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Comparative Study
. 2009 Jul;201(1):105.e1-4.
doi: 10.1016/j.ajog.2009.03.020. Epub 2009 Apr 18.

Cervicoisthmic cerclage: transabdominal vs transvaginal approach

Marili U Witt  1 , Saju D Joy, Jennifer Clark, Amy Herring, Watson A Bowes, John M Thorp
Affiliations
Comparative Study

Cervicoisthmic cerclage: transabdominal vs transvaginal approach

Marili U Witt et al. Am J Obstet Gynecol. 2009 Jul.

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.

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