Successful pregnancy outcome after pre-pregnancy transabdominal cerclage in a patient with cervical insufficiency

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Abstract

Presently, recurrent miscarriage remains an urgent medical and social problem. This pathology affects the female reproductive function and consequently leads to a decrease in the birth rate. The etiology of recurrent miscarriage is frequently attributed to cervical insufficiency. This condition is associated with spontaneous abortion and early preterm birth, which significantly increases perinatal mortality and morbidity of newborns in the early neonatal period.

This paper presents a case of full-term pregnancy after laparoscopic transabdominal cerclage at the pre-pregnancy stage. The patient complained of recurrent miscarriage, having had a history of three pregnancies that ended in spontaneous abortion in the second trimester. All pregnancies were associated with cervical insufficiency. In view of the burdened obstetric history, the patient underwent laparoscopic transabdominal cerclage. The patient completed this pregnancy and was delivered by cesarean section at 39 weeks of gestation. The postpartum period was uneventful, and the woman and baby were discharged home on day 5.

The treatment of miscarriage requires an individualized approach. For patients with recurrent episodes of asymptomatic cervical shortening, laparoscopic transabdominal cerclage is an effective method that facilitates full-term pregnancy.

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About the authors

Marina N. Mochalova

Chita State Medical Academy

Email: marina.mochalova@gmail.com
ORCID iD: 0000-0002-5941-0181
SPIN-code: 1068-3570

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, Chita

Anna I. Galeeva

Chita State Medical Academy; Transbaikal Regional Clinical Hospital

Email: plotkina.ann@yandex.ru
ORCID iD: 0000-0001-8234-1797
Russian Federation, Chita; Chita

Ilya B. Plotkin

Transbaikal Regional Clinical Hospital

Email: doc-plotkin@yandex.ru
ORCID iD: 0000-0002-3983-6572
Russian Federation, Chita

Elena M. Chatskis

Russian Railway Medicine Clinical Hospital

Email: len130922@yandex.ru
ORCID iD: 0009-0006-2355-8682
Russian Federation, Chita

Lyubov A. Kuzmina

Regional Clinical Hospita

Author for correspondence.
Email: prostopochta1804@mail.ru
ORCID iD: 0000-0003-2035-7966

MD

Russian Federation, Chita

References

  1. Russian Society of Obstetricians and Gynecologists. Habitual Miscarriage. Clinical Guidelines. Moscow: Ministry of Health of the Russian Federation; 2022. [cited 2024 Oct 12]. Available from: https://roag-portal.ru/recommendations_obstetrics
  2. Averiaskina MN, Bakhtiyarov KR, Chilova RA. Laparoscopic cerclage – an effective method of treating cervical insufficiency. Medical Council. 2022;16(23):231–235. EDN: WZMKBO doi: 10.21518/2079-701X-2022-16-23-231-235
  3. Bespalova ON, Sargsyan GS. Selection of the method for correction of cervical incompetence. Journal of Obstetrics and Women’s Diseases. 2017;66(3):157–168. EDN: YZBNVZ doi: 10.17816/JOWD663157-168
  4. McDonald IA. Suture of the cervix for inevitable miscarriage. J Obstet Gynaecol Br Emp. 1957;64(3):346–350. doi: 10.1111/j.1471-0528.1957.tb02650.x
  5. Borisyuk SV, Simonov AA, Fedorova NE, et al. Surgical treatment of the cervical incompetence. Orenburg Medical Bulletin. 2015;III(2):67–70. EDN: TWESER
  6. Wang YY, Duan H, Zhang XN, et al. A novel cerclage insertion: modified laparoscopic transabdominal cervical cerclage with transvaginal removing (MLTCC-TR). J Minim Invasive Gynecol. 2020;27(6):1300–1307. doi: 10.1016/j.jmig.2019.09.774

Supplementary files

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2. Fig. 1. Intraoperative view of placement the mercylene tape

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3. Fig. 2. Intraoperative view of the lower uterus segment during cesarean section

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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от 15.07.2002 г.