Transabdominal Cerclage During Pregnancy: A Retrospective Single Operator Series Over a Quarter Century

Authors

David R Hall
Mari van de Vyver

Publication Date

3-1-2023

Journal

International Journal of Gynecology and Obsterics

Abstract

OBJECTIVE: To describe the pregnancy outcomes and complications observed in a series of cases of transabdominal cerclage (TAC), which is reserved for highly selected women with recurrent mid-trimester pregnancy loss, due to cervical insufficiency.

METHODS: A retrospective audit covering 25 years (January 1, 1997 to December 31, 2021) was performed at the Obstetric Special Care division, Tygerberg Academic Hospital in Cape Town, South Africa. All 118 pregnancies from 94 procedures, operated and managed by the principal author were included for descriptive analysis.

RESULTS: Eighty-four (91.3%) of the 92 first pregnancies after first insertion had successful outcomes. All second and third pregnancies (24/24; 100%) were successful. Eight pregnancies did not achieve viability, two women (2/8) did however achieve a successful pregnancy after a subsequent repeat TAC procedure. For the viable pregnancies (110/118), the median gestational age at delivery was 37 weeks (range 28-39 weeks). The median intraoperative blood loss during cerclage insertion was 100 ml (range 25-750 ml).

CONCLUSION: In experienced hands, TAC during pregnancy is a safe and effective operation, when other less invasive procedures have failed.

Keywords

Pregnancy, Female, Humans, Infant, Retrospective Studies, Cerclage, Cervical, South Africa, Pregnancy Outcome, Uterine Cervical Incompetence, Abortion, Habitual, Premature Birth, cervical insufficiency, cervix, transabdominal cerclage

Comments

PMID: 36029114