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Laparoscopic cervico-isthmic cerclage: About 25 cases.
J Gynecol Obstet Hum Reprod. 2018 Oct; 47(8):385-389.JG

Abstract

INTRODUCTION

The purpose of this study is to report on our experience of laparoscopic cervico-isthmic cerclage.

MATERIAL AND METHOD

A monocentric retrospective study covering a 13-year period during which 25 cases of laparoscopic cerclage outside of pregnancy were performed, using the technique described by Dubuisson, at the University Hospital of Clermont-Ferrand. Individual patient data included pregnancy outcomes before and after cerclage and the characteristics of surgery.

RESULTS

The mean age of the patients was 33.9 (±4.6) years. A total of 68 pregnancies were recorded before cerclage, including 31 late miscarriages, 11 premature deliveries, with only 9 pregnancies attaining full-term. The average time of surgery was 54 (±17.5) minutes with a hospital stay of 24h. 3 minor intraoperative complications (12%) with hemorrhage <300cc were noted and managed intraoperatively. In some cases laparoscopy allowed treatment of associated pathologies (septum resection, adhesiolysis, endometriosis, ovarian drilling, tube assessment). 21 pregnancies (68% of patients) were recorded post cerclage including 5 early miscarriages and 16 cesarean deliveries with an average time taken to conceive of 11.8 months. The overall neonatal survival rate after cerclage was 76.2% versus 16.20% before surgery (p<0.0001), with a 100% neonatal survival rate beyond the 1st trimester as compared to 21.6% before cerclage (p<0.0001).

Authors+Show Affiliations

CHU Clermont-Ferrand, 1, place Lucie et Raymond Aubrac, 63100 Clermont-Ferrand cedex 1, France. Electronic address: asgremeau@chu-clermontferrand.fr.CHU Clermont-Ferrand, 1, place Lucie et Raymond Aubrac, 63100 Clermont-Ferrand cedex 1, France.CHU Clermont-Ferrand, 1, place Lucie et Raymond Aubrac, 63100 Clermont-Ferrand cedex 1, France.CHU Clermont-Ferrand, 1, place Lucie et Raymond Aubrac, 63100 Clermont-Ferrand cedex 1, France.CHU Clermont-Ferrand, 1, place Lucie et Raymond Aubrac, 63100 Clermont-Ferrand cedex 1, France.CHU Clermont-Ferrand, 1, place Lucie et Raymond Aubrac, 63100 Clermont-Ferrand cedex 1, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29990537

Citation

Gremeau, Anne-Sophie, et al. "Laparoscopic Cervico-isthmic Cerclage: About 25 Cases." Journal of Gynecology Obstetrics and Human Reproduction, vol. 47, no. 8, 2018, pp. 385-389.
Gremeau AS, Corvaisier M, Bourdel N, et al. Laparoscopic cervico-isthmic cerclage: About 25 cases. J Gynecol Obstet Hum Reprod. 2018;47(8):385-389.
Gremeau, A. S., Corvaisier, M., Bourdel, N., Canis, M., Gallot, D., & Pouly, J. L. (2018). Laparoscopic cervico-isthmic cerclage: About 25 cases. Journal of Gynecology Obstetrics and Human Reproduction, 47(8), 385-389. https://doi.org/10.1016/j.jogoh.2018.07.002
Gremeau AS, et al. Laparoscopic Cervico-isthmic Cerclage: About 25 Cases. J Gynecol Obstet Hum Reprod. 2018;47(8):385-389. PubMed PMID: 29990537.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic cervico-isthmic cerclage: About 25 cases. AU - Gremeau,Anne-Sophie, AU - Corvaisier,Marion, AU - Bourdel,Nicolas, AU - Canis,Michel, AU - Gallot,Denis, AU - Pouly,Jean Luc, Y1 - 2018/07/07/ PY - 2018/05/22/received PY - 2018/06/27/revised PY - 2018/07/02/accepted PY - 2018/7/11/pubmed PY - 2019/1/8/medline PY - 2018/7/11/entrez KW - Cerclage KW - Laparoscopy SP - 385 EP - 389 JF - Journal of gynecology obstetrics and human reproduction JO - J Gynecol Obstet Hum Reprod VL - 47 IS - 8 N2 - INTRODUCTION: The purpose of this study is to report on our experience of laparoscopic cervico-isthmic cerclage. MATERIAL AND METHOD: A monocentric retrospective study covering a 13-year period during which 25 cases of laparoscopic cerclage outside of pregnancy were performed, using the technique described by Dubuisson, at the University Hospital of Clermont-Ferrand. Individual patient data included pregnancy outcomes before and after cerclage and the characteristics of surgery. RESULTS: The mean age of the patients was 33.9 (±4.6) years. A total of 68 pregnancies were recorded before cerclage, including 31 late miscarriages, 11 premature deliveries, with only 9 pregnancies attaining full-term. The average time of surgery was 54 (±17.5) minutes with a hospital stay of 24h. 3 minor intraoperative complications (12%) with hemorrhage <300cc were noted and managed intraoperatively. In some cases laparoscopy allowed treatment of associated pathologies (septum resection, adhesiolysis, endometriosis, ovarian drilling, tube assessment). 21 pregnancies (68% of patients) were recorded post cerclage including 5 early miscarriages and 16 cesarean deliveries with an average time taken to conceive of 11.8 months. The overall neonatal survival rate after cerclage was 76.2% versus 16.20% before surgery (p<0.0001), with a 100% neonatal survival rate beyond the 1st trimester as compared to 21.6% before cerclage (p<0.0001). SN - 2468-7847 UR - https://www.unboundmedicine.com/medline/citation/29990537/Laparoscopic_cervico-isthmic_cerclage:_About_25_cases L2 - https://linkinghub.elsevier.com/retrieve/pii/S2468-7847(18)30221-6 DB - PRIME DP - Unbound Medicine ER -