Abstract :Objective: Introducing a novel method of dealing with bulging fetal membranes in the mid trimester
using Mersilene tape with favorable obstetric and neonatal outcome in terms of prolongation of
pregnancy, fetal viability and neonatal survival.
Material and Methods: Analysis of twenty-four pregnancies complicated by bulging membranes in
mid-trimester during 26-year study period including 14 singleton, 8 twin and 2 triple pregnancies.
All cases of cervical dilatation and bulging of membranes were diagnosed by ultrasound scan
and speculum examination. Patients have received perioperative antibiotic, Indomethacin and
Progesterone. Emergency cervical cerclage was accomplished using Mersilene 5 mm tape after
pulling the margins of the dilated cervix over the bulging fetal membranes without having to touch
or push the membranes and without doing amnioreduction. The exclusion criteria were rupture of
membranes, uterine contractions, bleeding, chorioamnionitis and fetal anomalies.
Results: Emergency cervical cerclage on 24 patients with bulging membranes in mid-trimester. The
pregnancies were prolonged by 9.4 ± 5.6 weeks in the singleton group, 8 ± 5.6 weeks in the twin
group, and 8 ± 4 weeks in the triplet group. Fetal viability was achieved in 20 patients (83.3%), and
the neonatal survival was 96.6%.
Conclusions: Favorable obstetric outcome can be achieved with bulging membranes in midtrimester
pregnancies using the novel method. There is no need to push the bulging membranes.