Double McDonald Cerclage in a Woman With Recurrent Spontaneous Preterm Birth: Case Report
DOI:
https://doi.org/10.36602/Keywords:
Cervical incompetence, Recurrent , Preterm birth, Double McDonald CerclageAbstract
Preterm birth is one of leading cause for neonatal death. Cervical incompetence is a primary reason for preterm birth and the single McDonald cervical cerclage technique is commonly used to manage this problem. However, theoretically; in certain clinical scenario such as bulging membranes (funneling cervix), double-level cerclage significantly prolonged the pregnancy and so reduced preterm birth. This presentation described a case of 30 years old with history of three lost babies because of prematurity (cervical incompetence). She had single McDonald cervical cerclage during second and third pregnancies. At this pregnancy, double McDonald carclage was applied at thirteen weeks gestation and patient kept on tocolytics on needed. At thirty seven weeks with four days, elective operative delivery was done and baby girl with average birth weight. Conclusion: double cerclage provides comparable outcomes to single cerclage when used preventatively on certain cases. So, utilizing both mechanical and infection-preventing techniques could enhance cervical strength and extend the duration of pregnancy in certain individuals.
Downloads
References
Hochuli, E.; and Vogt, H.P. (1987), [Double cerclage. Cervix insufficiency in the middle trimester and its treatment]. Geburtshilfe Frauenheilkd, 47, 537–538. (In German).
Shirodkar, V.N. (1955), A new method of operative treatment for habitual abortions in the second trimester of pregnancy. Antiseptic, 52, 299–300.
McDonald, I.A., (1957), Suture of the cervix for inevitable miscarriage. J. Obstet. Gynaecol. Br. Emp., 64, 346–350.
Damalie, F.J.M.K.; Nkini, A.N.; Nansubuga, S.; Ntege, R. (2024), Double cervical cerclage for cervical insufficiency: A case report. Afr. J. Reprod. Health, 28, 117–125.
Park, Y.; Park, M. (2023), Second emergent double McDonald cerclage is useful in patients with amnionic membrane bulging into vagina after the first cervical cerclage. Ultrasound Obstet. Gynecol., 62, 222–223.
Vaughan, M.; Emms, A.; Hodgetts Morton, V.; Morris, R.K.; Israfil-Bayli, F.; Pilarski, N. (2025), Optimal surgical technique at cervical cerclage to prevent pregnancy loss, a systematic review. Eur. J. Obstet. Gynecol. Reprod. Biol., epub ahead of print.
Kosi ´nska-Kaczy´ nska, K.; Rebizant, B.; Bednarek, K.; Dabrowski, F.; Kajdy, A.; Muzyka-Placzy´ nska, K.; Filipecka-Tyczka, D.; Uzar.; Kwiatkowski, S.; Torbe, A.; (2023), Emergency cerclage using double-level versus single-level suture in the management of cervical insufficiency (Cervical Occlusion double-level Stitch Application, COSA): Study protocol for a multicentre, non-blinded, randomised controlled trial. BMJ Open, 13, e071564.
Ogawa, M.; Sanada, H.; Tsuda, A.; Hirano, H.; Tanaka, T. Modified (1999), cervical cerclage in pregnant women with advanced bulging membranes: Knee-chest positioning. Acta Obstet. Gynecol. Scand., 78, 779–782.
Park, M.I.; Lee, M.H.; Kong, M.S.; Hwang, J.H.; Chung, S.R.; Moon, H. (2000), Clinical experience of 15 cases of modified McDonald cerclage using Beriplast™ in incompetent internal os of cervix. Korean J. Obstet. Gynecol., 43, 1407–1413.
Lee, S.H.; Yoon, H.J.; Lee, Y.O.; Kim, H.H.; Han, H.J.; Park, M.I. (2004), Comparison of outcomes of incompetent cervix patients treated with the transvaginal cerclage and the modified transvaginal cerclage using fibrin sealant. J. Korean Soc. Perinatol., 15, 147–153.
Banerjee, A.; Smith, J.; Doe, K. (2020), ModifiedWurm transvaginal cerclage to prevent preterm birth. BJOG, 127, 145.
Gnanarathne, S.; Rathnayake, C. (2025), Extending the pregnancy from pre-viable to viable: The place of emergency cerclage. Int. J. Gynaecol. Obstet., early view.
Funding: This research received no external funding.
Consent: Patient’s consent had been taken for publication.
Acknowledgments: The authors express their sincere gratitude to all staff members in journal, The authors have reviewed and edited all work and take full responsibility for the content of this publication.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Hanan Eljabu، Ibrahim Larbah (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
