Transvaginal cervicoisthmic cerclage using a polypropylene sling: Pregnancy outcome

Aim: To report pregnancy outcome following prophylactic transvaginal cervicoisthmic cerclage using a polypropylene sling in a population of high-risk pregnant women. Materials and Methods: A retrospective study with a continuous series of 57 women presenting with prior failure of McDonald cerclage (n = 47) and/or absent portio-vaginalis of the cervix (n = 10). Results: Cervicoisthmic cerclage was performed between 12 and 16 weeks of gestation (median 14 weeks' gestation). No intraoperative complication occurred. Preterm labor treated with parenteral tocolysis occurred in 14 women (24%). Cesarean delivery was systematically performed. Median gestational age at delivery was 37.2 weeks' gestation (interquartile range: 36.5-38.0). Overall neonatal survival rate was 94%. Conclusion: Transvaginal cervicoisthmic cerclage using a polypropylene sling may be considered as an effective alternative to the transabdominal cervicoisthmic cerclage in women presenting with previous cerclage failure.