{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:54:12Z","timestamp":1791561252331,"version":"4.3.4"},"reference-count":17,"publisher":"Walter de Gruyter GmbH","issue":"8","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2026-0202_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate maternal and neonatal outcomes after prophylactic and ultrasound-indicated emergency cervical cerclage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2026-0202_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included all the women who underwent McDonald cervical cerclage at a tertiary medical center during 2010\u20132024 and delivered at\u00a0\u226523\u00a0weeks. Women were categorized according to the clinical timing and urgency of cerclage placement: prophylactic cerclage, placed electively based on obstetric history before cervical change was detected; and ultrasound-indicated emergency cerclage, performed for ultrasound-detected cervical shortening in the absence of contractions, bleeding, ruptured membranes, or physical examination\u2013detected cervical dilation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2026-0202_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cerclage was performed earlier in the prophylactic (n=127) than the emergency (n=52) group (14.1\u00a0\u00b1\u00a01.2 vs. 18.4\u00a0\u00b1\u00a03.2\u00a0weeks, p&lt;0.001). Significant differences were not observed between the groups in the mean gestational age at cerclage removal (37.1\u00a0\u00b1\u00a03.4 vs. 37.2\u00a0\u00b1\u00a03.4\u00a0weeks, p=0.614) or\u00a0the mean gestational age at delivery (38.0\u00a0\u00b1\u00a03.2 vs. 37.0\u00a0\u00b1\u00a03.6\u00a0weeks, p=0.885). Nor did the proportions differ significantly of spontaneous preterm birth &lt;37\u00a0weeks (18.1 vs. 19.2\u202f%, p=1.00) or &lt;32\u00a0weeks (7.1 vs. 5.8\u202f%, p=1.000). Neonatal outcomes, including birthweight, admission to the neonatal intensive care unit, respiratory complications, and\u00a0neonatal mortality, were comparable. Multivariable analysis confirmed that cerclage, whether prophylactic or emergency, was not independently associated with spontaneous preterm birth &lt;37\u00a0weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2026-0202_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Emergency cerclage was not associated with worse maternal and neonatal outcomes compared with prophylactic cerclage in this cohort, suggesting that, in selected patients, it may be a reasonable management approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2026-0202","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:55:31Z","timestamp":1787216131000},"page":"1297-1304","source":"Crossref","is-referenced-by-count":0,"title":["Maternal and neonatal outcomes after prophylactic and ultrasound-indicated emergency cervical cerclage"],"prefix":"10.1515","volume":"54","author":[{"given":"Maya Frank","family":"Wolf","sequence":"first","affiliation":[{"name":"Raya Strauss Wing of Obstetrics and Gynecology, Galilee Medical Center , Nahariya , Israel"},{"name":"Azrieli Faculty of Medicine, Bar Ilan University , Safed , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Levine","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine, Bar Ilan University , Safed , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liron","family":"Kinog","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine, Bar Ilan University , Safed , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ala","family":"Aiob","sequence":"additional","affiliation":[{"name":"Raya Strauss Wing of Obstetrics and Gynecology, Galilee Medical Center , Nahariya , Israel"},{"name":"Azrieli Faculty of Medicine, Bar Ilan University , Safed , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lior","family":"Lowenstein","sequence":"additional","affiliation":[{"name":"Raya Strauss Wing of Obstetrics and Gynecology, Galilee Medical Center , Nahariya , Israel"},{"name":"Azrieli Faculty of Medicine, Bar Ilan University , Safed , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwan","family":"Odeh","sequence":"additional","affiliation":[{"name":"Raya