Obstet Gynecol Sci.  2016 Jul;59(4):319-322. 10.5468/ogs.2016.59.4.319.

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

• Joung EJ
• Go EB
• Kwack JY
• Kwon YS

• KMID: 2329055
• DOI: http://doi.org/10.5468/ogs.2016.59.4.319

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 transvaginal cervical cerclage. Both patients successfully maintained their pregnancy until full term after undergoing transabdominal cervicoisthmic cerclage at more than 18 weeks of gestation.

Keyword

Cervicoisthmic cerclage; Delivery; Uterine cervical incompetence

MeSH Terms

Adult
Cerclage, Cervical
Cesarean Section
Conization
Female
Follow-Up Studies
Humans
Infant
Parturition
Pregnancy*
Uterine Cervical Incompetence

Figure

• 

  Fig. 1 Serial changes in cervical length of the patient (case 1). (A) At 19+4 weeks of gestation, the length of the cervix was measured to be 17 mm, (B) at 21+4 weeks of gestation, it was measured to be 7 mm and (C) after transabdominal cervicoisthmic cerclage it was measured to be 32 mm. (D) The photograph of the anterior side of the uterus after completion of transabdominal cervicoisthmic cerclage (case 2).

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