Trans-abdominal cerclage

 

The treatment of repeated early pregnancy loss caused by incompetence of the cervix by means of trans-vaginal cervical cerclage is well documented, however, the vaginal procedure may be rendered unfeasible or unsuccessful by a cervix that is badly lacerated, very short, or absent. Benson and Durfee, in 1965 were the first to report on transabdominal cervical cerclage, stating,"we have reasoned, if cervical cerelage during gestation is indicated but the vaginal approach is impossible, why not accomplish constriction from above?" All agree, however, that whatever approach is used, the operation is better done during pregnancy.
In 1977 we introduced a modified technique reporting our first 10 cases with fetal salvage of 87.9% in otherwise hopeless cases (Mahran, 1978). In 1991 Novy published a review of 25 years experience of published cases (111 cases).
This study includes 250 cases our experience until the end of the year 2001 with an adjusted fetal salvage of 90.7 %.