Simplified laparoscopic cervical cerclage after failure of vaginal suture: technique and results of a consecutive series of 100 cases

Objective: To evaluate the efficacy of simplified laparoscopic cervical cerclage (SLCC) in the prevention of miscarriage and preterm delivery in women with cervical incompetence who failed to have a live birth following a vaginal cervical cerclage in a previous pregnancy. Study design: From Dec 2010 to January 2015, a consecutive cases of 100 subjects with cervical incompetence but who failed to have a live birth following a vaginal cervical cerclage in a previous pregnancy underwent SLCC. Surgical outcome parameters (estimated total blood loss, operation time, complications) were recorded, the outcome of any subsequent pregnancy was evaluated. Results: Among the 100 cases of SLCC, the mean +/- SD (range) surgical time was 26 +/- 4.7 (20-40) min. After the operation, 82 women conceived, 3 of them conceived twice. There were altogether 85 pregnancies, including 12 early miscarriages and one case of ectopic pregnancy. Among the 55 pregnancies which progressed beyond the first trimester and in whom the final outcome was confirmed, the live birth rate was 53/55 (96.4%). The mean gestational age at delivery of this group of women was 37.5 +/- 1.8 weeks. Conclusions: The simplified laparoscopic cervical cerclage is a simple, safe, and effective procedure for the treatment of cervical incompetence which had previously failed to benefit from vaginal cervical cerclage. (C) 2016 Elsevier Ireland Ltd. All rights reserved.