Study on Pregnancy Outcomes after Transabdominal Cervico-Isthmic Cerclage before Pregnancy / 대한산부인과학회잡지

OBJECTIVE: Our purpose was to evaluate the effect of transabdominal cervicoisthmic cerclage before pregnancy among the patients who had poor obstetric outcome from previous failed transvaginal cervical cerclage and/or an anatomically defective cervix. STUDY DESIGN: A retrospective review of pre-conceptional transabdominal cervicoisthmic cerclage patients was conducted at Hanyang University Medical Center from 1989 to 1997, and analysis of the pregnancy outcomes after preconceptional transabdominal cervicoisthmic cerclage operation. RESULTS: The fifteen patients had 11 successful pregnancy outcomes. Two patients had two consecutive succesful pregnancies and repeat cesarean section deliveries after TCIC. CONCLUSION: We conclude that the transabdominal cervicoisthmic cerclage before pregnancy offers a high rate of fetal salvage with a minimal complications in patients with extremely poor obstertric histories as a result of cervical incompetence, where vaginal cerclage is not warranted.

Study on Pregnancy Outcomes after Transabdominal Cervico-Isthmic Cerclage during Pregnancy / 대한산부인과학회잡지

OBJECTIVE: Transabdominal cervico-isthmic cerclage(TCIC) may increase the fetal salvage rate and pregnancy outcome in selected women when poor obstetric outcome is related to previously failed transvaginal cervical cerclage and an anatomically defective cervix. Our purpose was to evaluate the outcomes after transabdominal cervicoisthmic cerclage during pregnancy. STUDY DESIGN: A retrospective review was done from patients who had been received transabdominal cervicoisthmic cerclage during pregnancy at Hanyang University Medical Center from October, 1989 to April 1997. The fetal salvage rate before and after post-conceptional transabdominal cervicoisthmic cerclage were compared and analysed. RESULTS: The seventy-eight patients had 95 successful pregnancies out of a total of 97. Thus the fetal salvage rate of TCIC during in pregnancy was 97.9 %. Of 78 patients, nineteen patients had the second succesful pregnancies and repeat cesarean deliveries after TCIC. CONCLUSION: We conclude that the transabdominal cervicoisthmic cerclage during pregnancy offers a high fetal salvage rate with a minimal complications in patients with extremely poor obstertric histories as a result of cervical incompetence, where vaginal cerclage is not warranted.