Efficacy of cervical cerclage as a prophylactic measure in the management of triplet gestations

Abstract

Introduction: Prophylactic cervical cerclage has been introduced to treat cervical insufficiency, which is associated with a variety of perinatal complications. This literature review aims to evaluate the efficacy of this procedure in preventing cervical insufficiency in triplet gestations and therefore the various complications including pre-term delivery. Methods: Three academic search engines, including “Medline”, “Science Direct” and “Scopus” were used. Key words used include “cervical insufficiency”, “multiple pregnancy”, “triplet”, “preterm labor”, “cerclage”, “cervical shortening”, “prolong of preganancy” and “management”. Results: Nine studies were retrieved, amongst which six are retrospective international researches, and three are meta-analysis not limited to triplet pregnancies. Majority of these researches shows no clear benefit in using cervical cerclage for women who have cervical shortening. Conclusions: Prophylactic cervical cerclage is found to have no clear benefit for women with cervical insufficiency, who have triplet pregnancies. However, improvement can be made in future research for more accurate analysis of its efficacy.