Preconceptional laparoscopic abdominal cerclage: a multicenter cohort study - 27/09/12
, Jon I. Einarsson, MD, MPH c, Henricus A.M. Brölmann, MD a, Florentien E.M. Vree, MD b, Thomas F. McElrath, MD, PhD c, Judith A.F. Huirne, MD, PhD a
Reprints: Nicole B. Burger, MD, Department of Obstetrics and Gynecology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The NetherlandsRésumé |
Objective |
The purpose of this study was to evaluate the effectiveness of laparoscopic abdominal cerclage placement in the prevention of recurrent preterm birth.
Study Design |
We conducted a multicenter cohort study with retrospective Dutch (32 patients) and Boston (34 patients) cohorts who had undergone preconceptional laparoscopic abdominal cerclage placement. Eligible patients had at least 1 second/third trimester fetal loss or delivered at <34 weeks of gestation because of cervical insufficiency and/or a short or absent cervix. Primary outcome was delivery of an infant at ≥34 weeks of gestation with neonatal survival. Secondary outcome measures included surgical and pregnancy outcomes and patients' satisfaction (Dutch cohort).
Results |
Surgical outcomes of 66 patients were excellent, with 3 minor complications. After preconceptional laparoscopic abdominal cerclage, 35 pregnancies were evaluated. Twenty-five patients (71.4%) delivered at ≥34 weeks of gestation; 3 patients (8.6%) experienced a second-trimester fetal loss. The total fetal survival rate was 90.0%.
Conclusion |
Preconceptional laparoscopic abdominal cerclage shows encouraging and favorable perinatal outcomes in patients with a poor obstetric history.
Le texte complet de cet article est disponible en PDF.Key words : abdominal cerclage, cervical insufficiency, preconceptional laparoscopic abdominal cerclage
Plan
| The authors report no conflict of interest. J.I.E. is a consultant for Ethicon Endo-Surgery. |
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| Cite this article as: Burger NB, Einarsson JI, Brölmann HAM, et al. Preconceptional laparoscopic abdominal cerclage: a multicenter cohort study. Am J Obstet Gynecol 2012;207:273.e1-12. |
Vol 207 - N° 4
P. 273.e1-273.e12 - octobre 2012 Retour au numéro
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