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Laparoscopic transabdominal cervicoisthmic cerclage during pregnancy
Chi-Heum Cho1, Taek-Hoon Kim, Sang-Hoon Kwon
1Department of Obstetrics and Gynecology, School of Medicine and Institute for Medical Genetics, Keimyung University, Taegu, South Korea.
Study Objective:
To evaluate and describe our experience in the management of recurrent second-trimester miscarriage and preterm delivery by laparoscopic transabdominal cervicoisthmic cerclage (LTCC), after failure of transvaginal cervical cerclage.
Design:
Retrospective review (Canadian Task Force classification III).
Setting:
Tertiary care teaching hospital.
Patients:
Twenty women in whom it was not technically possible to perform transvaginal cerclage.
Intervention:
LTCC.
Measurements And Main Results:
Mean operating time was 55 minutes (range 40-75 min). There were no operative or immediate postoperative complications. Mean gestational age at the time of cerclage placement was 12.1 weeks (range 11-14 wks). Nineteen women successfully delivered 21 live babies (2 sets of twins; live birth rate 95%). One loss occurred after rupture of membrane at 19 weeks' after cerclage.
Conclusion:
LTCC during pregnancy can be safe and effective treatment for well-selected patients with cervical incompetence, and eliminates the need for open laparotomy.