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Transabdominal Cervical Cerclage

  • Sabahattin Anıl Arı
  • Ali Akdemir
  • Fatih Sendag
Chapter

Abstract

Preterm delivery is the one of the major challenges in modern obstetrics. Preterm delivery increases the risk of neonatal morbidity and mortality in industrialized countries and imposes substantial costs on the healthcare system. Preterm birth has multiple risk factors, including cervical insufficiency. The reported incidence of cervical insufficiency is 0.1–1% of all pregnancies. Surgical treatment options for this condition are transvaginal or transabdominal cervical cerclage. Transabdominal cervicoisthmic cerclage is usually reserved for patients who have previously unsuccessful transvaginal cerclages or anatomical limitations and can have a pregnancy take home rate of 95%. The procedures generally are performed in the late first trimester, early second trimester (10–14 weeks of gestation), or prepregnancy.

Keywords

Cervical insufficiency Preterm delivery Transabdominal cerclage Painless cervical dilation Cervicoisthmic cerclage Laparoscopic surgery Minimal invasive surgery Fertility Removal of cerclage Neonatal mortality 

References

  1. 1.
    American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No.142: Cerclage for the management of cervical insufficiency. Obstet Gynecol 2014;123:372–9.Google Scholar
  2. 2.
    Iams JD, Johnson FF, Sonek J, Sachs L, Gebauer C, Samuels P. Cervical competence as a continuum: a study of ultrasonographic cervical length and obstetric performance. Am J Obstet Gynecol. 1995;172:1097–103.CrossRefGoogle Scholar
  3. 3.
    Saccone G, Ciardulli A, Xodo S, Dugoff L, Ludmir J, Pagani G, et al. Cervical pessary for preventing preterm birth in singleton pregnancies with short cervical length: a systematic review and meta-analysis. J Ultrasound Med. 2017;36(8):1535–43.  https://doi.org/10.7863/ultra.16.08054. Epub 11 Apr 2017.CrossRefPubMedGoogle Scholar
  4. 4.
    McDonald IA. Suture of the cervix for inevitable miscarriage. J Obstet Gynaecol Br Emp. 1957;64:346–50.CrossRefGoogle Scholar
  5. 5.
    Shirodkar VN. A new method of operative treatment for habitual abortions in the second trimester of pregnancy. Antiseptic. 1955;52:299–300.Google Scholar
  6. 6.
    Berghella V, Szychowski JM, Owen J, Hankins G, Iams JD, Sheffield JS, et al. Suture type and ultrasound-indicated cerclage efficacy. Vaginal Ultrasound Trial Consortium. J Matern Fetal Neonatal Med. 2012;25:2287–90.CrossRefGoogle Scholar
  7. 7.
    Harger JH. Cerclage and cervical insufficiency: an evidence based analysis. Obstet Gynecol. 2002;100:1313–27.PubMedGoogle Scholar
  8. 8.
    Davis G, Berghella V, Talucci M, Wapner RJ. Patients with a prior failed transvaginal cerclage: a comparison of obstetric outcomes with either transabdominal or trans-vaginal cerclage. Am J Obstet Gynecol. 2000;183:836–9.CrossRefGoogle Scholar
  9. 9.
    Burger NB, Brolmann HA, Einarsson JI, Langebrekke A, Huirne JA. Effectiveness of abdominal cerclage placed via laparotomy or laparoscopy: systematic review. J Minim Invasive Gynecol. 2011;18:696–704.CrossRefGoogle Scholar
  10. 10.
    Romero R, Espinoza J, Erez O, Hassan S. The role of cervical cerclage in obstetric practice: can the patient who could benefit from this procedure be identified? Am J Obstet Gynecol. 2006;194:1–9.CrossRefGoogle Scholar
  11. 11.
    Sneider K, Christiansen OB, Sundtoft IB, Langhoff-Roos J. Recurrence rates after abdominal and vaginal cerclages in women with cervical insufficiency: a validated cohort study. Arch Gynecol Obstet. 2017;295(4):859–66.  https://doi.org/10.1007/s00404-017-4315-y. Epub 23 Feb 2017.CrossRefPubMedGoogle Scholar
