Clinical usefulness of transabdominal cervicoisthmic cerclage in IIOC patients for whom transvaginal cervicoisthmic cerclage is unsuitable

Park, Sung Ho; Heo, Jin Sook; Lee, Sang Hun; Park, Ki Han; Choung, Tae Bum; Jun, Hyun Ah; Kim, Hong Bae; Lee, Keun Young; Kang, Song Won

Abstract

OBJECTIVE
Our purpose was to review the clinical use of transabdominal cervicoishmic cerclage to determine whether it is a valid alternative to transvaginal cerclage. Study design : A retrospective review was carried out of transabdominal cerclage patients at our hospital from Jan. 1999 to May. 2001. Analysis of the clinical use of transabdominal rather than the vaginal approach in some IIOC patients was performed and fetal outcomes was evaluated.
RESULTS
Fifteen patients underwent transabdominal cerclages. The primary indication for transabdominal cervicoisthmic cerclage was failed transvaginal cerclage in 9 patients and anatomic unsuitability for transvaginal cerclage in 6 patients. Follow-up was conducted for all except one patient. All patients were successfully delivered of live babies by Cesarean section. Complications including blood loss requiring transfusion did not occur. However one baby died at postpartal 1 day because of congenital Tetralogy of Fallot.
CONCLUSION
All patients had histories compatible with incompetent cervix requiring cerclage, and none were suitable candidates for vaginal cerclage. Our results and review of the literature confirm that Transabdominal cervicoisthmic cerclage has an important role to play for carefully selected patients.