Successful Late Emergency Cerclage for Painless Cervical Dilation in Triplet Gestation.

INTRODUCTION: The efficacy of emergency cerclage placement in triplet pregnancies remains controversial. This case describes a favorable outcome following such an intervention in prolonging gestation and improving neonatal outcomes in high-risk multiple gestations complicated by cervical insufficiency. CASE PRESENTATION: We report a bichorionic triamniotic (BCTA) triplet pregnancy in a primigravida admitted at 21 + 5 weeks gestation with asymptomatic cervical dilation and bulging membranes. After thorough counseling regarding risks and benefits, an emergency McDonald cerclage was placed at 22 + 4 weeks. The pregnancy was prolonged until 29 + 3 weeks, when the patient underwent cesarean delivery of three healthy neonates following preterm premature rupture of membranes and suspected chorioamnionitis. Informed consent was obtained from the patient for publication. DISCUSSION: Despite the inherent risks, emergency cerclage may be considered in highly selected triplet pregnancies with cervical insufficiency. This case underscores the importance of individualized decision-making and may contribute to the existing literature and generate hypotheses for future research.