{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:33:32Z","timestamp":1787016812403,"version":"build-2736575974"},"reference-count":12,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"unspecified","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,17]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>A woman in her mid-30s at 24+5 weeks of a dichorionic diamniotic twin pregnancy with single intrauterine fetal demise presented with simultaneous prolapse of both amniotic sacs into the vagina and a 3\u2009cm dilated cervix. She underwent ultrasound-guided amnioreduction and an emergency double McDonald cerclage using two Ethibond #2 sutures placed 1\u2009cm apart. The pregnancy was successfully prolonged to 36+5 weeks, resulting in caesarean delivery of a healthy neonate weighing 2220\u2009g and the demised co-twin. This case is unique, as it provides the first documented clinical and ultrasound images of simultaneous prolapse of both sacs in a twin pregnancy successfully managed by double cerclage.<\/jats:p>","DOI":"10.1136\/bcr-2025-270124","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T13:56:07Z","timestamp":1770299767000},"page":"e270124","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Emergency double McDonald cerclage in twin gestation with single fetal death and simultaneous prolapse of both amniotic sacs"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0890-0259","authenticated-orcid":false,"given":"Moon-Il","family":"Park","sequence":"first","affiliation":[{"name":"Obstetrics, Dongtan Jeil Women\u2019s Hospital (Ringgold ID: 838046), Hwaseong-si, Gyeonggi-do, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2132-0295","authenticated-orcid":false,"given":"Yong-Jin","family":"Park","sequence":"additional","affiliation":[{"name":"Obstetrics, Dongtan Jeil Women\u2019s Hospital (Ringgold ID: 838046), Hwaseong-si, Gyeonggi-do, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"2026020505560059000_19.2.e270124.1","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.1111\/aogs.14255","article-title":"Emergency cervical cerclage in twin and singleton pregnancies with 0-mm cervical length or prolapsed membranes","volume":"100","author":"Freegard","year":"2021","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2026020505560059000_19.2.e270124.2","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-022-04438-z","article-title":"Successful delayed delivery of the second twin by evacuating the cord prolapsed first fetus and emergent cerclage: a report of 2 cases","volume":"22","author":"Park","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026020505560059000_19.2.e270124.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.06.054"},{"key":"2026020505560059000_19.2.e270124.4","first-page":"1407","article-title":"Clinical experience of 15 cases of modified McDonald cerclage using Beriplast in incompetent internal os of cervix","volume":"43","author":"Park","year":"2000","journal-title":"Korean J Obstet Gynecol"},{"key":"2026020505560059000_19.2.e270124.5","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.ajog.2014.07.022","article-title":"Use of a uniconcave balloon in emergency cerclage","volume":"212","author":"Son","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"2026020505560059000_19.2.e270124.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004266","article-title":"Cervical cerclage for prevention of preterm birth and adverse perinatal outcome in twin pregnancies with short cervical length or cervical dilatation: A systematic review and meta-analysis","volume":"20","author":"D\u2019Antonio","year":"2023","journal-title":"PLoS Med"},{"key":"2026020505560059000_19.2.e270124.7","unstructured":"Hulshoff AP , Oepkes D , Vis JY , et al . 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