Cervical insufficiency [CI] describes the painless dilation and shortening of the cervix at the end of the first trimester or early in the second trimester of the pregnancy and may result to miscarriage or preterm labor. The usual treatment is transvaginal cerclage [TVC]. There are however patients which should not be submitted in TVC, since TVC cannot be technically performed or may not be effective. In these women, transabdominal cerclage [TAC] placement may be the optimal alternative. We present a case of a gravid patient at week 22 of gestation, who underwent an emergency TAC, due to CI. TAC took place two days after the diagnosis of CI successfully, without any complication. The pregnancy proceeded without any other complication and a healthy female infant was delivered in 34th week due to beginning of labor, by elective cesarean section. According to our knowledge, there are no other reports of TAC placement, in a pregnant patient at week 22; a short review of the literature is also presented.
Nikolaidou ME and Fotopoulos S