Laparoscopic Cerclage in a Patient of Cervical Incompetence
Abstract
Cervical incompetence may be due to obstetric or gynecological or congenital causes. The laparoscopic cerclage is highly recommended for previous failed vaginal cerclage and is superior to laparotomy approach in terms of low morbidity and faster recovery. In this case report, we tried to evaluate obstetric outcome of preconceptional laparoscopic cerclage in a patient of cervical incompetence. A 31-year-old lady presented with primary infertility. She had two first-trimester and two second-trimester abortions. Vaginal cerclage was done in subsequent pregnancy by MacDonald’s method, which failed to prolong pregnancy. Hence, preconceptional laparoscopic cerclage was done with Mersilene tape. Main outcome was neonatal survival and prolongation of gestation. The lady successfully completed 36 weeks and delivered a baby weighing 2.94 kg, by elective LSCS without any complications. Preconceptional laparoscopic cerclage proved to be safe and effective, resulting in favorable obstetric outcome in this lady having cervical incompetence and bad obstetric history.

Case Report
The aim of this case study was to evaluate obstetric outcome of preconceptional laparoscopic cerclage in a patient of cervical incompetence. A 31-year-old lady, married since 14 years, presented with primary infertility. She was obese with typical signs and symptoms of polycystic ovarian syndrome. She conceived four times, with IVF-ICSI treatment. In her first pregnancy, she had single gestation, but aborted at 16 weeks. Second time she conceived, it was twin gestation, but resulted in missed abortion at 8 weeks. In her third pregnancy, MacDonald’s vaginal cerclage was done at 13 weeks i/v/o previous h/o second trimester miscarriage and transvaginal scan suggestive of short cervix. NT scan and dual marker test were done and confirmed normal before cerclage. She was advised rest, tocolytics, but in spite of all the precautions, she aborted at 18 - 19 weeks. The fourth pregnancy was a blighted ovum at 7 weeks.....

http://www.jcgo.org/index.php/jcgo/article/view/415/272
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