Laparoscopic transabdominal cervicoisthmic cerclage during pregnancy.
OBJECTIVE
To evaluate and describe our experience in the management of recurrent second-trimester miscarriage and preterm delivery by laparoscopic transabdominal cervicoisthmic cerclage (LTCC), after failure of transvaginal cervical cerclage.


METHODS
Retrospective review (Canadian Task Force classification III).


METHODS
Tertiary care teaching hospital.


METHODS
Twenty women in whom it was not technically possible to perform transvaginal cerclage.


METHODS
LTCC.


RESULTS
Mean operating time was 55 minutes (range 40-75 min). There were no operative or immediate postoperative complications. Mean gestational age at the time of cerclage placement was 12.1 weeks (range 11-14 wks). Nineteen women successfully delivered 21 live babies (2 sets of twins; live birth rate 95%). One loss occurred after rupture of membrane at 19 weeks' after cerclage.


CONCLUSIONS
LTCC during pregnancy can be safe and effective treatment for well-selected patients with cervical incompetence, and eliminates the need for open laparotomy.
Department of Obstetrics and Gynecology, School of Medicine and Institute for Medical Genetics, Keimyung University, Taegu, South Korea.
Chi-Heum
CH
Cho
Taek-Hoon
TH
Kim
Sang-Hoon
SH
Kwon
Jong-In
JI
Kim
Sung-Do
SD
Yoon
Soon-Do
SD
Cha
D000026:Abortion, Habitual / Q000517:prevention & control; D000328:Adult; D023802:Cerclage, Cervical / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors; D002581:Uterine Cervical Incompetence / Q000601:surgery*