PPROM with a cerclage: what to know

A cerclage is a stitch placed around the cervix to help it stay closed during pregnancy. If the membranes rupture, fluid can leak around the stitch and the risk of infection or labour must be assessed. The stitch may need to be removed if labour starts, if infection is suspected or if birth is advised, but the decision depends on your examination and pregnancy circumstances.

Do not try to feel for, loosen or remove the stitch yourself. A cerclage does not prevent PPROM, and fluid leakage should be assessed even when there are no contractions or pain.

Call your maternity unit urgently if you notice a gush or trickle of fluid. Use a clean pad, record the time and colour of the leakage, and avoid sex or inserting anything into the vagina until reviewed. Tell the team when the cerclage was placed, why it was recommended, and whether you have had bleeding, contractions, fever or reduced fetal movements.

The team may discuss monitoring, infection treatment when indicated, an antenatal steroid injection and the safest timing of birth. If birth is planned, induction of labour may be discussed when clinically appropriate. See [Antenatal Steroid Injection](/treatments/pregnancy-and-birth-care/antenatal-corticosteroid-injection/) and [Induction of Labour](/treatments/pregnancy-and-birth-care/induction-of-labour/).

Seek immediate maternity assessment for fever, chills, feeling unwell, abdominal tenderness, regular contractions, pelvic pressure, vaginal bleeding, foul-smelling or green fluid, or reduced fetal movements. These signs can require rapid review of the cerclage and the pregnancy, even if the fluid leak later stops.

Ask whether the cerclage should remain in place, what findings would require removal, how infection will be checked, and whether you need hospital monitoring. Ask who to call day or night and what plan applies if contractions begin before you reach the hospital.