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|Title:||Laparoscopic transabdominal cerclage: outcomes of 121 pregnancies.|
|Epworth Authors:||Ades, Alex|
|Keywords:||Pre‐Pregnancy Laparoscopic Transabdominal Cerclage|
Mid‐Trimester Pregnancy Loss
Agora Centre for Women's Health, Epworth HealthCare VIC, Australia
|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.|
|Journal Title:||The Australian & New Zealand journal of Obstetrics & Gynaecology|
|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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