• amniotic sac prolapse;
  • conservative management;
  • exam-indicated cerclage;
  • neonatal survival;
  • prolongation of pregnancy


Aim:  To evaluate pregnancy outcome in women with fetal membranes at or beyond external os who underwent exam-indicated cerclage or conservative management.

Material and Methods:  Retrospective cohort study including 52 patients with fetal membranes at or beyond external os between 17 and 27 weeks of gestation, treated in two third-level hospitals, between January 2001 and April 2009. The outcomes of interest of the study, prolongation of pregnancy and neonatal survival rate, were stratified according to type of management, parity, clinical conditions and blood tests at admission and calculated using the Kaplan–Meier algorithm.

Results:  Of 52 women, 37 received exam-indicated cerclage and 15 were managed conservatively. The rate of patients still pregnant beyond 180 days within the cerclage group differed significantly from those of the conservative management group (80% vs 0%, respectively) (P-value < 0.001). No difference has been found according to neonatal survival (82% versus 53%, respectively).

Conclusion:  Exam-indicated cerclage appears to prolong gestation compared to expectant management.