Late Cervical Cerclage at 30 Weeks of Gestation: A Case Report

A 34-year-old woman was experiencing her fourth pregnancy, which was totally normal till she arrived at 29.1 weeks of gestation, beginning with uterine activity, which required hospitalization and was controlled with intravenous (IV) medication. Once discharged, in her follow-up appointment a week later, when she was 30.3 weeks, a cervical shortening was observed when the transvaginal ultrasound was made. This, in conjunction with her previous history of preterm birth, led to the decision to place a McDonald-type cerclage even when guidelines usually recommend the procedure before 28 weeks. When she was 35.5 weeks pregnant, she started with uterine activity, so it was decided to remove the cerclage and expect a natural delivery. She gave birth to a female baby without complications. What we want to highlight from the following clinical case is that it is valid to place a cerclage after week 28. Each case should be assessed individually; weeks of gestation do not appear to be an absolute contraindication, but signs of infection should be considered. Late cerclage placement should be considered in specific cases with the purpose of avoiding days at the neonatal intensive care unit, as neonatal comorbidities in well-selected cases.