Modified transabdominal cervico-isthmic cerclage: analysis of 16 cases

Objective: The aim of the study is to evaluate 16 cases retrospectively who underwent modified transabdominal cervico-isthmic cerclage. Methods: The cases that had unsuccessful vaginal cerclage history and underwent abdominal cervico-isthmic cerclage were analyzed retrospectively. Sociodemographic characteristics of the cases, problems encountered during and after the operation and gestational outcomes were recorded by investigating patient files. Descriptive methods were used for the statistical analysis of the data. Results: None of the cases developed intraoperative complication. Mean week of gestation and mean week of delivery for the operation were found as 14±4 and 34.4±6 days, respectively. Gestation reached to 34 weeks and above in 81.25% of the cases. Premature rupture of membrane developed in two cases and these pregnancies were terminated with anterior hysterectomy. The rate of complication at early period after the operation was found as 12.5%. Preterm labor occurred in one case after 12 weeks (at 29 weeks of gestation) following the operation; there was no response to the tocolytic treatment, therefore cesarean section was performed. All patients had cesarean section and the rate of live birth after the operation was 87.5%. Conclusion: Modified transabdominal cervico-isthmic cerclage practice is considered as an initiative to get successful perinatal outcomes in cases which are inappropriate for vaginal approach.