Laparoscopic Abdominal Cerclage as an Effective Option for Refractory Cervical Insufficiency: A Case Report

TL;DR

Laparoscopic abdominal cerclage successfully treated a woman with cervical insufficiency after a failed traditional treatment.

Contribution

This case report highlights laparoscopic abdominal cerclage as a safe and effective alternative for refractory cervical insufficiency.

Findings

A 35-year-old woman with a history of second-trimester losses successfully underwent laparoscopic abdominal cerclage.

The procedure resulted in a full-term delivery with a healthy newborn.

Laparoscopic cerclage is shown to be a viable option when transvaginal cerclage fails.

Abstract

Cervical insufficiency is an important cause of preterm birth and fetal loss and is traditionally treated by transvaginal cervical cerclage. However, when this technique has failed or is not feasible, transabdominal cerclage may be performed, with the laparoscopic approach emerging as the preferred option. We report the case of a 35-year-old woman with recurrent second-trimester loss and a prior failed transvaginal cerclage, who underwent laparoscopic abdominal cerclage at nine weeks’ gestation. The procedure was uncomplicated, and the pregnancy ensued without major events. An elective caesarean section was performed at 37 weeks’ gestation, resulting in the delivery of a 2765g newborn with an Apgar score of 9/10. This case illustrates the effectiveness of laparoscopic abdominal cerclage as a safe, reproducible, and highly effective option for women with refractory cervical insufficiency.

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