Transvaginal cervicoisthmic cerclage for patients with extremely high-risk history of preterm delivery.

Abstract

Transvaginal cervicoisthmic cerclage was carried out in 12 such patients who were at high-risk of premature delivery. Patients who underwent transvaginal cervicoisthmic cerclage had undergone conization, cervical radical hysterectomy or another form of extensive cervical resection, or had a history of third-trimester miscarriage or premature delivery despite having previously undergone cervical cerclage several times for cervical incompetence. There were seven cases of pregnancy after extensive conization, and four had a history of failed cervical cerclage. Two of these cases were the same individual, who became pregnant twice after extensive conization and gave birth to a live infant each time. The mean age at surgery was 35.7 years, and cerclage was performed at 11-19 weeks' gestation. All of the infants survived to hospital discharge. Transvaginal cervicoisthmic cerclage may be considered effective for patients with the history of recurring pregnancy loss due to previous failure of prophylactic cerclage.