timestamp":1791031967412,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cervical cerclage is conventionally classified as history\u2010indicated, ultrasound\u2010indicated, or examination\u2010indicated cerclage, the latter often performed as emergency cervical cerclage. These categories remain clinically useful because they describe common pathways of risk recognition, surveillance, intervention, and rescue. However, they are sometimes interpreted as biologically uniform or sequential stages of cervical insufficiency. This narrative review examines the historical and diagnostic basis of the conventional classification and focuses on its limitations for describing emergency cerclage. The three categories can also be understood as reflecting how and when cervical vulnerability becomes detectable: through antecedent obstetric history, sonographic cervical change, or physical examination findings. This interpretation does not diminish the importance of obstetric history or imply that ultrasound surveillance should delay preventive intervention. Rather, history and surveillance are complementary routes to timely recognition. In emergency cerclage, indication labels alone do not describe membrane exposure or prolapse, membrane reducibility, residual cervical tissue, procedural feasibility, or operative configuration. Therefore, we propose retaining the established indication\u2010based classification while supplementing it with structured reporting of detection timing and operative context. This reporting approach might improve interpretation and comparability of emergency cerclage studies without replacing established clinical terminology.<\/jats:p>","DOI":"10.1002\/ijgo.71385","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T11:59:22Z","timestamp":1791028762000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reinterpreting cervical cerclage classification: Diagnostic detection and operative context"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2132-0295","authenticated-orcid":false,"given":"Yong\u2010Jin","family":"Park","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Cervical Insufficiency Center Dongtan Jeil Women's Hospital  Hwaseong Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0890-0259","authenticated-orcid":false,"given":"Moon\u2010Il","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Cervical Insufficiency Center Dongtan Jeil Women's Hospital  Hwaseong Republic of Korea"},{"name":"Department of Obstetrics and Gynecology Hanyang University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,3]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008991.pub3"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2025.101727"},{"key":"e_1_2_13_4_1","unstructured":"Royal College of Obstetricians and Gynaecologists.Cervical Cerclage. Green\u2010top Guideline No. 75. London: RCOG2023."},{"key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1097\/01.AOG.0000443276.68274.cc","article-title":"Practice bulletin No. 142: Cerclage for the management of cervical insufficiency","volume":"123","author":"American College of Obstetricians and Gynecologists","year":"2014","journal-title":"Obstet Gynecol"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2024.05.006"},{"key":"e_1_2_13_7_1","unstructured":"National Institute for Health and Care Excellence.Preterm labour and birth. NICE Guideline NG25. London: NICE2015. Updated 2019 2022. 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