Transvaginal hemiperitoneal cervical cerclage for cervical insufficiency: A single-center retrospective study.

Abstract

Background: Cervical insufficiency (CI) is thought to be responsible for 8% of miscarriages and preterm births. Cervical cerclage is the main treatment for CI. There are different approaches to cervical cerclage, and it is particularly important to find a method of cervical cerclage that is simple to perform and results in better pregnancy outcomes.

Objective: This study investigates the clinical efficacy of transvaginal hemiperitoneal cervical cerclage in the treatment of CI and its impact on maternal and fetal outcomes.

Methods: We performed a descriptive retrospective single-center study, including all patients who had a transvaginal hemiperitoneal cervical cerclage between January 1, 2020, and December 31, 2023. The main outcomes measured were pregnancy outcomes.

Results: Twenty transvaginal hemiperitoneal cervical cerclages were performed over the period studied: 35% had a history of cervical conization, 65% had history of one or more mid-trimester miscarriages, and 15% had a history of a failed emergency or prophylactic cerclage. The median gestational age (GA) at cerclage placement was 14.19 ± 2.88 weeks of gestation (WG). There was one case of delivery between 28 and 32 weeks, and there were five cases of delivery between 32 and 37 weeks and 11 cases of delivery over 37 weeks, of which three cases were in pregnancy, at gestational weeks of 16, 18, and 21 weeks, respectively. The mean gestational age of cerclage removal, was 36.42 ± 2.76 (WG).

Conclusion: The transvaginal hemiperitoneal cervical cerclage is simple to operate, not limited by gestational age, and less invasive and has a low cost. It is effective in patients with a short cervix and has good pregnancy outcomes.