American Journal of Obstetrics and Gynecology
SMFM paperTransabdominal cerclage after comprehensive evaluation of women with previous unsuccessful transvaginal cerclage
Section snippets
Materials and Methods
One hundred fourteen patients were referred to a single Maternal Fetal Medicine specialist (R.H.D.) between 1994 and 2006. Strict criteria were used to identify appropriate candidates for TAC placement. Preconception work up included a hysterosalpingogram or sonohysterogram for uterine cavity evaluation (75 patients). Thrombophilia work-up was performed that included anticardiolipin antibody (ACA) immunoglobulin G/M, lupus anticoagulant (LAC), protein S and C levels, antigen (Ag), antithrombin
Results
The results after TAC are shown in Table 1. Seventy-five women underwent 75 TAC procedures in singleton pregnancies. Seventy-two patients had no intraoperative or postoperative complications of TAC placement. The most serious complication of TAC placement was a bowel perforation that occurred while the right angle clamp passed through the broad ligament. This was oversewn with no subsequent sequelae. One woman had an incisional hernia, and another woman had a wound infection. No patients
Comment
Cervical insufficiency often is diagnosed on the basis of an obstetric history of repeated painless mid-trimester losses or preterm deliveries. Although TVC has been an accepted management for cervical insufficiency for decades, its efficacy remains in question. TAC has been used in women with congenitally short or extensively amputated cervices, markedly scarred or lacerated cervices, cervicovaginal fistulas, subacute cervicitis, or failed TVC. In this retrospective series, we present a large
References (24)
Transabdominal cervicoisthmic cerclage for the management of repetitive abortion and premature delivery
Am J Obstet Gynecol
(1982)- et al.
Transabdominal cerclage: a laparoscopic approach
Obstet Gynecol
(1998) - et al.
Transabdominal cerclage for closure of the incompetent cervix
Eur J Obstet Gynecol
(1987) - et al.
Transabdominal cerclage
Eur J Obstet Gynecol
(1991) Transabdominal cervicoisthmic cerclage: a reappraisal 25 years after its introduction
Am J Obstet Gynecol
(1991)- et al.
Validity of indications for transabdominal cervicoisthmic cerclage for cervical incompetence
Am J Obstet Gynecol
(1995) - et al.
Transabdominal cervico-isthmic cerclage in the management of cervical incompetence
Eur J Obstet Gynecol
(1997) - et al.
Preconception transabdominal cervico-isthmic cerclage
Am J Obstet Gynecol
(2004) - et al.
Laparoscopic transabdominal cervico-isthmic cerclage
Fertil Steril
(1998) - et al.
Laparoscopic abdominal cerclage
Obstet Gynecol Clin N Am
(2004)
Laparoscopic transabdominal cervicoisthmic cerclage during pregnancy
J Am Assoc Gynecol Laparosc
Patients with a prior failed transvaginal cerclage: a comparison of obstetric outcomes with either transabdominal or transvaginal cerclage
Am J Obstet Gynecol
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Cite this article as: Debbs RH, DeLa Vega GA, Pearson S, Sehdev H, Marchiano D, Ludmir J. Transabdominal cerclage after comprehensive evaluation of women with previous unsuccessful transvaginal cerclage. Am J Obstet Gynecol 2007;197:317.e1-317.e4.