title: Treatment of cervical incompetence by transabdominal cervicoisthmic cerclage.
abstract: Cervical incompetence is a condition traditionally treated by cervical cerclage which in most cases is inserted via the transvaginal route. However the insertion of a transabdominal cervicoisthmic suture is indicated in those patients with recurrent mid-trimester losses due to an incompetent cervix where it is not technically possible to insert a transvaginal suture. Between 1987 and 1996, 12 women at the Royal Women's Hospital, Melbourne were treated with transabdominal cervicoisthmic cerclage (TCC). Eight patients had cerclage in the nonpregnant state, and 4 were pregnant at the time. The completed pregnancies thus far have resulted in 10 surviving infants, a successful pregnancy rate of 69.2%. This compares favourably with a corrected preTCC successful pregnancy rate of only 13%. There were minimal intraoperative complications in our series. Bleeding, chorioamnionitis and premature rupture of the membranes have been reported elsewhere and occurred in 2 of our patients. Our results and a review of the literature confirms that TCC has an important role in carefully-selected patients.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Melbourne.
authors.forename: S
authors.initials: S
authors.lastname: Craig
authors.forename: J R
authors.initials: JR
authors.lastname: Fliegner
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013536:Suture Techniques; D002581:Uterine Cervical Incompetence / Q000601:surgery*