title: Transvaginal placement of cervicoisthmic cerclage: report on pregnancy outcome.
abstract: OBJECTIVE
  This study was undertaken to review pregnancy course and outcome in 56 pregnancies after the placement of a cervicoisthmic cerclage transvaginally.
  
  
  METHODS
  Fifty-three pregnant patients with unique indications such as previous failure of conventional cerclages or compromised cervical anatomy, underwent transvaginal placement of a cervicoisthmic cerclage during pregnancy.
  
  
  RESULTS
  There was 100% fetal survival. Preterm birth rate was 32% and births at less than 30 weeks occurred in 21% of our patients. In 6 patients, the suture was not removed and 3 patients had an additional gestation with the same suture. Serious complications included 1 instance of intraoperative bladder laceration and 1 of intrapartum cervical tear. Minor complications included a postoperative hematoma and transient urinary retention with pelvic pain in 2 patients.
  
  
  CONCLUSIONS
  The placement of transvaginal cervicoisthmic cerclage was associated with favorable pregnancy outcome and may be considered as a suitable safe alternative to the transabdominal cerclage.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, California Pacific Medical Center, San Francisco, 94118, USA. Katzmi@sutterhealth.org
authors.forename: Michael
authors.initials: M
authors.lastname: Katz
authors.forename: Carol
authors.initials: C
authors.lastname: Abrahams
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D023802:Cerclage, Cervical / Q000379:methods / Q000706:statistics & numerical data*; D002584:Cervix Uteri / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D011183:Postoperative Complications; D011247:Pregnancy; D011256:Pregnancy Outcome; D002581:Uterine Cervical Incompetence / Q000453:epidemiology / Q000601:surgery*