Which condition would require cervical cerclage in a twin pregnancy?

Cervical cerclage is a surgical procedure where a stitch is placed in the cervix to help support it during pregnancy, particularly in cases of cervical incompetence. In a twin pregnancy, the risk of premature birth is higher, and the status of the cervix becomes even more critical for maintaining the pregnancy.

Asymptomatic cervical dilation before 24 weeks is a significant indication for cervical cerclage in twin pregnancies. When cervical dilation occurs without symptoms, it suggests that the cervix is unable to maintain the pregnancy effectively, increasing the risk of premature delivery. In this context, placing a cerclage can provide additional support to the cervix, potentially prolonging the pregnancy and improving outcomes for the fetuses.

The other conditions listed do not specifically warrant a cervical cerclage. Chorioamnionitis, which is an infection of the amniotic fluid, typically requires management that focuses on treating the infection rather than mechanical support of the cervix. Preterm labor with contractions indicates that the body is actively trying to start labor, and cerclage is typically not placed in this scenario as it may not prevent labor and can pose risks. Heavy vaginal bleeding could suggest other complications that need to be addressed, and while it may be concerning