{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T19:18:31Z","timestamp":1788808711787,"version":"build-2803163510"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T00:00:00Z","timestamp":1713830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T00:00:00Z","timestamp":1713830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007765","name":"Shenyang Science and Technology Bureau","doi-asserted-by":"crossref","award":["21-173-9-15"],"award-info":[{"award-number":["21-173-9-15"]}],"id":[{"id":"10.13039\/501100007765","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cervical cerclage is the only effective treatment for cervical insufficiency, effectively preventing late miscarriage and preterm birth. The effectiveness and safety of emergency cervical cerclage (ECC) as an emergency treatment when the cervix is already dilated or when there is protrusion of the fetal membranes into the vagina remain controversial, especially in pregnancies at 24\u201328\u00a0weeks when the fetus is viable. There is still no consensus on whether emergency cervical cerclage should be performed in such cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the effectiveness and safety of emergency cervical cerclage in singleton pregnant women at 24\u201328\u00a0weeks of gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study employed a single-center prospective cohort design, enrolling singleton pregnant women at 24\u201328\u00a0weeks of gestation with ultrasound or physical examination indicating cervical dilation or even membrane protrusion. Emergency cervical cerclage was compared with conservative treatment. The primary endpoints included a comprehensive assessment of perinatal pregnancy loss, significant neonatal morbidity, and adverse neonatal outcomes. Secondary endpoints included prolonged gestational age, preterm birth, neonatal hospitalization rate, premature rupture of membranes, and intrauterine infection\/chorioamnionitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From June 2021 to March 2023, a total of 133 pregnant women participated in this study, with 125 completing the trial, and were allocated to either the Emergency Cervical Cerclage (ECC) group (72 cases) or the conservative treatment group (53 cases) based on informed consent from the pregnant women. The rate of adverse neonatal outcomes was 8.33% in the ECC group and 26.42% in the conservative treatment (CT) group, with a statistically significant difference (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.06). There were no significant differences between the two groups in terms of perinatal pregnancy loss and significant neonatal morbidity. The conservative treatment group had a mean prolonged gestational age of 63.0 (23.0, 79.5) days, while the ECC group had 84.0 (72.5, 89.0) days, with a statistically significant difference between the two groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Compared with CT group, the ECC group showed a significantly reduced incidence of preterm birth before 28\u00a0weeks, 32\u00a0weeks, and 34\u00a0weeks, with statistical significance (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.046, 0.007, 0.001), as well as a significantly decreased neonatal hospitalization rate (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.013, 0.031). Additionally, ECC treatment did not increase the risk of preterm premature rupture of membranes or intrauterine infection\/chorioamnionitis, with no statistically significant differences (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.406, 0.397).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In singleton pregnant women with cervical insufficiency at 24\u201328\u00a0weeks of gestation, emergency cervical cerclage can reduce adverse neonatal pregnancy outcomes, effectively prolong gestational age, decrease preterm births before 28\u00a0weeks, 32\u00a0weeks, and 34\u00a0weeks, lower neonatal hospitalization rates, and does not increase the risk of preterm premature rupture of membranes or intrauterine infection\/chorioamnionitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-024-07493-3","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T23:50:51Z","timestamp":1713829851000},"page":"229-235","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Analysis of perinatal outcomes for emergency cervical cerclage in singleton pregnancies at 24\u201328\u00a0weeks of gestation"],"prefix":"10.1007","volume":"310","author":[{"given":"Xiling","family":"Yi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2556-9782","authenticated-orcid":false,"given":"Jing","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyan","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hengyu","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianping","family":"Cong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengli","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,23]]},"reference":[{"issue":"1","key":"7493_CR1","doi-asserted-by":"publisher","first-page":"e37","DOI":"10.1016\/S2214-109X(18)30451-0","volume":"7","author":"S