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Transvaginal placement of cervicoisthmic cerclage: report on pregnancy outcome.

Katz M, Abrahams C

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, California Pacific Medical Center, San Francisco, 94118, USA. Katzmi@sutterhealth.org

OBJECTIVE: This study was undertaken to review pregnancy course and outcome in 56 pregnancies after the placement of a cervicoisthmic cerclage transvaginally. STUDY DESIGN: Fifty-three pregnant patients with unique indications such as previous failure of conventional cerclages or compromised cervical anatomy, underwent transvaginal placement of a cervicoisthmic cerclage during pregnancy. RESULTS: There was 100% fetal survival. Preterm birth rate was 32% and births at less than 30 weeks occurred in 21% of our patients. In 6 patients, the suture was not removed and 3 patients had an additional gestation with the same suture. Serious complications included 1 instance of intraoperative bladder laceration and 1 of intrapartum cervical tear. Minor complications included a postoperative hematoma and transient urinary retention with pelvic pain in 2 patients. CONCLUSION: The placement of transvaginal cervicoisthmic cerclage was associated with favorable pregnancy outcome and may be considered as a suitable safe alternative to the transabdominal cerclage.

Published 22 June 2005 in Am J Obstet Gynecol, 192(6): 1989-92; discussion 1992-4.
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