**Core Concept**
Circlage is a surgical procedure performed to reinforce the cervix in cases of cervical insufficiency, preventing preterm birth. It is typically indicated in pregnancies with a history of second-trimester loss or cervical shortening. The procedure is contraindicated when there is active infection, membrane rupture, or signs of labor onset, as these increase the risk of complications.

**Why the Correct Answer is Right**
Circlage is performed in pregnancies before 14 weeks to prevent preterm birth due to cervical insufficiency. However, it is **not** contraindicated in pregnancies beyond 14 weeks. In fact, after 14 weeks, the risk of fetal demise or complications increases, and the procedure is generally avoided in such cases due to the high risk of preterm labor and fetal loss. Thus, "pregnancy beyond 14 weeks" is **not** a contraindication — it is actually a reason to **avoid** the procedure. This makes it the correct choice in a "all except" question.

**Why Each Wrong Option is Incorrect**
Option A: Leaking membranes indicate rupture of membranes, which increases infection risk and is a contraindication.
Option B: Features of amnionitis (infection of amniotic sac) indicate active infection and are absolute contraindications to circlage.
Option C: History of vaginal bleeding may suggest cervical insufficiency or pathology, but more importantly, it may signal active cervical changes or preterm labor — hence, a contraindication.

**Clinical Pearl / High-Yield Fact**
Circlage is most effective when performed between 12–14 weeks of gestation. Performing it after 14 weeks significantly increases the risk of fetal loss and preterm birth — thus, it is contraindicated in such cases. Always assess for ruptured membranes and infection before performing the procedure.

✓ Correct Answer: D. Pregnancy beyond 14 weeks