Chawanpaiboon","year":"2019","unstructured":"Chawanpaiboon S, Vogel JP, Moller AB et al (2019) Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health 7(1):e37\u2013e46","journal-title":"Lancet Glob Health"},{"issue":"10063","key":"7493_CR2","doi-asserted-by":"publisher","first-page":"3027","DOI":"10.1016\/S0140-6736(16)31593-8","volume":"388","author":"L Liu","year":"2019","unstructured":"Liu L, Oza S, Hogan D et al (2019) Global, regional, and national causes of under-5 mortality in 2000\u201315: an updated systematic analysis with implications for the sustainable development goals. Lancet 388(10063):3027\u20133035","journal-title":"Lancet"},{"key":"7493_CR3","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008991.pub3","author":"Z Alfirevic","year":"2017","unstructured":"Alfirevic Z, Stampalija T, Medley N (2017) Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy. Cochrane Database Syst Rev. https:\/\/doi.org\/10.1002\/14651858.CD008991.pub3","journal-title":"Cochrane Database Syst Rev"},{"issue":"6","key":"7493_CR4","first-page":"1270","volume":"10","author":"OM Wierzchowska","year":"2021","unstructured":"Wierzchowska OM, Kimber TZ, Leszczy\u0144ska GB et al (2021) Emergency cervical cerclage. Clin Med 10(6):1270","journal-title":"Clin Med"},{"key":"7493_CR5","unstructured":"Queensland Health (2020) Queensland clinical guidelines: preterm labour and birth. Guideline No. MN20.6-V9-R25. www.health.qld.gov.au\/qcg"},{"issue":"39","key":"7493_CR6","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1159\/000433465","volume":"2","author":"M Rius","year":"2016","unstructured":"Rius M, Cobo T, Garc\u00eda-Posadas R, Hern\u00e1ndez S et al (2016) Emergency cerclage: improvement of outcomes by standardization of management. Fetal Diagn Ther 2(39):134\u2013139","journal-title":"Fetal Diagn Ther"},{"issue":"4","key":"7493_CR7","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1034\/j.1600-0412.2000.079004265.x","volume":"79","author":"A Caruso","year":"2000","unstructured":"Caruso A, Trivellini C, Carolis SD, Paradisi G et al (2000) Emergency cerclage in the presence of protruding membranes: is pregnancy outcome predictable? Acta Obstet Gynecol Scand 79(4):265\u2013268","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"1","key":"7493_CR8","doi-asserted-by":"publisher","first-page":"80","DOI":"10.3109\/14767058.2013.805196","volume":"27","author":"Y \u00c7avus","year":"2014","unstructured":"\u00c7avus Y, Uysal A, Balsak D et al (2014) Emergency cervical cerclage: Effect on pregnancy outcome and mode of delivery. J Matern Fetal Neonatal Med 27(1):80\u201383","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"3","key":"7493_CR9","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1055\/s-2007-999307","volume":"9","author":"AG Mitra","year":"1992","unstructured":"Mitra AG, Katz VL, Bowes WA et al (1992) Emergency cerclages: a review of 40 consecutive procedures. Am J Perinatol 9(3):142\u2013145","journal-title":"Am J Perinatol"},{"issue":"5","key":"7493_CR10","doi-asserted-by":"publisher","first-page":"319","DOI":"10.14740\/jocmr2108w","volume":"7","author":"L Ciancimino","year":"2015","unstructured":"Ciancimino L, Lagan\u00e0 AS, Imbesi G et al (2015) Valuation of maternal-fetal outcomes after emergency vaginal cerclage performed with Shirodkar-Mcdonald combined modified technique. J Clin Med Res 7(5):319\u2013323","journal-title":"J Clin Med Res"},{"issue":"1","key":"7493_CR11","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.ejogrb.2007.11.009","volume":"139","author":"JH Stupin","year":"2008","unstructured":"Stupin JH, David M, Siedentopf JP et al (2008) Emergency cerclage versus bed rest for amniotic sac prolapse before 27 gestational weeks. A retrospective, comparative study of 161 women. Eur J Obstet Gynecol Reprod Biol 139(1):32\u201337","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"4","key":"7493_CR12","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1067\/S0002-9378(03)00718-X","volume":"189","author":"SM Althuisius","year":"2003","unstructured":"Althuisius SM, Dekker GA, Hummel P et al (2003) Cervical incompetence prevention randomized cerclage trial: cervical incompetence prevention randomized cerclage trial: emergency cerclage with bed rest versus bed rest alone. Am J Obstet Gynecol 189(4):907\u2013910","journal-title":"Am J Obstet Gynecol"},{"issue":"2","key":"7493_CR13","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1111\/jog.12207","volume":"40","author":"S Aoki","year":"2006","unstructured":"Aoki S, Ohnuma E, Kurasawa K et al (2006) Emergency cerclage