Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 11 2024 11 04 2500 2508 Jin Lu Department of Obstetrics and Gynecology, Second Affiliated Hospital of Soochow University, Suzhou, China Ling Zhou Department of Obstetrics and Gynecology, Second Affiliated Hospital of Soochow University, Suzhou, China Minqin Xu Department of Obstetrics and Gynecology, Second Affiliated Hospital of Soochow University, Suzhou, China Li Yang Department of Obstetrics and Gynecology, Second Affiliated Hospital of Soochow University, Suzhou, China Xue Li Department of Obstetrics and Gynecology, Second Affiliated Hospital of Soochow University, Suzhou, China 2024 03 27 2024 11 04 Background: We aimed to determine whether the prepregnancy cerclage for women with cervical incompetence with absent ecto‑cervix affects the time from surgery to conception and subsequent pregnancy outcome. Methods: This retrospective study was carried out on patients with at least one previous history of second-trimester abortion and extremely short cervix found by gynecological examination. A total of 40 cases of McDonald's cerclage before pregnancy were performed. The time from surgery to conception and pregnancy outcome were followed up for 4 years. The main outcomes were the time from surgery to conception, and the gestational week of delivery, miscarriage rate, preterm delivery rate. Results: Between September 2018 and December 2022, 37 women became pregnant following prepregnancy cerclage. In total, 36 babies were born to 37 mothers. The recurrence rate of second-trimester miscarriage was 8.11% (3/37) and the preterm birth rate was 29.73% (11/37). Mean time from surgery to conception was 38w (range 2w-160w).Mean gestational age at delivery was 36 weeks +4 (256 days).The live birth rate was 100%. There were no maternal complications, no intestinal and bladder injuries. Conclusion: Cervical incompetence patients with absent ecto‑cervix may benefit from prepregnancy cerclage without affecting the interpregnancy interval. https://ijph.tums.ac.ir/index.php/ijph/article/view/34999 https://ijph.tums.ac.ir/index.php/ijph/article/download/34999/8393