Pre-pregnancy transabdominal cerclage.
A consecutive series of 45 women with one or more previous second trimester deliveries, who had a pre-pregnancy transabdominal cerclage (TAC) from 1999 to July 2007, was followed until January 2008. Within the observation period 50 pregnancies occurred in 36 women. Seven resulted in first trimester abortions, none in second trimester abortions or deliveries, and six were on-going pregnancies. In the remaining 37 pregnancies the fetal salvage rate was 100%, and cesarean section was performed after 34 weeks (mean 36+5 weeks) in 36 (97%) pregnancies. One woman had three successful pregnancies following the procedure. No serious complications were associated with the application of TAC. One woman had a hysterectomy following cesarean section. Pre-pregnancy TAC is a procedure with few complications and excellent outcome. The method may be considered in women with a second trimester fetal loss, when cervical incompetence cannot be ruled out.
Thuesen
Lea Langhoff
LL
Department of Obstetrics and Gynecology, Rigshospitalet, University Hospital of Copenhagen, Denmark. lea@thuesen.com
Diness
Birgitte Rode
BR
Langhoff-Roos
Jens
J
D000026:Abortion, Habitual / Q000517:prevention & control*; D000328:Adult; D023802:Cerclage, Cervical / Q000009:adverse effects / Q000379:methods*; D002585:Cesarean Section; D005260:Female; D005865:Gestational Age; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology / Q000517:prevention & control*; D012307:Risk Factors; D013997:Time Factors; D017211:Treatment Failure; D002581:Uterine Cervical Incompetence / Q000601:surgery*