Related Experiment Video
Updated: Jun 23, 2026
Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Cervicoisthmic cerclage: transabdominal vs transvaginal approach
Marili U Witt1, Saju D Joy, Jennifer Clark
1Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7570, USA.
Objective:
We sought to compare the outcomes of cervicoisthmic (CI) cerclage using traditional transabdominal (TA) approach vs the lesser used transvaginal (TV) approach.
Study Design:
We conducted a retrospective cohort study of women who underwent placement of a CI cerclage.
Results:
Before CI placement, the abdominal group had a total of 100 pregnancies that continued beyond the first trimester and had 27 (27%) surviving infants. After cerclage placement, there were 34 pregnancies and 24 (71%) surviving infants. Before cerclage placement, the vaginal group had a total of 90 pregnancies that continued beyond the first trimester and had 11 (12%) surviving infants. After cerclage placement, there were 29 pregnancies and 20 (69%) surviving infants. The vaginal cerclage group had a significantly shorter mean operative time of 33 vs 69 minutes, and shorter hospital stay of 0.5 vs 3.2 days.
Conclusion:
Both TV and TA CI cerclage offers select patients with cervical insufficiency improved neonatal survival. The TV placement of a CI has less morbidity than the TA approach with a comparable neonatal survival.