Strauss Wing of Obstetrics and Gynecology, Galilee Medical Center , Nahariya , Israel"},{"name":"Azrieli Faculty of Medicine, Bar Ilan University , Safed , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5270-8436","authenticated-orcid":false,"given":"Inshirah","family":"Sgayer","sequence":"additional","affiliation":[{"name":"Raya Strauss Wing of Obstetrics and Gynecology, Galilee Medical Center , Nahariya , Israel"},{"name":"Azrieli Faculty of Medicine, Bar Ilan University , Safed , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"2026100915172389824_j_jpm-2026-0202_ref_001","doi-asserted-by":"crossref","unstructured":"Eleje, GU, Eke, AC, Ikechebelu, JI, Ezebialu, IU, Okam, PC, Ilika, CP. Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton pregnancies. Cochrane Database Syst Rev 2020;9:CD012871. https:\/\/doi.org\/10.1002\/14651858.CD012871.pub2.","DOI":"10.1002\/14651858.CD012871.pub2"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_002","doi-asserted-by":"crossref","unstructured":"ACOG practice bulletin no. 142: cerclage for the management of cervical insufficiency. Obstet Gynecol 2014;123:372\u20139. https:\/\/doi.org\/10.1097\/01.AOG.0000443276.68274.cc.","DOI":"10.1097\/01.AOG.0000443276.68274.cc"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_003","doi-asserted-by":"crossref","unstructured":"Prediction and prevention of spontaneous preterm birth: ACOG practice bulletin, number 234. Obstet Gynecol 2021;138:e65\u201390. https:\/\/doi.org\/10.1097\/AOG.0000000000004479.","DOI":"10.1097\/AOG.0000000000004479"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_004","doi-asserted-by":"crossref","unstructured":"Hulshoff, CC, Bosgraaf, RP, Spaanderman, MEA, Inthout, J, Scholten, RR, van Drongelen, J. The efficacy of emergency cervical cerclage in singleton and twin pregnancies: a systematic review with meta-analysis. Am J Obstet Gynecol MFM 2023;5:100971. https:\/\/doi.org\/10.1016\/j.ajogmf.2023.100971.","DOI":"10.1016\/j.ajogmf.2023.100971"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_005","doi-asserted-by":"crossref","unstructured":"Wierzchowska-Opoka, M, Kimber-Trojnar, \u017b, Leszczy\u0144ska-Gorzelak, B. Emergency cervical cerclage. J\u00a0Clin Med 2021;10:1270. https:\/\/doi.org\/10.3390\/jcm10061270.","DOI":"10.3390\/jcm10061270"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_006","doi-asserted-by":"crossref","unstructured":"van Dijk, CE, Breuking, SH, Jansen, S, Limpens, JCEJM, Kazemier, BM, Pajkrt, E. Perioperative complications of a transvaginal cervical cerclage in singleton pregnancies: a systematic review and meta-analysis. Am J Obstet Gynecol 2023;228:521\u201334.e19. https:\/\/doi.org\/10.1016\/j.ajog.2022.10.026.","DOI":"10.1016\/j.ajog.2022.10.026"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_007","doi-asserted-by":"crossref","unstructured":"Mor, M, Levi, A, Rafaeli-Yehudai, T, Ezratty, J, Shiber, Y, Smorgick, N, et al.. Should it really be called a heroic cerclage? The obstetrical results of emergency late second-trimester cerclage compared with early history-indicated elective cerclage: a retrospective trial. Arch Gynecol Obstet 2024;310:1121\u20139. https:\/\/doi.org\/10.1007\/s00404-023-07224-0.","DOI":"10.1007\/s00404-023-07224-0"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_008","doi-asserted-by":"crossref","unstructured":"Nelson, L, Dola, T, Tran, T, Carter, M, Luu, H, Dola, C. Pregnancy outcomes following placement of elective, urgent and emergent cerclage. J\u00a0Matern Fetal Neonatal Med 2009;22:269\u201373. https:\/\/doi.org\/10.1080\/14767050802613199.","DOI":"10.1080\/14767050802613199"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_009","doi-asserted-by":"crossref","unstructured":"Chen, Q, Chen, G, Li, N. Clinical effect of emergency cervical cerclage and\u00a0elective cervical cerclage on pregnancy outcome in cervical-incompetent pregnant women. Arch Gynecol Obstet 