Clinical Investigation

Our case series of the emergency Mcdonald cerclage and the review of the literature

  • Göğşen Mehmet Önalan
  • Serdar Kaya
  • Filiz Fatma Yanık
  • Barış Mülayim
  • Hulusi Bülent Zeyneloğlu

Turk J Obstet Gynecol 2010;7(3):202-205

Cervical incompetence is defined as failure of the cervix to retain the fetus in utero until term due to a structural or functional weakness. It is characterized by painless dilation and effacement of the cervix, usually in the second trimester of pregnancy, leading to premature rupture of membranes and expulsion of the fetus. It has been estimated that cervical incompetence is responsible for 0.2% of all spontaneous abortions, contributes to 16%–20% of all second trimester pregnancy losses and occurs in 8%–15% among women with a history of recurrent spontaneous abortions. Approximately 10% of preterm deliveries are also caused by cervical incompetence. Emergency cerclage is performed under the clinical presentation characterized by advanced cervical dilation with or without protrusion of the fetal membranes into the vagina. The aim of the study was to compare the results of pregnancy and neonatal outcome of cervical cerclage performed during the second trimester of pregnancy in different emergency situations: with bulging of membranes and without.


Eight cases of Mcdonald cervical cerclage were reviewed retrospectively from 2000 to 2009 all cases being emergencies.


Of the 8 emergency cases, 7 were successful (delivery over 26 weeks gestation and 6 of them delivered over 31 weeks), only 1 failed. The average period of time between emergency cerclage to delivery is 9,3 weeks. It was found that in lineer regression analysis there is a negative correlation between cervical dilatation & twin pregnancy and pregnancy length.


In this small sample of patients requiring emergency cerclage; patient selection with appropriate dilation and effacement of the cervix, negative cultures; brought in us a critical 9,3 weeks (average) for fetal viability with no complication.

Keywords: Emergency Mcdonald cerclage, cervical incompetence