[Laparoscopic abdominal cerclage in a patient with recurrent miscarriages abortions - case report]. 2016

K Huml, and L Kantor, and M Procházka, and M Studničková, and R Pilka

OBJECTIVE The use of laparoscopic abdominal cerclage in a patient with habitual miscarriage. METHODS Case report and literature review. METHODS Department of Obstetrics and Gynecology, University Hospital Olomouc, Faculty of Medicine, Palacký University Olomouc, Department of Neonatology, University Hospital Olomouc, Faculty of Medicine, Palacký University Olomouc, Institute of Medical Genetics, University Hospital Olomouc, Faculty of Medicine, Palacký University Olomouc. METHODS The patient is a 37 years old woman with a history of recurrent miscarriages. She had one labor at term and six pregnancies that were lost in the second trimester despite McDonald cerclages. Abdominal cerclages are necessary when the standard transvaginal cerclages fail or anatomical abnormalities preclude the vaginal placement. The disadvantage of the transabdominal approach is that it requires at least 2 laparotomies with significant morbidity and hospital stays. We discuss a case of abdominal cerclage performed laparoscopically. A 5 mm Mersilene tape was placed laparoscopically at the level of the internal os as an interval procedure. We feel it offers less morbidity and in the proper hands eliminates or significantly shortens hospital stays. Subsequent pregnancy was terminated at 28 weeks by caesarean section after premature rupture of membranes. CONCLUSIONS Laparoscopic abdominal cerclage seems to be relatively effective option for the prevention of habitual abortion patients, which fail conventional surgical procedures in dealing with cervical incompetence. The success of subsequent full term pregnancy is given as 70%.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011262 Pregnancy Trimester, Second The middle third of a human PREGNANCY, from the beginning of the 15th through the 28th completed week (99 to 196 days) of gestation. Midtrimester,Pregnancy, Second Trimester,Trimester, Second,Midtrimesters,Pregnancies, Second Trimester,Pregnancy Trimesters, Second,Second Pregnancy Trimester,Second Pregnancy Trimesters,Second Trimester,Second Trimester Pregnancies,Second Trimester Pregnancy,Second Trimesters,Trimesters, Second
D002581 Uterine Cervical Incompetence Incompetent UTERINE CERVIX is usually diagnosed in the second trimester of PREGNANCY. It is characterized by passive painless cervical dilation in the absence of UTERINE CONTRACTION; BLEEDING; INFECTION; and sometimes with the amniotic sac (AMNIOTIC MEMBRANE) bulging through the partially dilated cervix. Left untreated, this condition may lead to premature pregnancy loss, such as HABITUAL ABORTION. Cervix Incompetence,Incompetent Cervix,Cervical Incompetence, Uterine,Cervices, Incompetent,Cervix, Incompetent,Incompetence, Cervix,Incompetence, Uterine Cervical,Incompetent Cervices
D002585 Cesarean Section Extraction of the FETUS by means of abdominal HYSTEROTOMY. Abdominal Delivery,Delivery, Abdominal,C-Section (OB),Caesarean Section,Postcesarean Section,Abdominal Deliveries,C Section (OB),C-Sections (OB),Caesarean Sections,Cesarean Sections,Deliveries, Abdominal
D005260 Female Females
D005322 Fetal Membranes, Premature Rupture Spontaneous tearing of the membranes surrounding the FETUS any time before the onset of OBSTETRIC LABOR. Preterm PROM is membrane rupture before 37 weeks of GESTATION. Premature Rupture of Membrane (Pregnancy),PROM (Pregnancy),Premature Rupture of Fetal Membranes,Preterm PROM (Pregnancy),Preterm Premature Rupture of Fetal Membranes,Membrane Premature Rupture (Pregnancy),Membrane Premature Ruptures (Pregnancy),PROM, Preterm (Pregnancy)
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000026 Abortion, Habitual Three or more consecutive spontaneous abortions. Abortion, Recurrent,Miscarriage, Recurrent,Recurrent Early Pregnancy Loss,Habitual Abortion,Habitual Abortions,Recurrent Abortion,Recurrent Abortions,Recurrent Miscarriage,Recurrent Miscarriages

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