title: Abdominal cerclage in twin pregnancy after radical surgical conization.
abstract: Radical and repeated cone biopsies are associated with a high risk of spontaneous preterm birth. A 30-year-old gravida 1 presented with a spontaneous dichorionic twin pregnancy. She had a history of two radical surgical conizations. By speculum examination, no cervical tissue was detected. A history-indicated transabdominal cervicoisthmic cerclage was performed at 12 + 4/7 gestational weeks because of assumed cervicoisthmic insufficiency. The pregnancy continued until 34 + 3/7 weeks when the patient developed preeclampsia indicating Cesarean delivery. Transabdominal cerclage in twin pregnancy has rarely been described, but it may be considered in case of extreme cervical shortening after radical cervical surgery, as it would in singleton pregnancy.
authors.affiliation: Department of Prenatal and Perinatal Medicine, Clara Angela Foundation, Koenigsallee 36, 14193 Berlin, Germany ; Department of Pre- and Perinatal Medicine, Center of Mother and Child, University Hospital of Giessen and Marburg, Philipps University of Marburg, Campus Marburg, Baldinger Straße 1, 35043 Marburg, Germany.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kyvernitakis
authors.affiliation: Department of Obstetrics and Gynecology, Radboudumc, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.
authors.forename: Fred
authors.initials: F
authors.lastname: Lotgering
authors.affiliation: Department of Prenatal and Perinatal Medicine, Clara Angela Foundation, Koenigsallee 36, 14193 Berlin, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Arabin