versus expectant management for prolapsed fetal membranes: a retrospective, comparative study. J Obstet Gynaecol Res 40(2):381\u2013386","journal-title":"J Obstet Gynaecol Res"},{"key":"7493_CR14","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000187896.04535.e6","author":"G Daskalakis","year":"2006","unstructured":"Daskalakis G, Papantoniou N, Mesogitis S et al (2006) Management of cervical insufficiency and bulging fetal membranes. Obstet Gynecol. https:\/\/doi.org\/10.1097\/01.AOG.0000187896.04535.e6","journal-title":"Obstet Gynecol"},{"issue":"4","key":"7493_CR15","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1080\/01443615.2016.1268574","volume":"37","author":"M Bayrak","year":"2017","unstructured":"Bayrak M, Gul A, Goynumer G (2017) Rescue cerclage when foetal membranes prolapse into the vagina. J Obstet Gynaecol 37(4):471\u2013475","journal-title":"J Obstet Gynaecol"},{"issue":"13","key":"7493_CR16","doi-asserted-by":"publisher","first-page":"2088","DOI":"10.3109\/14767058.2015.1075202","volume":"29","author":"A Ciavattini","year":"2016","unstructured":"Ciavattini A, Carpini GD, Boscarato V et al (2016) Effectiveness of emergency cerclage in cervical insufficiency. J Matern Fetal Neonatal Med 29(13):2088\u20132092","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"5","key":"7493_CR17","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1590\/1806-9282.65.5.598","volume":"65","author":"MMF Costa","year":"2019","unstructured":"Costa MMF, Amorim Filho AG, Barros MF, Rodrigues AS et al (2019) Emergency cerclage: gestational and neonatal outcomes. Rev Assoc Med Braz 65(5):598\u2013602","journal-title":"Rev Assoc Med Braz"},{"issue":"1","key":"7493_CR18","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1097\/AOG.0000000000000850","volume":"126","author":"RM Ehsanipoor","year":"2015","unstructured":"Ehsanipoor RM, Seligman NS, Saccone G et al (2015) Physical examination-indicated cerclage: a systematic review and meta-analysis. Obstet Gynecol 126(1):125\u2013135","journal-title":"Obstet Gynecol"},{"issue":"11","key":"7493_CR19","doi-asserted-by":"publisher","first-page":"1444","DOI":"10.1111\/aogs.13968","volume":"99","author":"C Chatzakis","year":"2020","unstructured":"Chatzakis C, Efthymiou A, Sotiriadis A et al (2020) Emergency cerclage in singleton pregnancies with painless cervical dilatation: a meta-analysis. Acta Obstet Gynecol Scand 99(11):1444\u20131457","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"2","key":"7493_CR20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0278342","volume":"18","author":"Y Wei","year":"2023","unstructured":"Wei Y, Wang S (2023) Comparison of emergency cervical cerclage and expectant treatment in cervical insufficiency in singleton pregnancy: a meta-analysis. PLoS ONE 18(2):e0278342","journal-title":"PLoS ONE"},{"issue":"2","key":"7493_CR21","first-page":"170","volume":"80","author":"OA Olatunbosun","year":"1995","unstructured":"Olatunbosun OA, al-Nuaim L, Turnell RW (1995) Emergency cerclage compared with bed rest for advanced cervical dilatation in pregnancy. Int Surg 80(2):170\u2013174","journal-title":"Int Surg"},{"issue":"25","key":"7493_CR22","doi-asserted-by":"publisher","first-page":"5607","DOI":"10.1080\/14767058.2021.1888287","volume":"35","author":"LK Proctor","year":"2022","unstructured":"Proctor LK, Ronzoni S, Melamed N et al (2022) Amnioreduction with rescue cerclage at advanced cervical dilation or gestational age. J Matern Fetal Neonatal Med 35(25):5607\u20135610","journal-title":"J Matern Fetal Neonatal Med"},{"key":"7493_CR23","doi-asserted-by":"publisher","first-page":"4202","DOI":"10.12659\/MSM.916480","volume":"25","author":"Q Pang","year":"2019","unstructured":"Pang Q, Xiaoning J, Lei C (2019) Perinatal outcomes after emergency cervical cerclage for cervical insufficiency with prolapsed membranes. Med Sci Monit 25:4202\u20134206","journal-title":"Med Sci Monit"}],"container-title":["Archives of Gynecology and Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-024-07493-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00404-024-07493-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-024-07493-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T08:10:16Z","timestamp":1718179816000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00404-024-07493-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,23]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["7493"],"URL":"https:\/\/doi.org\/10.1007\/s00404-024-07493-3","relation":{},"ISSN":["1432-0711"],"issn-type":[{"value":"1432-0711","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,23]]},"assertion":[{"value":"9 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Shenyang Maternal and Child Health Hospital (2021.8.20.\/No.202129).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}