Transabdominal cerclage for closure of the incompetent cervix.

In addition to the limited published experience with transabdominal cervical cerclage (TCC) we report the use of this procedure in 14 women with a diagnosis of cervical incompetence, and a cervical deformity or defect precluding the usual transvaginal approach. In 13 pregnant patients and in one nonpregnant woman a band was placed transabdominally around the cervix at the level of the isthmus. No significant perioperative complications occurred. Two women had two consecutive pregnancies following TCC, so we report the outcome of 16 pregnancies. Fetal salvage increased from 16% before to 94% after TCC. Our experience and an analysis of the available literature support the view that TCC may be a beneficial procedure in women with cervical incompetence due to a severely traumatized cervix.