Expectant management compared with physical examination-indicated cerclage (EM-PEC) in selected women with a dilated cervix at 140/7-256/7 weeks: results from the EM-PEC international cohort study

In this study, the largest cohort reported to date, physical examination-indicated cerclage appears to prolong gestation and improve neonatal survival, compared with expectant management in selected women with cervical dilation between 140/7 and 256/7 weeks. A randomized, controlled trial should be conducted to determine whether these potential benefits outweigh the risks of cerclage placement in this population.