Transabdominal cervical cerclage during pregnancy. A modified technique

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Surgical Innovation

Background:

• Cervical insufficiency poses a significant risk for preterm birth.
• Transvaginal cervical cerclage is the standard procedure but not feasible for all patients.
• A modified transabdominal approach is needed for cases with severely shortened or damaged cervices.

Purpose of the Study:

• To present a modified transabdominal surgical technique for cervical cerclage.
• To evaluate the feasibility and outcomes of this modified procedure in high-risk pregnancies.

Main Methods:

• A modified transabdominal cervical cerclage was performed via laparotomy.
• A nylon tape was placed around the uterine isthmus and secured to surrounding ligaments.
• The procedure was performed on 10 patients with contraindications for transvaginal cerclage.

Main Results:

• No operative or postoperative complications were observed in the 10 cases.
• Seven of the ten infants survived after delivery via cesarean section at or near term.
• The mothers in the successful cases had a history of significantly high rates of prior pregnancy loss.

Conclusions:

• The modified transabdominal cervical cerclage is a viable and safe alternative for patients with severely compromised cervices.
• This technique can improve pregnancy outcomes in women with a history of recurrent pregnancy loss due to cervical insufficiency.