Laparoscopic transabdominal cervical cerclage: a 6-year experience

Area of Science:

• Reproductive Medicine
• Minimally Invasive Surgery
• Maternal-Fetal Medicine

Background:

• Cervical cerclage is a long-standing treatment for cervical insufficiency.
• Transabdominal cerclage is used when transvaginal cerclage is not feasible or has failed.
• Laparoscopic abdominal cerclage aims to decrease surgical morbidity associated with laparotomy.

Purpose of the Study:

• To assess the obstetric outcomes of laparoscopic transabdominal cerclage.
• To evaluate surgical morbidity associated with the laparoscopic approach.

Main Methods:

• Observational study of women undergoing laparoscopic transabdominal cerclage (2007-2013).
• Inclusion criteria: cervical insufficiency diagnosis (history or short/absent cervix).
• Primary outcome: neonatal survival; Secondary outcomes: delivery at ≥34 weeks, surgical morbidity.

Main Results:

• 64 women underwent the procedure; 35 pregnancies documented.
• Perinatal survival rate: 95.8%; Mean gestational age at delivery: 35.8 weeks.
• 83% delivered at ≥34 weeks; 1.6% intra-operative adverse event with no postoperative sequelae.

Conclusions:

• Laparoscopic transabdominal cerclage is safe and effective for women with poor obstetric history.
• Favorable obstetric outcomes achieved, comparable to open laparotomy.
• Minimally invasive approach offers reduced morbidity and positive results.