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Laparoscopic Transabdominal Cerclage and Subsequent Pregnancy Outcomes When Left In Situ
1Department of Obstetrics and Gynaecology, University of Melbourne, Royal Women's Hospital, and the AGORA Specialist Centre, Melbourne, Victoria, Australia.
Objective:
To evaluate obstetric outcomes of subsequent pregnancies in women who had a laparoscopic transabdominal cerclage.
Methods:
A prospective observational study of consecutive women who became pregnant a second or third time after a laparoscopic transabdominal cerclage. Eligible women were considered not suitable for a transvaginal cerclage or had previously failed a transvaginal cerclage. The primary outcome was neonatal survival and the secondary outcome was delivery at 34 weeks of gestation or more.
Results:
During the study period (2007-2018), 22 women who had undergone a laparoscopic transabdominal cerclage and completed one pregnancy with the cerclage in situ became pregnant a second or third time. In the first pregnancies with the cerclage in situ, the neonatal survival rate was 100% (22/22) and 86% (19/22) of women delivered after 34 weeks of gestation. In the second pregnancies, the neonatal survival rate was 95% (21/22) and 86% (19/22) of women delivered after 34 weeks of gestation. In the third pregnancies, the neonatal survival rate was 100% (3/3) and 100% (3/3) of women delivered after 34 weeks of gestation.
Conclusion:
When left in situ for subsequent pregnancies, laparoscopic transabdominal cerclage is associated with a high rate of neonatal survival.
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