Experience of laparoscopic transabdominal cerclage for correcting cervical incompetence
Ldynina T.Yu., Pogodin O.O., Ivshin A.A., Shakurova E.Yu.
Relevance: The significance and relevance of the issue of miscarriage due to cervical incompetence have been determined. According to Order 1130n and relevant clinical guidelines, the main methods for treating cervical incompetence are the combined use of progestogens in combination with obstetric pessaries or surgical correction. The article presents the experience of using laparoscopic transabdominal cerclage (LTC) in K.A. Gutkin Republican Perinatal Center, Petrozavodsk, Russia. LTC can be considered as a method of choosing the correction of cervical incompetence in patients with repeated cases of termination of pregnancy.
Case report: This is a clinical observation of a favorable termination of pregnancy after LTC in a patient with a congenital abnormality of the reproductive apparatus and habitual miscarriage due to cervical incompetence. Surgical treatment was performed at the preconception stage by applying the tape “Cervix-Set” to the uterine isthmus. The patient became pregnant after ART, cryopreservation. During pregnancy, the patient was admitted to an obstetric hospital three times as there was a threat of pregnancy termination. The length of the closed part of the cervix remained within normal values during cervicometry. The pregnant woman had a cesarean section to deliver her baby at 36 weeks 1 day gestation due to premature rupture of membranes.
Conclusion: Given the limited experience of managing patients with LTC, it is necessary to conduct further studies on the effectiveness and safety of this operation.
Authors’ contributions: Ldynina T.Yu. – review of publications on the topic, analysis of the obtained data, writing the text of the article; Pogodin O.O. – management and surgical treatment of the patient, obtaining the clinical data; Ivshin A.A. – obtaining and analyzing literary data, editing the article; Shakurova E.Yu. – design development, organization of research and supervision.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
Ethical Approval: The study was approved by the Ethical Review Board of the K.A. Gutkin Republican Perinatal Center, Petrozavodsk, Russia.
Patient Consent for Publication: The patient signed an informed consent for the publication of depersonalized data.
For citation: Ldynina T.Yu., Pogodin O.O., Ivshin A.A., Shakurova E.Yu. Experience of
laparoscopic transabdominal cerclage for correcting cervical incompetence.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (5): 152-156 (in Russian)
https://dx.doi.org/10.18565/aig.2023.283
Keywords
habitual miscarriage
pregnancy loss
cervical incompetence
transabdominal cervical cerclage
laparoscopic cerclage
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Received 07.12.2023
Accepted 26.04.2024
About the Authors
Tatiana Yu. Ldynina, obstetrician-gynecologist at the Obstetrics Department, K.A. Gutkin Republican Perinatal Center, Ministry of Health of the Republic of Karelia,185002, Russia, Republic of Karelia, Petrozavodsk, Syktyvkarskaya str., 9, +7(953)531-04-52.
Oleg O. Pogodin, obstetrician-gynecologist, Head of the Gynecology Department, K.A. Gutkin Republican Perinatal Center, Ministry of Health of the Republic of Karelia, 185002, Russia, Republic of Karelia, Petrozavodsk, Syktyvkarskaya str., 9, +7(921)227-82-85.
Alexander A. Ivshin, PhD, Associate Professor, Head of the Department of Obstetrics and Gynecology, Dermatovenerology of the Medical Institute, Petrozavodsk State University, 185035, Russia, Republic of Karelia, Petrozavodsk, Krasnoarmeyskaya str., 31, +7(909)567-12-51, https://orcid.org/0000-0001-7834-096X
Elena Yu. Shakurova, obstetrician-gynecologist, Deputy Chief Physician for Medical Affairs, K.A. Gutkin Republican Perinatal Center, Ministry of Health of the Republic of Karelia, 185002, Russia, Republic of Karelia, Petrozavodsk, Syktyvkarskaya str., 9, +7(964)317-84-81.
Corresponding author: Alexander A. Ivshin, scipeople@mail.ru
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