Evidence map›Paper›PMID 42699737›Full record

ArticleClinical case reports international2026

Should Primigravidas or Secundigravidas be Routinely Screened for Cervical Insufficiency? Insights from Two Cases of Emergency Cerclage Using a Modified Macdonald Technique.

George Uchenna Eleje, Isaiah Chukwuebuka Umeoranefo, Chichi Ukoha, Ekeuda Uchenna Nwankwo, Emmanuel Chukwubuikem Egwuatu, Odigonma Zinobia Ikpeze, Charles Chukwuka Ezema, Obinna Kenneth Nnabuchi, Chigozie Geoffrey Okafor, Kingsley Chidiebere Nwaogu and 30 more

Abstract read
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Article in Clinical case reports international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

40 authors.

George Uchenna ElejeDepartment of Obstetrics and Gynaecology, Effective Care Research Unit, Nnamdi Azikwe University, Nigeria.
Isaiah Chukwuebuka UmeoranefoDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Chichi UkohaDepartment of Obstetrics and Gynaecology, Barts Health NHS Foundation Trust, UK.
Ekeuda Uchenna NwankwoRural Community Clinical School, School of Medicine, Deakin University, Australia.
Emmanuel Chukwubuikem EgwuatuDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Odigonma Zinobia IkpezeDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Charles Chukwuka EzemaDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Obinna Kenneth NnabuchiDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Chigozie Geoffrey OkaforDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Kingsley Chidiebere NwaoguDepartment of Radiology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Michel Chiedu EgbuniweDepartment of Nursing, University of Sunderland, Sunderland, United Kingdom.
Emeka Philip IgbodikeDepartment of Obstetrics and Gynaecology, University of Lagos, Nigeria.
Kenechukwu Ezekwesili ObiDepartment of Obstetrics and Gynaecology, Effective Care Research Unit, Nnamdi Azikwe University, Nigeria.
Adanna Vivian EgwimDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Chukwuemeka Chukwubuikem OkoroDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Chukwudubem Chinagorom OnyejiakaDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Chiemezie Mac-Kingsley AgbanuDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Donald Ugochukwu NwasikeDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Emeka Godswill IgboekweDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Chijioke Ogomegbunam EzeigweDepartment of Obstetrics and Gynaecology, Effective Care Research Unit, Nnamdi Azikwe University, Nigeria.
Stanley Chigaemezu EgboguDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Casmir Chukwudi MadubukoDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Alexander Arinze MathiasDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Martin Chinedu AndehDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Nkejesus Chidube ObiDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Ebube BelieveGod AkosaDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Lambert Chukwu OnyejiakuDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
James Egwuatu OkonkwoDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Ifeanyi Kingsley NwaejuDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Tochukwu Chukwuemeka ObiechinaDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Chidebe Christian AnikweDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
John Chukwuemeka NkesiDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Felix Nwabunwanne EmodiDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Samuel Nnaji UgaduDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Ijeoma Rita ChukwukaDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Florence Olumma NduDepartment of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nigeria.
Emmanuel Onyebuchi UgwuDepartment of Obstetrics and Gynaecology, College of Medicine, University of Nigeria, Nigeria.
Joseph Ifeanyichukwu IkechebeluDepartment of Obstetrics and Gynaecology, Effective Care Research Unit, Nnamdi Azikwe University, Nigeria.
Gerald Okanandu UdigweDepartment of Obstetrics and Gynaecology, Effective Care Research Unit, Nnamdi Azikwe University, Nigeria.
Ahizechukwu Chigoziem EkeDivision of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, USA.

Funding

African Association for Health Professions Education and ResearchR25TW011217 · FIC · INFECTIOUS DISEASES INSTITUTE · PI ADEJUMO, PRISCA, NACHEGA, JEAN BISIMWA · 2018 to 2023
$3.9M
FIC NIH HHS R25 TW011217
6 · The paper itself

Abstract

Cervical insufficiency is a significant contributor to mid-trimester pregnancy loss and preterm birth. Emergency cervical cerclage is a potentially life-saving intervention, but its use remains controversial, especially in primigravidas or secundigravidas with no identifiable risk factors. We report two cases involving a primigravida and a secundigravida, both presenting with painless cervical dilation and bulging fetal membranes at 22- and 21-weeks' gestation, respectively. Neither had a history of cervical procedures or prior pregnancy losses. Following emergency transvaginal cervical cerclage the first case progressed to a live birth at 36 weeks gestation while the second, unfortunately experienced pregnancy loss at 23 weeks. We presented these case reports to highlight that cervical insufficiency could present unexpectedly in women without traditional risk factors, and that emergency cerclage may improve outcomes, but risks remain. Routine second-trimester cervical length screening may therefore be warranted in primigravidas or secundigravidas to identify at-risk pregnancies and allow for timely elective intervention.

Indexed as

Cervical incompetenceCervical insufficiencyEmergency cerclageModified MacDonald techniquePreterm Birth preventionPrimigravidaSecondigravida

Identifiers

PMID42699737
PMCPMC13544369

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.