  12. 12.
    Sumners JE, Kuper SG, Foster TL. Transabdominal cerclage. Clin Obstet Gynaecol. 2016;59(2):295–301.CrossRefGoogle Scholar
  13. 13.
    Tusheva OA, Cohen SL, McElrath TF, et al. Laparoscopic placement of cervical cerclage. Rev Obstet Gynecol. 2012;5:e158–65.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Tulandi T, Alghanaim N, Hakeem G, et al. Pre- and post-conceptional abdominal cerclage by laparoscopy or laparotomy. J Minim Invasive Gynecol. 2014;21:987–93.CrossRefGoogle Scholar
  15. 15.
    Ades A, Dobromilsky KC, Cheung KT, Umstad MP. Transabdominal cervical cerclage: laparoscopy versus laparotomy. J Minim Invasive Gynecol. 2015;22(6):968–73.  https://doi.org/10.1016/j.jmig.2015.04.019. Epub 28 Apr 2015.CrossRefPubMedGoogle Scholar
  16. 16.
    Bolla D, Gasparri ML, Badir S, Bajka M, Mueller MD, Papadia A, et al. Cervical length after cerclage: comparison between laparoscopic and vaginal approach. Arch Gynecol Obstet. 2017;295(4):885–90.  https://doi.org/10.1007/s00404-016-4285-5. Epub 3 Mar 2017.CrossRefPubMedGoogle Scholar
  17. 17.
    Walsh TM, Borahay MA, Fox KA, Kilic GS. Robotic-assisted, ultrasound-guided abdominal cerclage during pregnancy: over- coming minimally invasive surgery limitations? J Minim Invasive Gynecol. 2013;20:398–400.CrossRefGoogle Scholar
  18. 18.
    Zeybek B, Borahay MA, Kilic GS. Overcoming the obstacles of visualization in robotically-assisted abdominal cerclage using indocyanine green. J Robot Surg. Published ahead of print 16 Apr 2016.  https://doi.org/10.1007/s11701-016-0585-9.CrossRefGoogle Scholar
  19. 19.
    Gibbs S, Widelock T, Elkattah R, Depasquale S. Additional uses of a vaginal fornices delineator. Am J Obstet Gynecol. 2015;213:433.e1–3.CrossRefGoogle Scholar
  20. 20.
    Althuisius S, Dekker G, Hummel P, Bekedam D, Kuik D, van Geijn H. Cervical incompetence prevention randomized cerclage trial (CIPRACT): effect of therapeutic cerclage with bed rest vs. bed rest only on cervical length. Ultrasound Obstet Gynecol. 2002;20:163–7.CrossRefGoogle Scholar
  21. 21.
    Wolfe L, DePasquale S, Adair CD, Torres C, Stallings S, Briery C, et al. Robotic-assisted laparoscopic placement of transabdominal cerclage during pregnancy. Am J Perinatol. 2008;25:653–5.CrossRefGoogle Scholar
  22. 22.
    Groom K, Jones BA, Edmonds K, Bennett PR. Preconception transabdominal cervicoisthmic cerclage. Am J Obstet Gynecol. 2004;191(1):230–4.CrossRefGoogle Scholar
  23. 23.
    Dawood F, Farquharson RG. Transabdominal cerclage: preconceptual versus first trimester insertion. Eur J Obstet Gynecol Reprod Biol. 2016;199:27–31.  https://doi.org/10.1016/j.ejogrb.2016.01.035. Epub 8 Feb 2016.CrossRefPubMedGoogle Scholar
  24. 24.
    Vousden NJ, Carter J, Seed PT, Shennan AH. What is the impact of preconception abdominal cerclage on fertility: evidence from a randomized controlled trial. Acta Obstet Gynecol Scand. 2017;96:543–6.CrossRefGoogle Scholar
  25. 25.
    Laskin MD, Yinon Y, Whittle WL. Preterm premature rupture of membranes in the presence of cerclage: is the risk for intra-uterine infection and adverse neonatal outcome increased? J Matern Fetal Neonatal Med. 2012;25:424–8.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Sabahattin Anıl Arı
    • 1
  • Ali Akdemir
    • 1
  • Fatih Sendag
    • 1
  1. 1.Department of Obstetrics and GynecologyEge University HospitalBornovaTurkey

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