When can history indicated cerclage be placed?

History-indicated cerclage is a surgical procedure performed to help support the cervix in women who have a history of cervical incompetence or preterm birth. The ideal timing for placement of this type of cerclage is between 13 and 14 weeks gestation.

At this gestational age, the risks of miscarriage from the procedure are lower, and the benefits of protecting the pregnancy from potential preterm labor and cervical dilation are maximized. Placement of cerclage after 14 weeks can carry increased risks, particularly if cervical changes have already started. Thus, performing the procedure before significant cervical dilation occurs (usually after 16 weeks) is crucial for its success.

Doing the cerclage at 10 weeks may be too early, as the risk of miscarriage and complications could be higher. Similarly, waiting to perform the procedure after cervical dilation has been noted is also not ideal, as it would likely have diminished effectiveness. Placing a cerclage anytime during pregnancy is not standard practice, as the timing significantly affects both the safety of the procedure and the outcomes for both the mother and the fetus.