Laparoscopic Transabdominal Cerclage: Successful Term Pregnancy Following Radical Trachelectomy

Abstract

Background: Radical trachelectomy is an effective fertility-sparing treatment for early stage cervical cancer but is associated with an increased incidence of preterm labor and mid-trimester pregnancy loss. Cervical cerclage is associated with improved pregnancy outcomes in patients who have previously undergone trachelectomy. Some researchers have reported complications associated with cerclage placement at the time of radical trachelectomy. Case: A 36-year-old woman underwent trachelectomy and laparoscopic pelvic lymphadenectomy for a stage 1b cervical adenocarcinoma. Eighteen months later, the patient became pregnant through in-vitro fertilization. After placement of a laparoscopic transabdominal cerclage at 10 weeks and 6 days of gestation, the patient had a sucessful term pregnancy: Results: This patient had an uneventful pregnancy and underwent routine antenatal care plus regular ultrasound testing. Via cesarean section at 38 weeks of gestation, she was delivered of a healthy baby boy weighing 3100 g. Conclusions: Laparoscopic transabdominal cerclage has shown good pregnancy outcomes in patients with cervical insufficiency. This procedure can be an effective option for patients who have undergone trachelectomy. ( J GYNECOL SURG 30:165)