Laparoscopic Cervical Cerclage: A Series in Women with a History of Second Trimester Miscarriage

Abstract

We sought to develop a laparoscopic technique for placement of a cervical cerclage in women with a history of failed vaginal cerclage and recurrent miscarriage. This was a case series, design classification III. The study took place at The Recurrent Miscarriage Clinic at National Women's Hospital, Auckland, New Zealand. Ten women with a history of second trimester miscarriage after failed vaginal cerclage, and 1 woman with a history of second trimester miscarriage and findings of a clinically deficient cervix were studied. A laparoscopic cervical cerclage was placed before pregnancy. No intraoperative or postoperative complications were experienced. Ten of 11 women subsequently became pregnant and all delivered live babies by cesarean section in the third trimester. Laparoscopic cervical cerclage is feasible and effective. Outcomes are good in a particularly high-risk group of women with cervical incompetence, who have had failed vaginal cerclage and have a history of recurrent pregnancy loss.