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Successful Transabdominal Cerclage for Recurrent Second-Trimester Loss in a Low-Resource Environment: A Case Report
Rex Mawuli Kwadjo Djokoto1,2, Edward Anabila Agana2,3, Kingsley Afreh Nduroh2,3
1Department of Obstetrics and Gynaecology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, knust.edu.gh.
Case Reports in Obstetrics and Gynecology
|August 13, 2026
Summary
Transabdominal cerclage (TAC) offers a viable solution for severe cervical insufficiency, preventing midtrimester pregnancy loss. This case report highlights the successful application of TAC in Ghana, leading to live births in all three patients.
Area of Science:
- Maternal-Fetal Medicine
- Surgical Obstetrics
- Reproductive Health
Background:
- Cervical insufficiency is a primary cause of recurrent midtrimester pregnancy loss.
- Transabdominal cerclage (TAC) is an effective treatment for severe cervical insufficiency but lacks documentation in West African settings.
- Previous transvaginal cerclage attempts failed in the reported cases.
Purpose of the Study:
- To document the first use of transabdominal cerclage (TAC) in Ghana for severe cervical insufficiency.
- To report the outcomes of TAC in a West African clinical setting.
Main Methods:
- Open transabdominal cerclage (TAC) using 5-mm Mersilene tape was performed on three women between 12-13 weeks of gestation.
- Patients had a history of severe cervical insufficiency and prior failed transvaginal cerclages.
Main Results:
- All three pregnancies resulted in live births, with a total of five neonates delivered.
- Deliveries occurred at 38w4d (singleton), 35w2d (singleton), and 30w1d (triplets).
- No major intraoperative or postoperative complications were observed.
Conclusions:
- Transabdominal cerclage (TAC) is a feasible intervention for severe cervical insufficiency in a Ghanaian specialist hospital.
- Preliminary outcomes are encouraging, suggesting TAC's potential in the West African region.
- Larger studies are required to confirm efficacy and generalizability.
