title: Abdominal cerclage for the treatment of recurrent cervical insufficiency: laparoscopy or laparotomy?
abstract: OBJECTIVE
  The purpose of this study was to compare the efficacy of traditional abdominal cerclage (AC) with laparoscopic cerclage (LC).
  
  
  METHODS
  Eligible women had at least 1 second trimester pregnancy loss due to cervical insufficiency, and had undergone at least 1 failed transvaginal cerclage. A prospective cohort of patients undergoing LC was compared with a historical control group of patients who had AC. A successful primary outcome was defined as delivery of a viable infant with neonatal survival.
  
  
  RESULTS
  We were able to evaluate 19 pregnancies following unique abdominal cerclage placement, 12 laparoscopic and 7 at the time of laparotomy. Nine of 12 (75%) undergoing LC and 5 of 7 (71%) pregnancies undergoing AC successfully delivered a viable infant (P = .63). LC during pregnancy was successful in 4 of 5 (80%) cases as compared to 3 of 5 (60%) cases with AC during pregnancy (P = 1.0).
  
  
  CONCLUSIONS
  Operative laparoscopy is a safe and effective alternative to laparotomy for the placement of abdominal cerclage.
authors: Department of Obstetrics and Gynecology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA. caterja@musc.edu
authors: James F
authors: JF
authors: Carter
authors: David E
authors: DE
authors: Soper
authors: Laura M
authors: LM
authors: Goetzl
authors: J Peter
authors: JP
authors: Van Dorsten
mesh_terms: D000005:Abdomen; D000026:Abortion, Habitual / Q000209:etiology; D000328:Adult; D000556:Ambulatory Surgical Procedures; D023802:Cerclage, Cervical / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D002581:Uterine Cervical Incompetence / Q000601:surgery; D055815:Young Adult