Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biol
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Preconception Laparoscopic Cervical Cerclage: The Preferred Technique for Cervical Incompetence?

Kedar R Jape, Philip K Rowlands and John L Yovich

Objective: To explore the ease and effectiveness of placing a cervical suture preconception using a laparoscopic technique.

Design: A case study with systematic literature review.

Setting: PIVET Medical Centre, a private facility providing comprehensive services over 35 years in gynaecology, andrology and reproductive endocrinology for infertility and recurrent pregnancy loss.

Patients: Case report of a 35 year old woman with recurrent mid-trimester pregnancy losses and well-define cervical incompetence.

Intervention: Preconception placement of cervical suture by laparoscopic trans-abdominal cerclage (LTAC) as a day case.

Main outcome measure: Details of ensuing pregnancy.

Results: Conception without delay and normal pregnancy with delivery by elective caesarean section near term of healthy 2645 g female infant.

Conclusion: We are impressed with the ease of the LTAC technique which appears likely to have fewer complications than traditional vaginal techniques, as well as speedier recovery compared to a laparotomy approach.