Aim: Preterm birth is a worldwide health problem. After unsuccessful transvaginal cerclage, the transabdominal isthmo-cervical cerclage can be indicated. A laparoscopic approach has been described.
Methods: A search was performed including the combination of: "((cerclage) AND (laparoscopy)) AND (pregnancy)". A systematic review was performed to compare indications, outcomes, techniques, and safety.
Results & discussion: 42 articles were found through database search. 30 articles were included for review. By reviewing the literature, the transabdominal cervico-isthmic laparoscopic cerclage is highly effective in selected patients with a history of refractory cervical insufficiency. This technique has a high neonatal survival rate when placed in preconceptional or post conceptional patients. Moreover, laparoscopic cervical cerclage is a safe procedure when laparoscopic expertise is present.
Keywords: cervical cerclage; laparoscopy; pregnancy.
A transvaginal cerclage is a procedure that places a stitch or tape within the cervix to mechanically close the cervix to prevent it from opening too early during pregnancy. However, if transvaginal cerclage fails, doctors may recommend a transabdominal isthmo-cervical cerclage using a laparoscopic approach. A systematic review analyzed 30 articles to compare the reasons for surgery, outcomes, techniques, and safety. The review suggests that this procedure is highly effective for certain patients with a history of refractory cervical insufficiency. It appears to be a safe technique with a high rate of survival for newborns and rare complications.
© 2023 The Authors.