Cervical length after cerclage: comparison between laparoscopic and vaginal approach.

Bolla, Daniele Maik; Gasparri, Maria Luisa; Badir, Sabrina; Bajka, Michael; Mueller, Michael; Papadia, Andrea; Raio, Luigi (2017). Cervical length after cerclage: comparison between laparoscopic and vaginal approach. Archives of gynecology and obstetrics, 295(4), pp. 885-890. Springer 10.1007/s00404-016-4285-5

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PURPOSE The aim of our study was to investigate the sonographic changes of the cervical length during pregnancy after the placement of a transvaginal cervical cerclage (TVC) or a laparoscopic abdominal cerclage (LAC) in patients with cervical insufficiency (CI). METHODS Between January 2008 and March 2015, a retrospective analysis of all women undergoing a prophylactic laparoscopic (LAC group) or transvaginal (TVC group) cerclage due to cervical insufficiency was conducted. Nonparametric variables were analysed with the Mann-Whitney (U) test, and categorical-type outcomes were analysed with the Fisher's exact test. A p value <0.05 was considered as significant. Data analysis was performed using Prism 5 for Mac OS X. RESULTS Thirty-eight patients were included. Of these, 18 and 20 underwent an LAC and a TVC, respectively. Mean gestational age at surgery in the LAC and TVC groups was 11.4 ± 1.6 and 17 ± 3 weeks, respectively (p < 0.05). The cervical length prior to surgery was similar among the two groups. After cerclage placement, the distance between the tape and the external cervical os differed significantly between the two groups (LAC: 31.5 ± 8.8 mm vs TVC: 13.5 ± 4.9 mm; p < 0.0001) (Fig. 1). During pregnancy, the cervical length in the TVC group showed a significant shortening (from 26.6 ± 7 mm before surgery to 13.2 ± 7 mm at 33 weeks; p < 0.0001), while in the LAC group, the cervical length remained unchanged. CONCLUSIONS In patients with CI, LAC is associated with a better preservation of the cervical length throughout pregnancy as compared to TVC.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Bolla, Daniele Maik; Mueller, Michael; Papadia, Andrea and Raio, Luigi

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0932-0067

Publisher:

Springer

Language:

English

Submitter:

Monika Zehr

Date Deposited:

15 Feb 2018 14:47

Last Modified:

26 Oct 2019 08:51

Publisher DOI:

10.1007/s00404-016-4285-5

PubMed ID:

28255763

Uncontrolled Keywords:

Cervical insufficiency Laparoscopic abdominal cerclage Prophylactic cerclage Transvaginal cerclage

BORIS DOI:

10.7892/boris.111039

URI:

https://boris.unibe.ch/id/eprint/111039

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