{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T15:59:59Z","timestamp":1775491199565,"version":"3.50.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T00:00:00Z","timestamp":1743984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>In a woman who received cerclage in the previous pregnancy, obstetricians were highly likely to perform this surgery in her subsequent pregnancy. However, many researchers have advocated against the use of repeat cerclage. The objective of this study was to evaluate the effectiveness of repeat cerclage in managing the subsequent pregnancy for participants with a history of cervical cerclage. We retrospectively collected data from patients who had a history of cervical cerclage and received repeat cerclage in the subsequent pregnancy. A self-controlled comparative analysis was undertaken to evaluate the differences in baseline characteristics and pregnancy outcomes between the initial cerclage and the repeat cerclage. A total of 173 patients were included in the study. These patients were divided into two groups, the initial cerclage group and the repeat cerclage group. Consequently, the gestational age at delivery, birth weight, live birth outcome, and neonatal morbidity in the repeat cerclage group were significantly improved compared to the initial cerclage group (<jats:italic>p<\/jats:italic> &amp;lt;\u202f0.001 for all aforementioned indicators). All patients were further divided into four subgroups based on their indications for initial cerclage. Specifically, 54 patients received an initial cerclage due to prior history (group A), 45 patients based on ultrasound findings (group B), 63 patients due to physical examination (group C), and 11 participants for inappropriate indications (group D). As a result, repeat cerclage significantly increased both gestational age at delivery and birth weight in group A, group B, and group C, with statistical significance noted as follows: group A (<jats:italic>p<\/jats:italic>\u202f=\u202f0.007 for gestational age, <jats:italic>p<\/jats:italic>\u202f=\u202f0.044 for birth weight), group B (<jats:italic>p<\/jats:italic>\u202f=\u202f0.002 for gestational age, <jats:italic>p<\/jats:italic>\u202f=\u202f0.011 for birth weight), and group C (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001 for both) No significant differences were noted in group D. In conclusion, the clinical outcome of repeat cerclage in patients with a prior history of cervical cerclage, regardless of whether it was indicated by history, ultrasound, or physical examination, was found to be significantly beneficial for the patients. For patients who have undergone a prior cerclage based on evidence-supported indications of CI, repeat cerclage may be a prudent consideration.<\/jats:p>","DOI":"10.3389\/fmed.2025.1544075","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T05:26:31Z","timestamp":1744003591000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The role of repeat cerclage in managing subsequent pregnancies for patients with a prior history of cervical cerclage: a retrospective self-control study"],"prefix":"10.3389","volume":"12","author":[{"given":"Lidan","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengyang","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"573","DOI":"10.3390\/ijerph18020573","article-title":"Prenatal environmental metal exposure and preterm birth: a scoping review","volume":"18","author":"Khanam","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.1111\/1471-0528.17003","article-title":"Cervical cerclage: green-top guideline no. 75","volume":"129","author":"Shennan","year":"2022","journal-title":"BJOG"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"6","DOI":"10.3390\/jcm10061270","article-title":"Emergency cervical cerclage","volume":"10","author":"Wierzchowska-Opoka","year":"2021","journal-title":"J Clin Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1097\/OGX.0000000000001182","article-title":"Cervical cerclage: a comprehensive review of major guidelines","volume":"78","author":"Giouleka","year":"2023","journal-title":"Obstet Gynecol Surv"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1055\/s-2008-1075037","article-title":"Prior cerclage: to repeat or not to repeat? That is the question","volume":"25","author":"Pelham","year":"2008","journal-title":"Am J Perinatol"},{"key":"ref6","first-page":"880","article-title":"Once a cerclage, not always a cerclage","volume":"39","author":"Fejgin","year":"1994","journal-title":"J Reprod Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.ejogrb.2015.02.007","article-title":"Prior ultrasound-indicated cerclage: how should we manage the next pregnancy?","volume":"188","author":"Vousden","year":"2015","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1055\/a-2075-3021","article-title":"The association between fetal Doppler and uterine artery blood volume flow in term pregnancies: a pilot study","volume":"45","author":"La Verde","year":"2024","journal-title":"Ultraschall Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1111\/aogs.13770","article-title":"The predictive capacity of uterine artery Doppler for preterm birth-a cohort study","volume":"99","author":"van Zijl","year":"2020","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e0178072","DOI":"10.1371\/journal.pone.0178072","article-title":"Cerclage position, cervical length and preterm delivery in women undergoing ultrasound indicated cervical cerclage: a retrospective cohort study","volume":"12","author":"Cook","year":"2017","journal-title":"PLoS One"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1097\/AOG.0000000000000850","article-title":"Physical examination-indicated cerclage: a systematic review and Meta-analysis","volume":"126","author":"Ehsanipoor","year":"2015","journal-title":"Obstet Gynecol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1016\/S1701-2163(15)30764-7","article-title":"Cervical insufficiency and cervical 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Obstet"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1111\/1471-0528.17905","article-title":"Cervical cerclage: an evolving evidence base","volume":"131","author":"Story","year":"2024","journal-title":"BJOG"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1097\/OGX.0000000000001023","article-title":"Preterm labor: a comprehensive review of guidelines on diagnosis, management, prediction and prevention","volume":"77","author":"Giouleka","year":"2022","journal-title":"Obstet Gynecol Surv"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1097\/GRF.0b013e3181beabaf","article-title":"Contemporary use of cerclage in pregnancy","volume":"52","author":"Debbs","year":"2009","journal-title":"Clin Obstet Gynecol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1097\/AOG.0000000000001086","article-title":"Prior ultrasound-indicated cerclage: comparison of cervical length screening or history-indicated cerclage in the next pregnancy","volume":"126","author":"Suhag","year":"2015","journal-title":"Obstet Gynecol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2460339","DOI":"10.1080\/16549716.2025.2460339","article-title":"Prevalence and risk factors of gestational diabetes mellitus among pregnant women in northern Vietnam: a cross-sectional study","volume":"18","author":"Le","year":"2025","journal-title":"Glob Health Action"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1097\/01.NPR.0000000000000130","article-title":"Updates on thyroid disorders in pregnancy and the postpartum period","volume":"49","author":"Rosenberger","year":"2024","journal-title":"Nurse Pract"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1089\/jwh.2020.8860","article-title":"Clinical outcomes in high-risk pregnancies due to advanced maternal age","volume":"30","author":"Correa-de-Araujo","year":"2021","journal-title":"J Women's Health"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1544075\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T05:26:47Z","timestamp":1744003607000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1544075\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,7]]},"references-count":22,"alternative-id":["10.3389\/fmed.2025.1544075"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1544075","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,7]]},"article-number":"1544075"}}