Format

Send to

Choose Destination
Aust N Z J Obstet Gynaecol. 2018 Dec;58(6):606-611. doi: 10.1111/ajo.12774. Epub 2018 Jan 23.

Laparoscopic transabdominal cerclage: Outcomes of 121 pregnancies.

Author information

1
Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia.
2
Agora Centre for Women's Health, Epworth HealthCare Richmond, Richmond, Victoria, Australia.

Abstract

BACKGROUND:

Cervical insufficiency is a significant cause of morbidity and mortality. Cervical cerclage is one option in the management of cervical insufficiency.

AIM:

To evaluate obstetric outcomes following insertion of a pre-pregnancy laparoscopic transabdominal cerclage in women at high risk for pre-term labour and/or mid-trimester pregnancy loss.

METHODS:

A prospective observational study of consecutive women who underwent laparoscopic transabdominal cerclage from 2007 to 2017. Eligible women had a diagnosis of cervical insufficiency based on previous obstetric history and/or a short or absent cervix and were considered not suitable for a transvaginal cerclage. The primary outcome was neonatal survival and the secondary outcome was delivery of an infant at ≥34 weeks gestation. Surgical morbidity and complications were also evaluated.

RESULTS:

During the study period, 225 women underwent laparoscopic transabdominal cerclage. We present the outcomes of 121 pregnancies resulting in 125 babies. The perinatal survival rate of viable pregnancies was 98.5% with a mean gestational age at delivery of 35.2 weeks; 79.7% of babies were delivered at ≥34.0 weeks gestation.

CONCLUSION:

Laparoscopic transabdominal cerclage is a safe and effective procedure resulting in favourable obstetric outcomes in women with a poor obstetric history. For optimal success the procedure requires the correct surgical expertise, equipment and appropriate patient selection.

KEYWORDS:

cerclage; cervical insufficiency; laparoscopy; premature; preterm birth

PMID:
29359499
DOI:
10.1111/ajo.12774

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center