Emergency cerclage. A successful challenge despite advanced second trimester cervical dilatation.

A 22-year-old, primigravida +/- 20 weeks of gestation presented with abdominal pain. She was diagnosed as a case of advanced cervical incompetence. We carried out an emergency cerclage after 24 hours from her admission, while the cervix was fully dilated with bulging of the membranes and prolapse of both lower limbs in the middle of the vagina. She delivered normally at 38 weeks of gestation with favorable outcomes. We believe that even if miscarriage is inevitable, the so called emergency cerclage might be considered.