Laparoscopic Removal of Abdominal Cerclage and Vaginal Delivery at 21 Weeks

Alex Ades, MD, PhD, Kim C. Dobromilsky, BMBS, BPharm

AGORA Centre for Women’s Health, Epworth Hospital, Melbourne, Victoria, Australia (both authors).


Introduction: Transabdominal cerclage (TAC) is a procedure for cervical insufficiency in women in whom transvaginal cerclage cannot be performed. In recent years, laparoscopic transabdominal cerclage has gained favor by eliminating the need for laparotomy and reducing surgical morbidity.

Case Description: We present a case of laparoscopic removal of a TAC in a 27-year-old woman with uterus didelphys, who presented with fetal death in utero at 21 weeks 3 days.

Conclusion: This successful, minimally invasive technique eliminated the need for hysterotomy and the potential corresponding morbidity associated with the operation and allowed for normal spontaneous vaginal delivery.

Key Words: Hysterotomy, Transabdominal cerclage, Transvaginal cerclage, Uterine malformation, Uterus didelphys.

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