Effectiveness of abdominal cerclage placed via laparotomy or laparoscopy: systematic review

N B Burger, H A M Brölmann, J I Einarsson, A Langebrekke, J A F Huirne

Research output: Contribution to journalReview articleAcademicpeer-review

70 Citations (Scopus)

Abstract

Preterm delivery remains a primary cause of neonatal morbidity and mortality. One cause of preterm birth is cervical incompetence. In women with a shortened or absent cervix or in those in whom previous vaginal cerclage failed, abdominal cerclage may be recommended. We performed a systematic literature search of PubMed, EMBASE, and the Cochrane database. Thirty-one eligible studies were selected. Six studies (135 patients) reported on the laparoscopic approach, and 26 (1116 patients) on the abdominal approach. Delivery of a viable infant at 34 weeks of gestation or more varied from 78.5% (laparoscopic) to 84.8% (abdominal). Second-trimester fetal loss occurred in 8.1% (laparoscopic) vs 7.8% (abdominal), with no reported third-trimester losses (laparoscopic) vs 1.2% (abdominal). We conclude that abdominal cerclage is associated with excellent results as treatment of cervical incompetence, with high fetal survival rates and minimal complications during surgery and pregnancy. Further studies are needed to differentiate which method is superior.

Original languageEnglish
Pages (from-to)696-704
Number of pages9
JournalJournal of Minimally Invasive Gynecology
Volume18
Issue number6
DOIs
Publication statusPublished - 26 Oct 2011

Keywords

  • Abdomen/surgery
  • Cerclage, Cervical/methods
  • Female
  • Humans
  • Laparoscopy
  • Laparotomy
  • Pregnancy
  • Premature Birth/prevention & control
  • Treatment Outcome
  • Uterine Cervical Incompetence/surgery

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