Transabdominal cervicoisthmic cerclage in the management of recurrent second trimester miscarriage and XXXX .

@entity1 @entity3152 @entity600
OBJECTIVE: To evaluate the role of transabdominal cervicoisthmic cerclage (TCC) in the management of recurrent mid-trimester pregnancy miscarriage and @entity3152 . DESIGN: An observational study of 50 @entity1 with history of recurrent second trimester miscarriage and @entity3152 in whom TCC was performed. SETTING: A tertiary referral centre for high risk obstetrics. RESULTS: TCC was performed on 51 occasions in 50 @entity1 . One had TCC performed in two successive pregnancies. Prior to the procedure, they had experienced 36 first trimester miscarriages and 163 later pregnancy losses. These included 152 midtrimester miscarriages and 11 neonatal deaths after @entity3152 . There had been 4 survivors after @entity3152 . The total number of pregnancies after TCC was 61 with three @entity1 losing one pregnancy and subsequently having a successful pregnancy. Of these @entity1 44 now have had a successful outcome. Six have not had a successful outcome. Eight @entity1 have had two successful consecutive pregnancies after TCC. The fetal survival was 85.2% post-procedure. CONCLUSIONS: TCC is a procedure that may be used in a highly selected group of @entity1 with anatomical defects of the cervix and previous failed transvaginal cerclage resulting in recurrent second trimester pregnancy loss and @entity600 . Strict selection criteria were applied as TCC is an invasive procedure. Although TCC is not widely used our study suggests it may be the procedure to consider in @entity1 who have had recurrent second trimester pregnancy losses and preterm births associated with cervical damage.
