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Case Studies | Obstetrics and Gynecology | Volume 15 Issue 3, March 2026 | Pages: 1567 - 1571 | India
Optimizing Cervical Cerclage with Dydrogesterone: Evidence from a Case Series
Abstract: Preterm birth remains a leading cause of neonatal morbidity and mortality worldwide, with cervical insufficiency a major contributor to spontaneous pre-term birth. While cervical cerclage is an established intervention for restoring cervical competence, its effectiveness may be enhanced by adjunctive progesterone therapy, which possesses immunomodulatory properties and promotes uterine quiescence, reduces inflammatory pathways associated with preterm labor. This retrospective case series describes four pregnant women diagnosed with cervical insufficiency in the second trimester who were managed with either elective or emergency McDonald cerclage along with sustained-release oral dydrogesterone. All patients also received individualized supportive therapy, including tocolytics, calcium supplementation, aspirin, L-arginine, micronutrients and a few cephalosporin antibiotics and metronidazole to avoid postpartum infections. Across all cases, timely cerclage placement combined with continued dydrogesterone therapy was associated with suppression of uterine irritability and extension of gestation to term or near-term. No patient demonstrated cerclage failure, membrane rupture, or persistent uterine contractions. Early signs of infection noted in two patients were effectively managed with antibiotics, preventing progression to chorioamnionitis. All neonates were delivered healthy without the need for NICU admission. This case series highlights the synergistic benefit of combining mechanical reinforcement with hormonal support in women with cervical insufficiency. Oral dydrogesterone 30 mg SR supplementation appeared to maintain uterine quiescence and may have contributed to prolongation of pregnancy and favorable neonatal outcomes. These findings support further evaluation of oral dydrogesterone 30 mg SR as an adjunct to cerclage in high-risk cervical insufficiency.
Keywords: Cervical cerclage, Dyhydrogestrone, cervical insufficiency, cervical competence, preterm birth
How to Cite?: Dr Snehal Jagtap, Dr Aniruddha Madan Jagtap, Dr Sameer P Darawade, Dr. Rajashree Thoke, Dr Hinal Padalia, "Optimizing Cervical Cerclage with Dydrogesterone: Evidence from a Case Series", Volume 15 Issue 3, March 2026, International Journal of Science and Research (IJSR), Pages: 1567-1571, https://www.ijsr.net/getabstract.php?paperid=SR26324185700, DOI: https://dx.dx.doi.org/10.21275/SR26324185700