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Maternal-Fetal MedicineSociety
SG-009ProtocolPreterm birth

Cervical insufficiency

Diagnostic criteria, the three types of cerclage, the role of the pessary and subsequent monitoring.

Version 1.522 pagesUpdated 9 October 2024Perinatology Working Group

Key recommendations

  • History-indicated cerclage at 12–14 weeks
  • Ultrasound-indicated cerclage at ≤ 25 mm
  • Cerclage removal at 36–37 weeks
  • Pessary as an alternative in selected cases

The diagnosis of cervical insufficiency is clinical and rests on the history — painless cervical dilatation in the second trimester.

Note: A guideline is a recommendation and does not replace the clinician's professional judgement in an individual case. Departing from it is acceptable where the reasoning is documented.