Choosing Wisely:

Don’t perform serial cervical length measurement following cerclage placement.

Rationale and Comments: Although progressive cervical shortening after cerclage placement increases the risk of preterm birth, neither overall cervical length nor the length below the stitch correlates well with outcomes. Most importantly, there are currently no additional treatment options for a short cervix after cerclage (e.g., reinforcement suture does not improve outcomes). Although there may be theoretical psychological benefits to the patient and provider to visualize the stitch, there are insufficient data to suggest a clinical benefit of routine post-cerclage serial cervical length measurement.
Sponsoring Organizations:
  • Society for Maternal-Fetal Medicine
  • Sources:
  • Expert consensus
  • Disciplines:
  • Obstetrical
  • References: • Society for Maternal-Fetal Medicine (SMFM). McIntosh J, Feltovich H, Berghella V, Manuck T. The role of routine cervical length screening in selected high- and low-risk women for preterm birth prevention. Am J Obstet Gynecol. 2016 Sep;215(3):B2-7.
    • Baxter JK, Airoldi J, Berghella V. Short cervical length after history indicated cerclage: Is a reinforcing cerclage beneficial? Am J Obstet Gynecol. 2005;193:1204-7.

    Email Alerts

    Don't miss a single issue. Sign up for the free AFP email table of contents.

    Sign Up Now