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Transabdominal cerclage after comprehensive evaluation of women with previous unsuccessful transvaginal cerclage.

Debbs RH, DeLa Vega GA, Pearson S, Sehdev H, Marchiano D, Ludmir J

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA 19107, USA. rdebbs@comcast.net

OBJECTIVE: The purpose of this study was to assess the outcome after transabdominal-cerclage placement during pregnancy in women with previous unsuccessful transvaginal cerclage. STUDY DESIGN: We conducted a retrospective case series that described pregnancy outcome in women who were treated with transabdominal cerclage between 1994 and 2006. RESULTS: Seventy-five women with negative evaluation for recurrent pregnancy loss and > or = 1 previous unsuccessful transvaginal cerclage procedures were treated with transabdominal cerclage. The median gestational age at the time of cerclage placement was 13 weeks, and the median gestational age at delivery was 36 weeks. Seventy-two women delivered after 24 weeks of gestation, and 3 women delivered < or = 24 weeks of gestation. The fetal-salvage after transabdominal cerclage was 96%. CONCLUSION: Our findings suggest that, in women with a history of > or = 1 failed transvaginal cerclage, transabdominal cerclage is an effective procedure.

Published 10 September 2007 in Am J Obstet Gynecol, 197(3): 317.e1-4.
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