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Cervicoisthmic Cerclage: Transabdominal vs Transvaginal Approach

Citation

Witt, Marili U.; Joy, Saju D.; Clark, Jennifer; Herring, Amy H.; Bowes, Watson A., Jr.; & Thorp, John M., Jr. (2009). Cervicoisthmic Cerclage: Transabdominal vs Transvaginal Approach. American Journal of Obstetrics & Gynecology, 201(1), 105.e1-4. PMCID: PMC3157044

Abstract

Objective: We sought to compare the outcomes of cervicoisthmic (CI) cerclage using traditional transabdominal (TA) approach vs the lesser used transvaginal (TV) approach.
Study Design: We conducted a retrospective cohort study of women who underwent placement of a CI cerclage.
Results: Before CI placement, the abdominal group had a total of 100 pregnancies that continued beyond the first trimester and had 27 (27%) surviving infants. After cerclage placement, there were 34 pregnancies and 24 (71%) surviving infants. Before cerclage placement, the vaginal group had a total of 90 pregnancies that continued beyond the first trimester and had 11 (12%) surviving infants. After cerclage placement, there were 29 pregnancies and 20 (69%) surviving infants. The vaginal cerclage group had a significantly shorter mean operative time of 33 vs 69 minutes, and shorter hospital stay of 0.5 vs 3.2 days.
Conclusion: Both TV and TA CI cerclage offers select patients with cervical insufficiency improved neonatal survival. The TV placement of a CI has less morbidity than the TA approach with a comparable neonatal survival.

URL

http://dx.doi.org/10.1016/j.ajog.2009.03.020

Reference Type

Journal Article

Year Published

2009

Journal Title

American Journal of Obstetrics & Gynecology

Author(s)

Witt, Marili U.
Joy, Saju D.
Clark, Jennifer
Herring, Amy H.
Bowes, Watson A., Jr.
Thorp, John M., Jr.

PMCID

PMC3157044