Is an abdominal cerclage indicated with a cervical myomectomy? A case report

Abstract

Introduction: Cervical myomectomy can compromise cervical integrity and the risk of subsequent cervical incompetence is unclear. In this case report, the literature on cervical myomectomies is reviewed as well as that on the potential benefits of cervical cerclage. Case presentation: A 30-year-old woman, nulligravida, with a 12 cm cervical leiomyoma consulted for heavy menstrual bleeding and pelvic pain. After failure of multiple medical therapies, a laparoscopic cervical myomectomy was successfully performed after pre-operative uterine artery embolization using absorbable gelatin sponges to reduce surgical blood loss. Discussion: A concomitant laparoscopic cerclage was achieved in order to prevent cervical incompetence, given that the full thickness of the anterior cervix was penetrated during the myomectomy.

The minimally invasive approach to abdominal cerclage: indications, complications, and techniques for placement

“…There are a select group of patients for whom TAC can be considered first line; those with congenital malformations or prior cervical surgery that would make a TVC technically difficult or impossible (i.e. cervical laceration, large conization with inadequate residual tissue, trachelectomy) [10,14 ▪ ].…”

“…There are a select group of patients for whom TAC can be considered first line; those with congenital malformations or prior cervical surgery that would make a TVC technically difficult or impossible (i.e. cervical laceration, large conization with inadequate residual tissue, trachelectomy) [10,14 ]. The FIGO Working Group for Preterm Birth suggests offering a TAC to patients who experience a second trimester loss despite a history-indicated or ultrasound-indicated TVC.…”