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Successful term delivery cases of trans-abdominal cervicoisthmic cerclage performed at more than 18 weeks of gestation

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A 38-year-old nulliparous woman was referred to our clinic because of cervical incompetence at 19 weeks of gestation. Trans-abdominal cervicoisthmic cerclage was performed after failure of modified Shirodkar cerclage operation in the patient at 21 weeks of gestation via a laparotomic approach. Another 38-year-old patient, who underwent loop electrosurgical excision procedure conization for treatment of cervical dysplasia 4 years ago, presented for cervical incompetence. At 18 weeks of gestation, we performed trans-abdominal laparotomic cervicoisthmic cerclage without any post-operative complications. During antenatal follow-up, there were no obstetrical co-morbidities and finally she gave birth to a healthy infant at full term by cesarean section. We report two cases of women who underwent trans-abdominal cervicoisthmic cerclage surgery because of cervical incompetence as they were not suitable for trans-vaginal cervical cerclage. Both patients successfully maintained their pregnancy until full term after undergoing trans-abdominal cervicoisthmic cerclage at more than 18 weeks of gestation.

Abstract

A 38-year-old nulliparous woman was referred to our clinic because of cervical incompetence at 19 weeks of gestation. Trans-abdominal cervicoisthmic cerclage was performed after failure of modified Shirodkar cerclage operation in the patient at 21 weeks of gestation via a laparotomic approach. Another 38-year-old patient, who underwent loop electrosurgical excision procedure conization for treatment of cervical dysplasia 4 years ago, presented for cervical incompetence. At 18 weeks of gestation, we performed trans-abdominal laparotomic cervicoisthmic cerclage without any post-operative complications. During antenatal follow-up, there were no obstetrical co-morbidities and finally she gave birth to a healthy infant at full term by cesarean section. We report two cases of women who underwent trans-abdominal cervicoisthmic cerclage surgery because of cervical incompetence as they were not suitable for trans-vaginal cervical cerclage. Both patients successfully maintained their pregnancy until full term after undergoing trans-abdominal cervicoisthmic cerclage at more than 18 weeks of gestation.

참고문헌 (6)

  1. Zaveri V, "Abdominal versus vaginal cerclage after a failed transvaginal cerclage : a systematic review", Am J Obstet Gynecol, 187, pp.868~872 (2002)
  2. Tulandi T, "Pre and postconceptional abdominal cerclage by laparoscopy or laparotomy", J Minim Invasive Gynecol, 21, pp.987~993 (2014)
  3. Ades A, "Transabdominal cervical cerclage : laparoscopy versus laparotomy", J Minim Invasive Gynecol, 22, pp.968~973 (2015)
  4. Pereira RM, "Successful interval laparoscopic transabdominal cervicoisthmic cerclage preceding twin gestation : a case report", J Minim Invasive Gynecol, 16, pp.634~638 (2009)
  5. Carter JF, "Abdominal cerclage for the treatment of recurrent cervical insufficiency:laparoscopy or laparotomy?", Am J Obstet Gynecol, 201, pp.111.e1~111.e4 (2009)
  6. Shin SJ, "The feasibility of a modified method of laparoscopic transabdominal cervicoisthmic cerclage during pregnancy", J Laparoendosc Adv Surg Tech A, 25, pp.651~656 (2015)

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