Successful pregnancy following mid-trimester evacuation through a transabdominal cervical cerclage.
Preterm birth remains a major challenge in modern obstetrics and is increasing, even among low-risk primiparous women. Very few interventions have made a positive impact on outcome although cervical cerclage appears to benefit some women. Transabdominal cervical cerclage can be highly successful and should be considered in women with previous failed transvaginal cerclage, but requires operative abdominal delivery as it cannot be removed. The authors report the first case they are aware of, where a spontaneous abortion occurred with a transabdominal cerclage in situ and a mid-trimester dilation and evacuation was performed through the cerclage at 18 weeks gestation, instead of a hysterotomy. A subsequent pregnancy was successful and it was the first to go full term.
Division of Reproduction and Endocrinology, Department of Women's Health, St Thomas' Hospital, King's College London, London, UK. manju.chandiramani@kcl.ac.uk
Manju
M
Chandiramani
Lucy
L
Chappell
Samara
S
Radford
Andrew
A
Shennan
D000005:Abdomen; D000328:Adult; D023802:Cerclage, Cervical / Q000379:methods; D005113:Extraction, Obstetrical; D005260:Female; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second