Updates on laparoscopic cervical cerclage: obstetric outcomes and surgical techniques

Abstract

Aim: Preterm birth is a worldwide health problem. After unsuccessful transvaginal cerclage, the transabdominal isthmo-cervical cerclage can be indicated. A laparoscopic approach has been described. Methods: A search was performed including the combination of: “((cerclage) AND (laparoscopy)) AND (pregnancy)”. A systematic review was performed to compare indications, outcomes, techniques, and safety. Results & discussion: 42 articles were found through database search. 30 articles were included for review. By reviewing the literature, the transabdominal cervico-isthmic laparoscopic cerclage is highly effective in selected patients with a history of refractory cervical insufficiency. This technique has a high neonatal survival rate when placed in preconceptional or post conceptional patients. Moreover, laparoscopic cervical cerclage is a safe procedure when laparoscopic expertise is present.