Dilation and evacuation after preterm premature rupture of membranes with abdominal cerclage in situ

Perry, Alix; Serna, Tania Basu

doi:10.1016/j.contraception.2020.01.013

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…The same approach has also been used to remove stiches close to term to allow for a vaginal delivery [14]. In cases of first trimester miscarriage and early second-trimester preterm, prelabor membrane rupture, dilatation, and curettage or evacuation via TAC has been previously described [12, 15, 16].…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Laparoscopic Transabdominal Cerclage with a “Needle-Free” Technique: A Single-Center Experience

Azim¹,

Wieser²,

Ritter³

et al. 2020

Gynecol Obstet Invest

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Background: In high-risk patients with cervical incompetence, laparoscopic cerclage is a promising treatment option. However, the procedure exhibits relevant surgical risks. Aims: The purpose of this study was to evaluate a surgical “needle-free” technique for minimally invasive, laparoscopically placed cervico-isthmic cerclage in high-risk patients. Methods: This was a retrospective observational study over a 10-year period of pre- and postconceptional cerclage placement. The included patients either experienced previous transvaginal cerclage (TVC) failure or were not eligible for TVC. Laparoscopic transabdominal cerclage using a needle-less mersilene tape was performed via a broad ligament window lateral to the uterine vessels. Results: Laparoscopic transabdominal cerclage was successfully performed in all included women with a median operation time of 62 min. We did not observe any intra- or postoperative complications, particularly no bleeding complications. Nine of 11 women became pregnant and/or carried out a successful pregnancy, respectively. Importantly, we did not observe any cases of miscarriage or mid-trimester loss. Two patients did not conceive; however, their medical histories did include Asherman’s syndrome and advanced maternal age. Conclusion: Transabdominal laparoscopic “needle-free” cerclage is a safe and effective treatment option for a well-selected group of women at high risk of cervical incompetence. It provides good obstetric results without increasing perioperative morbidity.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Laparoscopic Transabdominal Cerclage with a “Needle-Free” Technique: A Single-Center Experience

Azim¹,

Wieser²,

Ritter³

et al. 2020

Gynecol Obstet Invest

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show abstract

“…However, laparoscopy is more challenging in pregnant patients, specifically with advanced gestational age. Another possibility is to perform dilation and curettage or dilation and evacuation with the abdominal cerclage in place [7,8]. A new technique to remove the abdominal cerclage is by colpotomy.…”

mentioning

confidence: 99%

Removal of an Abdominal Cerclage by Colpotomy: A Novel and Minimally Invasive Technique

Burger

Hof

Huirne

2020

Journal of Minimally Invasive Gynecology

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Abdominal cerclage is an effective treatment for cervical incompetence in patients with a previously failed vaginal cerclage or with anatomic restrictions to a vaginal cerclage. Management of second trimester complications that warrant a delivery impose a complex clinical situation in patients with an abdominal cerclage. We report 3 cases of successful removal of an abdominal cerclage by posterior and anterior colpotomy in the second trimester of pregnancy. This new and minimally invasive surgical technique avoids the need for extensive dilation, laparoscopy, or laparotomy to remove the cerclage and allow a vaginal delivery.

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Dilation and evacuation with an abdominal cerclage at 21 weeks gestation: A case report

Gilbert¹,

Amico

2022

Contraception

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Dilation and evacuation after preterm premature rupture of membranes with abdominal cerclage in situ

Cited by 3 publications

References 5 publications

Minimally Invasive Laparoscopic Transabdominal Cerclage with a “Needle-Free” Technique: A Single-Center Experience

Minimally Invasive Laparoscopic Transabdominal Cerclage with a “Needle-Free” Technique: A Single-Center Experience

Removal of an Abdominal Cerclage by Colpotomy: A Novel and Minimally Invasive Technique

Dilation and evacuation with an abdominal cerclage at 21 weeks gestation: A case report

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