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Laparoscopic transabdominal cervical cerclage: Case report of a woman without exocervix at 11 weeks gestation

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초록

Cervical incompetence is characterized by painless dilatation of the incompetent cervix and results in miscarriages and preterm delivery during second trimester. We report a 25-year-old patient, gravid 2, para 1, at 11 weeks’ gestation with the diagnosis of cervical incompetence, in whom transvaginal cerclage was not technically possible and laparoscopic cervical cerclage was performed successfully. There were no operative or immediate postoperative complications. A healthy infant was delivered at 35 weeks by cesarean section. Laparoscopic cervical cerclage during pregnancy can be safe and effective treatment for well-selected patients with cervical incompetence and eliminates the need for open laparotomy.

Abstract

Cervical incompetence is characterized by painless dilatation of the incompetent cervix and results in miscarriages and preterm delivery during second trimester. We report a 25-year-old patient, gravid 2, para 1, at 11 weeks’ gestation with the diagnosis of cervical incompetence, in whom transvaginal cerclage was not technically possible and laparoscopic cervical cerclage was performed successfully. There were no operative or immediate postoperative complications. A healthy infant was delivered at 35 weeks by cesarean section. Laparoscopic cervical cerclage during pregnancy can be safe and effective treatment for well-selected patients with cervical incompetence and eliminates the need for open laparotomy.

참고문헌 (7)

  1. Shennan A, "The cervix and prematurity: aetiology, prediction and prevention", Semin Fetal Neonatal Med, 9, pp.471~479 (2004)
  2. Harger JH, "Cerclage and cervical insufficiency: an evidence-based analysis", Obstet Gynecol, 100, pp.1313~1327 (2002)
  3. Schwartz RP, "Cervical cerclage: a review of 74 cases", J Reprod Med, 29, pp.103~106 (1984)
  4. Benson RC, "Transabdominal cervico uterine cerclage during pregnancy for the treatment of cervical incompetency", Obstet Gynecol, 25, pp.145~155 (1965)
  5. Cho CH, "Laparoscopic transabdominal cervicoisthmic cerclage during pregnancy", J Am Assoc Gynecol Laparosc, 10, pp.363~366 (2003)
  6. Liddell HS, "Laparoscopic cervical cerclage: a series in women with a history of second trimester miscarriage", J Minim Invasive Gynecol, 15, pp.342~345 (2008)
  7. Novy MJ, "Transabdominal cervicoisthmic cerclage: a reappraisal 25 years after its introduction", Am J Obstet Gynecol, 164(6 Pt 1), pp.1635~1641 (1991)

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