Indication-dependent heterogeneity in the effect of double-suture cerclage: concerns over indication classification and a call for stratified analysis - Takeaways - MDSpire
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Variation in Outcomes of Double-Suture Cerclage Based on Indication: Addressing Classification Issues and Advocating for Stratified Analysis

  • By

  • Yong-Jin Park

  • Moon-Il Park

  • June 12, 2026

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  • 1

    The study by Kahraman et al. compares perinatal outcomes of single- versus double-suture cervical cerclage using a modified Wurm technique.

  • 2

    Three cerclage indications—history-indicated, ultrasound-indicated, and emergency—represent distinct clinical scenarios with varying cervical compromise.

  • 3

    Evidence suggests that double cerclage shows comparable outcomes in history-indicated cases, modest benefits in ultrasound-indicated, and significant benefits in emergency cases.

  • 4

    The authors' data indicate a significant difference in term delivery rates between single and double cerclage in emergency cases, contradicting their overall conclusion.

  • 5

    Concerns about the classification of cerclage indications in the dataset raise questions about the reliability of subgroup analyses and the study's conclusions.

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