Therapeutic effect and safety of laparoscopic cervical cerclage for treatment of cervical insufficiency in first trimester or non-pregnant phase.

OBJECTIVE: To investigate the therapeutic effect and safety of cerclage placed in pregnancy via laparoscopy (CPL) in the first trimesteror in non-pregnant phase (CNL).

METHODS: A total of 134 cervical insufficiency patients who were treated with cervical cerclage were included. All the patients were divided into 3 groups. CPL group: 43 cases were treated with cerclage placed in pregnancy via laparoscopy in the first trimester, of which 26 cases received termination of pregnancy. CNL group: 58 cases were treated with cerclage placed via laparoscopy in the non-pregnant phase, of whom 34 received termination of pregnancy. TVC group: 33 cases received traditional vaginal cerclage placed in second trimester, of whom 33 cases received termination of pregnancy.

RESULTS: All patients received a successful operation without any complications during or after surgery. The post-operative hospitalization duration in CPL group was significantly shorter than that in TVC group. In 3 groups, for all patients who received termination of pregnancy, the postoperative full term delivery rate, fetal salvage rate (if pregnancy lasted ≥ 14 weeks), mean gestational weeks (if pregnancy lasted ≥ 14 wk) after operation, post-operation gestational age for all patients, and weeks of pregnancy gained were observed and analyzed. There were no significant differences of every index between CPL group and CNL group. Every index in TVC group was lower than that in both CNL group and CPL group.

CONCLUSION: CPL or CNL for treatment of cervical insufficiency is safe and effective, with a better therapeutic effect than that of TVC in the second trimester.