Research progress on the complications related to cervical cerclage failure

ObjectiveTo systematically clarify the severe complications, clinical risk factors, and predictive biomarkers associated with cervical cerclage (CC) failure to guide individualized clinical decisions.MethodsA narrative review was conducted by searching electronic databases (PubMed and Web of Science) for English-language studies. The review synthesizes evidence-based data on surgical complications, clinical risk factors, and novel inflammatory biomarkers.ResultsSevere post-operative adverse events, such as preterm premature rupture of membranes (PPROM) and chorioamnionitis (CAM), are most prevalent in physical examination-indicated cerclage (PEIC). Key risk factors for surgical failure include advanced cervical dilatation, fetal membrane protrusion, and vaginal microbial dysbiosis. Emerging evidence suggests that inflammatory markers in maternal blood (e.g., SII, SIRI) and amniotic fluid, alongside vaginal Lactobacillus abundance, serve as potential novel biomarkers for predicting cervical cerclage failure.ConclusionCervical insufficiency is increasingly recognized as an inflammation-related syndrome. While novel biomarkers show promise for predicting outcomes, their clinical value must be further validated through large-scale, prospective, multicenter studies.