Cerclage Outcome in Singleton Pregnancies for Women at Risk for Preterm Birth Following Assisted Reproductive Treatments

Preterm birth (PTB), defined as delivery before 37 weeks, is a leading cause of neonatal morbidity and mortality, with long-term health consequences. Most Preterm births are spontaneous, though some are iatrogenic. Assisted reproductive technology -conceived pregnancies, including in vitro fertilization, show higher Preterm birth risk, potentially related to infertility factors, maternal age, and assisted reproductive technology procedures. Aim to evaluate the obstetric and neonatal outcomes of singleton pregnancies at risk for preterm birth following assisted reproductive treatment underwent cervical cerclage placement. This prospective observational study, conducted at Basrah Maternity and Child Hospital (1st of December of 2024– 1st of December of 2025), evaluated obstetric and neonatal outcomes in 84 singleton ART pregnancies at risk of preterm birth undergoing cervical cerclage. Eligible women aged 18–45 years received cerclage between 12–16 weeks based on history, ultrasound findings, anatomical factors, or rescue indications. Data were collected via questionnaires, medical records, and transvaginal ultrasound. Cerclage was performed using the McDonald technique, with participants followed until delivery to assess maternal complications, mode of delivery, gestational age, and neonatal outcomes. Among 84 women undergoing cervical cerclage after ART, most were aged 30–35 years (47.6%). Term delivery was achieved in 72.6%. Caesarean section was common (63.1%), predominantly elective. Procedure-related morbidity was low, with 55.5% experiencing no complications; premature rupture of membrane (8.8%) and preterm labor (7.8%) were infrequent. Cerclage was mainly indicated by previous pregnancy loss (44. 04%) or ultrasound-detected cervical shortening (41.6%). Neonatal outcomes were generally favorable, with mean birth weight 3.3±0.4kg, 80.3% take-home babies, low neonatal intensive care unit admission (19.6%), and low neonatal mortality (4.9%). Cervical cerclage in assisted reproductive technology singleton pregnancies was safe and effective, achieving high term delivery rates, low complications, favourable neonatal outcomes, and low perinatal loss despite a high caesarean section rate.