Predictors of cervical cerclage success: The role of postoperative cervical length and maternal serum procalcitonin in a retrospective cohort study.

This study aimed to evaluate the predictive factors associated with the success of cervical cerclage, particularly focusing on postoperative cervical length and maternal serum procalcitonin levels. A cross-sectional retrospective study was conducted on 129 pregnant women who underwent cervical cerclage at a perinatal medical center. Patients were categorized into 3 groups: history-indicated (G1), ultrasound-indicated (G2), and rescue cerclage (G3). Preoperative and postoperative cervical length, procalcitonin, and C-reactive protein levels were analyzed in relation to pregnancy outcomes, including miscarriage, gestational age at delivery, and preterm premature rupture of membranes. Receiver operating characteristic curve analysis was performed to determine the optimal post-cerclage cervical length threshold for predicting successful pregnancy prolongation. Postoperative cervical length was significantly longer in patients with successful cerclage in the ultrasound-indicated (G2) and rescue cerclage (G3) groups (P = .0151 and P < .0001, respectively). The optimal post-cerclage cervical length cutoff values for predicting birth after 28 weeks were 23.87 mm for G2 (area under the curve [AUC] = 0.78) and 22.18 mm for the combined G2 and G3 group (AUC = 0.71). Higher procalcitonin levels were associated with unsuccessful cerclage and poor pregnancy outcomes in G1 and G2. Preoperative cervical length was not a significant predictor of cerclage success (AUC = 0.52). Postoperative cervical length is a strong predictor of cerclage success, particularly in ultrasound-indicated and rescue cerclage cases. Maternal serum procalcitonin may serve as a novel biomarker for assessing cerclage prognosis. Serial cervical length measurements and biomarker assessments could improve clinical management in these patients. Further prospective studies are warranted to validate these findings.