Preconception Laparoscopic Cervical Cerclage: The Preferred Technique for Cervical Incompetence?

Abstract

Objective: To explore the ease and effectiveness of placing a cervical suture preconception using a laparoscopic technique. Design: A case study with systematic literature review. Setting: PIVET Medical Centre, a private facility providing comprehensive services over 35 years in gynaecology, andrology and reproductive endocrinology for infertility and recurrent pregnancy loss. Patients: Case report of a 35 year old woman with recurrent mid-trimester pregnancy losses and well-define cervical incompetence. Intervention: Preconception placement of cervical suture by laparoscopic trans-abdominal cerclage (LTAC) as a day case. Main outcome measure: Details of ensuing pregnancy. Results: Conception without delay and normal pregnancy with delivery by elective caesarean section near term of healthy 2645 g female infant. Conclusion: We are impressed with the ease of the LTAC technique which appears likely to have fewer complications than traditional vaginal techniques, as well as speedier recovery compared to a laparotomy approach.