Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/1597
Title: Laparoscopic transabdominal cerclage: outcomes of 121 pregnancies.
Epworth Authors: Ades, Alex
Parghi, Sneha
Aref-Adib, Mehrnoosh
Keywords: Pre‐Pregnancy Laparoscopic Transabdominal Cerclage
Cervical Insufficiency
Laparoscopy
Premature
Preterm Birth
Cerclage
Cervical Cerclage
Pre‐Term Labour
Mid‐Trimester Pregnancy Loss
Neonatal Survival
Surgical Morbidity
Agora Centre for Women's Health, Epworth HealthCare VIC, Australia
Issue Date: Dec-2018
Publisher: Blackwell Publishing
Citation: Aust N Z J Obstet Gynaecol. 2018 Dec;58(6):606-611
Abstract: Background: Cervical insufficiency is a significant cause of morbidity and mortality. Cervical cerclage is one option in the management of cervical insufficiency. Aim: To evaluate obstetric outcomes following insertion of a pre‐pregnancy laparoscopic transabdominal cerclage in women at high risk for pre‐term labour and/or mid‐trimester pregnancy loss. Methods: A prospective observational study of consecutive women who underwent laparoscopic transabdominal cerclage from 2007 to 2017. Eligible women had a diagnosis of cervical insufficiency based on previous obstetric history and/or a short or absent cervix and were considered not suitable for a transvaginal cerclage. The primary outcome was neonatal survival and the secondary outcome was delivery of an infant at ≥34 weeks gestation. Surgical morbidity and complications were also evaluated. Results: During the study period, 225 women underwent laparoscopic transabdominal cerclage. We present the outcomes of 121 pregnancies resulting in 125 babies. The perinatal survival rate of viable pregnancies was 98.5% with a mean gestational age at delivery of 35.2 weeks; 79.7% of babies were delivered at ≥34.0 weeks gestation. Conclusion: Laparoscopic transabdominal cerclage is a safe and effective procedure resulting in favourable obstetric outcomes in women with a poor obstetric history. For optimal success the procedure requires the correct surgical expertise, equipment and appropriate patient selection.
URI: http://hdl.handle.net/11434/1597
DOI: doi: 10.1111/ajo.12774
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/29359499/
ISSN: 0004-8666
1479-828X
Journal Title: The Australian & New Zealand journal of Obstetrics & Gynaecology
Type: Journal Article
Affiliated Organisations: Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Australia
Type of Clinical Study or Trial: Observational Study
Appears in Collections:Obstetrics & Gynaecology

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