Abstract
Objective: To evaluate the effect of laparoscopic abdominal cerclage performed as an interval procedure in non-pregnant women at high risk of second trimester spontaneous abortion and early preterm birth. Design: Observational study. Sample: Fifty-two consecutive patients at high risk of preterm birth. Setting: Department of Obstetrics and Gynecology, Aarhus University Hospital. Methods: Patients were registered prospectively. Indications for surgery included classical cervical insufficiency, preterm premature rupture of membranes (PPROM) or two conizations/cervical amputation. Outcome of subsequent pregnancies was registered. Main outcome measure: Gestational age in subsequent pregnancies. Results: No operative or postoperative complications were observed. A total of 45 pregnancies were registered during the observation period. Among 36 pregnancies lasting beyond 16th week of gestation, 30 women (83.3%) gave birth by cesarean section after 36 weeks of gestation and the overall mean gestational age was 37.4 weeks compared to a mean gestational age of 25.2 weeks of the pregnancies prior to the cerclage. The cesarean sections were uncomplicated in all but one patient, where a re-laparotomy was needed six hours later due to atonic postpartum hemorrhage.without evident bleeding through the cervix. Conclusion: Laparoscopic abdominal cerclage is a feasible and safe procedure. Obstetrical outcomes are encouraging, but prospective studies are needed to define the effectiveness of the laparoscopic cerclage compared to the traditional transvaginal approach.
Originalsprog | Engelsk |
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Tidsskrift | Acta Obstetricia et Gynecologica Scandinavica |
Vol/bind | 91 |
Udgave nummer | 11 |
Sider (fra-til) | 1314-18 |
Antal sider | 5 |
ISSN | 0001-6349 |
DOI | |
Status | Udgivet - 2012 |
Udgivet eksternt | Ja |