Cervicoisthmic cerclage: transabdominal vs transvaginal approach

Abstract

Objective: We sought to compare the outcomes of cervicoisthmic (CI) cerclage using traditional transabdominal (TA) approach vs the lesser used transvaginal (TV) approach.

Study design: We conducted a retrospective cohort study of women who underwent placement of a CI cerclage.

Results: Before CI placement, the abdominal group had a total of 100 pregnancies that continued beyond the first trimester and had 27 (27%) surviving infants. After cerclage placement, there were 34 pregnancies and 24 (71%) surviving infants. Before cerclage placement, the vaginal group had a total of 90 pregnancies that continued beyond the first trimester and had 11 (12%) surviving infants. After cerclage placement, there were 29 pregnancies and 20 (69%) surviving infants. The vaginal cerclage group had a significantly shorter mean operative time of 33 vs 69 minutes, and shorter hospital stay of 0.5 vs 3.2 days.

Conclusion: Both TV and TA CI cerclage offers select patients with cervical insufficiency improved neonatal survival. The TV placement of a CI has less morbidity than the TA approach with a comparable neonatal survival.