Prevention of mid-trimester loss following full dilatation caesarean section: A potential role for transabdominal cervical cerclage

Second stage cesarean as risk factor for preterm birth: how to manage subsequent pregnancies?

“…The persistence of this risk factor supports the theory of Berghella et al 2 that structural damage is the likely underlying mechanism of preterm birth. We have found (as have others 5 ) that, although not uniformly present, anterior cervical defects can be seen by transvaginal ultrasound scanning. This supports the hypothesis that unintentional incisions in the cervix may be disrupting internal os function at late stage cesarean delivery, which is a concept clearly defined in 1939 by C. M. Marshall.…”

“…Watson et al are correct in pointing out that Wood et al was not the first study to report this association, as we mentioned in our editorial. [1][2][3][4] There are many more studies, easily found in PubMed and in the reference lists of the articles that we included in our editorial 1 and the articles 5,6 cited by Watson et al…”

Efficacy of transvaginal cervical cerclage in women at risk of preterm birth following previous emergency cesarean section

“…Evidence for treatments that recognize the additional risk factors posed by a previous EMCS is limited to case reports in the literature. 12,13 This study therefore aims to assess the efficacy of transvaginal cervical cerclage (TVC) in women who have experienced an LM or sPTB after an EMCS to prevent preterm birth.…”

Late‐stage Cesarean section causes recurrent early preterm birth: how to tackle this problem?

“…This makes sense physiologically if the suture is confined to encircling the vaginal (distal) portion of the cervix. Transabdominal cerclage has been suggested as the most effective management option in these women 30 , but larger studies are needed to support this. One can hypothesize that a transabdominal cerclage provides support above the level of the defect caused by a low incision in the cervical tissue, which logically would be the best way forward in future term pregnancy success.…”