Effectiveness of laparoscopic abdominal cerclage on pregnancy outcome in women with cervical incompetence: An observational cohort study

Abstract

Objective: To assess the successful pregnancy, preterm delivery and complications in patients with history of cervical insufficiency and failed vaginal cerclage who underwent laparoscopic abdominal cerclage (LAC).

Methods: In a mixed cohort study, the recorded data of 170 eligible patients in medical documents and hospital records were extracted at Arash Hospital, Tehran, Iran during the March 2022 to March 2025, retrospectively and the treatment outcomes gathered by medical history and telephone interview, prospectively. LAC approach was done after general anesthesia for all patients. Of all included patients, 94 cases got pregnant and during study and after follow up, pregnancy outcomes occurrence after cerclage, gestational age <35 weeks and ≥36 weeks, complications and failed pregnancies were recorded as primary study outcome. Data analysis performed with SPSS version 24 software, using descriptive and analytic statistics.

Results: 170 eligible women were included. Followed them during two years after operation, 94 women got pregnant. Of 94 pregnant women after LAC, 6 cases had unsuccessful pregnancy due to rupture of membranes, ectopic pregnancy, fetus heart abnormally, and intrauterine fetal death. Finally, from 81 mothers, 75 mothers had successful pregnancy and the LAC success rate of pregnancy was 92.6% and the incidence of delivery ≤35 weeks was 34%. Secondary infertility (P=0.04), lower maternal’ age (P=0.03), and higher body mass index (P=0.04) were associated with successful pregnancy. Shorter interval from cerclage to conception was related to more term deliveries (P=0.009) and successful pregnancy (P<0.001).

Conclusions: LAC could be considered as an effective treatment to preserving pregnancy and preventing the preterm delivery, in patients with cervical incompetence.

Keywords

Pregnancy / Abdominal cerclage / Insufficient cervical / Women / Child bring

Conflict of interest statement

The authors declare that they have no competing interests.

Acknowledgements

The authors are very grateful for all patients who participated in this study. In addition, we are appreciative for Tehran University of Medical Sciences due to its financial support.

Funding

This study received no extramural funding.

Availability of data and materials

Due to privacy and ethical restrictions, the data are not publicly available. However, the data sets used and/or analyzed during this study are available from the corresponding author on reasonable request.

Authors’ contributions

Reihaneh Hosseini and Zahra Asgari contributed to designing the study. Zahra Yazdi, Shirin Farhoodi, and Sarasadat Mollasaedi conducted the study and cooperated in data collection and following patients. Aynaz Boostan and Bahareh Khakifirouz analyzed the data and wrote the results. Reihaneh Hosseini and Zahra Yazdi prepared the manuscript draft and finally all authors read and approved the final manuscript.

Publisher’ s Note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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