Transvaginal placement of cervicoisthmic cerclage: report on pregnancy outcome.

Abstract

This study was undertaken to review pregnancy course and outcome in 56 pregnancies after the placement of a cervicoisthmic cerclage transvaginally. Fifty-three pregnant patients with unique indications such as previous failure of conventional cerclages or compromised cervical anatomy, underwent transvaginal placement of a cervicoisthmic cerclage during pregnancy. There was 100% fetal survival. Preterm birth rate was 32% and births at less than 30 weeks occurred in 21% of our patients. In 6 patients, the suture was not removed and 3 patients had an additional gestation with the same suture. Serious complications included 1 instance of intraoperative bladder laceration and 1 of intrapartum cervical tear. Minor complications included a postoperative hematoma and transient urinary retention with pelvic pain in 2 patients. The placement of transvaginal cervicoisthmic cerclage was associated with favorable pregnancy outcome and may be considered as a suitable safe alternative to the transabdominal cerclage.