Transabdominal cerclage: The journey of turning bad into good

Abstract

Recurrent pregnancy loss is a challenging obstetric condition that requires thorough evaluation and vigilant antenatal care. Cervical insufficiency is a well-recognized cause of late miscarriage. Here, we are reporting a case of multiple pregnancy failures including both 1st- and 2nd-trimester losses with cervical insufficiency after ruling out all other probable causes. The patient had a history of 3 failed transvaginal cervical cerclage procedures, and hence, in her 7th pregnancy, transabdominal cervical cerclage was attempted that resulted in salvaging the pregnancy beyond viability and the patient delivered a healthy baby through an emergency cesarean section near term. The patient was reconceived with the transabdominal cerclage in situ and delivered with a successful fetal and maternal outcome despite having multiple high-risk factors. This highlights the effectiveness of transabdominal cervical cerclage to prevent spontaneous mid-trimester loss and preterm delivery when previous transvaginal cerclage has failed.