2018;297:401\u20137. https:\/\/doi.org\/10.1007\/s00404-017-4602-7.","DOI":"10.1007\/s00404-017-4602-7"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_010","doi-asserted-by":"crossref","unstructured":"Guzman, ER, Forster, JK, Vintzileos, AM, Ananth, CV, Walters, C, Gipson, K. Pregnancy outcomes in women treated with elective versus ultrasound-indicated cervical cerclage. Ultrasound Obstet Gynecol 1998;12:323\u20137. https:\/\/doi.org\/10.1046\/j.1469-0705.1998.12050323.x.","DOI":"10.1046\/j.1469-0705.1998.12050323.x"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_011","doi-asserted-by":"crossref","unstructured":"Khan, MJ, Ali, G, Al Tajir, G, Sulieman, H. Evaluation of outcomes associated with placement of elective, urgent, and emergency cerclage. J\u00a0Obstet Gynaecol India 2012;62:660\u20134. https:\/\/doi.org\/10.1007\/s13224-012-0233-x.","DOI":"10.1007\/s13224-012-0233-x"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_012","doi-asserted-by":"crossref","unstructured":"Shennan, AH. Story L; Royal College of Obstetricians, Gynaecologists. Cervical cerclage: green-Top guideline no. 75. BJOG 2022;129:1178\u2013210. https:\/\/doi.org\/10.1111\/1471-0528.17003. Erratum in: BJOG 2024;131(4):526. 10.1111\/1471-0528.17735.","DOI":"10.1111\/1471-0528.17003"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_013","doi-asserted-by":"crossref","unstructured":"Oh, KJ, Romero, R, Park, JY, Lee, J, Conde-Agudelo, A, Hong, JS, et al.. Evidence that antibiotic administration is effective in the treatment of a subset of patients with intra-amniotic infection\/inflammation presenting with cervical insufficiency. Am J Obstet Gynecol 2019;221:140.e1\u2013140.e18. https:\/\/doi.org\/10.1016\/j.ajog.2019.03.017.","DOI":"10.1016\/j.ajog.2019.03.017"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_014","doi-asserted-by":"crossref","unstructured":"Aubin, AM, McAuliffe, L, Williams, K, Issah, A, Diacci, R, McAuliffe, JE, et al.. Combined vaginal progesterone and cervical cerclage in the prevention of preterm birth: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2023;5:101024. https:\/\/doi.org\/10.1016\/j.ajogmf.2023.101024.","DOI":"10.1016\/j.ajogmf.2023.101024"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_015","doi-asserted-by":"crossref","unstructured":"Tolosa, JE, Boelig, RC, Bell, J, Mart\u00ednez-Baladejo, M, Stoltzfus, J, Mateus, J, et al.. IC-CLEAR: international collaborative for cerclage longitudinal evaluation and research. Concurrent progestogen and cerclage to reduce preterm birth: a multicenter international retrospective cohort. Am J Obstet Gynecol MFM 2024;6:101351. https:\/\/doi.org\/10.1016\/j.ajogmf.2024.101351.","DOI":"10.1016\/j.ajogmf.2024.101351"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_016","doi-asserted-by":"crossref","unstructured":"Smith, J, DeFranco, EA. Tocolytics used as adjunctive therapy at the time\u00a0of cerclage placement: a systematic review. J\u00a0Perinatol 2015;35:561\u20135. https:\/\/doi.org\/10.1038\/jp.2015.38.","DOI":"10.1038\/jp.2015.38"},{"key":"2026100915172389824_j_jpm-2026-0202_ref_017","doi-asserted-by":"crossref","unstructured":"Delatorre, E, Provinciatto, H, Rolo, LC, Araujo J\u00fanior, E. Antibiotics and indomethacin as perioperative management for cerclage: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2025;304:104\u20138. https:\/\/doi.org\/10.1016\/j.ejogrb.2024.11.036.","DOI":"10.1016\/j.ejogrb.2024.11.036"}],"container-title":["Journal of Perinatal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2026-0202\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2026-0202\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:20:34Z","timestamp":1791559234000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2026-0202\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,20]]},"references-count":17,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,25]]},"published-print":{"date-parts":[[2026,10,26]]}},"alternative-id":["10.1515\/jpm-2026-0202"],"URL":"https:\/\/doi.org\/10.1515\/jpm-2026-0202","relation":{},"ISSN":["0300-5577","1619-3997"],"issn-type":[{"value":"0300-5577","type":"print"},{"value":"1619-3997","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,20]]}}}