Laparoscopic abdominal cerclage: a highly effective option for refractory cervical insufficiency

Laparoscopic abdominal cerclage is emerging as the preferred treatment option for patients with refractory cervical insufficiency. Laparoscopic abdominal cerclage reduces second-trimester loss and preterm birth with success rates similar to open abdominal cerclage. Increasing evidence also suggests improved neonatal survival rates with abdominal cerclage compared with repeat vaginal cerclage in patients who delivered prematurely despite a vaginal cerclage. The option to perform a highly effective treatment using minimally invasive techniques suggests laparoscopic abdominal cerclage will become the standard of care for refractory cervical insufficiency. This review examines the literature with regard to the indications and outcomes of abdominal cerclage, highlighting the laparoscopic technique. (C) 2020 by American Society for Reproductive Medicine.