Laparoscopic transabdominal cervicoisthmic cerclage during pregnancy

STUDY OBJECTIVE: To evaluate and describe our experience in the management of recurrent second-trimester miscarriage and preterm delivery by laparoscopic transabdominal cervicoisthmic cerclage (LTCC), after failure of transvaginal cervical cerclage. DESIGN: Retrospective review (Canadian Task Force classification III). SETTING: Tertiary care teaching hospital. PATIENTS: Twenty women in whom it was not technically possible to perform transvaginal cerclage. INTERVENTION: LTCC. MEASUREMENTS AND MAIN RESULTS: Mean operating time was 55 minutes (range 40-75 min). There were no operative or immediate postoperative complications. Mean gestational age at the time of cerclage placement was 12.1 weeks (range 11-14 wks). Nineteen women successfully delivered 21 live babies (2 sets of twins; live birth rate 95%). One loss occurred after rupture of membrane at 19 weeks' after cerclage. CONCLUSION: LTCC during pregnancy can be safe and effective treatment for well-selected patients with cervical incompetence, and eliminates the need for open laparotomy.