Selçuk YETKİNEL, Pınar Çağlar AYTAÇ, Tayfun ÇOK, Didem Alkaş YAĞINÇ, Erhan ŞİMŞEK
Çukurova Anestezi ve Cerrahi Bilimler Dergisi - 2026;9(3):653-663
Objective: To evaluate surgical and obstetric outcomes following preconceptional laparoscopic abdominal cerclage (LAC) in women with complex cervical insufficiency. Materials and Methods: This retrospective cohort study included women who underwent LAC between January 2018 and December 2025; follow-up ended on 31 January 2026. Data were extracted from an institutional database and verified by medical-record review. The primary outcome was live birth after LAC. Secondary outcomes included operative time, perioperative complications, gestational age at delivery, preterm birth, birthweight, and additional transvaginal cerclage. Exploratory subgroup comparisons assessed previous and additional transvaginal cerclage. Results: Sixty-nine women underwent 71 LAC procedures. Mean operative time was 74.1+/-25.4 minutes, with no recorded intraoperative or postoperative complications. Fifty-one women (73.9%) achieved 65 post-LAC pregnancies, of which 62 (95.4%) resulted in live birth. Two twin pregnancies yielded 64 liveborn neonates. Among 60 live-birth pregnancies with gestational-age data, mean gestational age was 37.12+/-1.66 weeks and four (6.7%) delivered before 34 weeks. Mean birthweight was 3003+/-602 g among 61 neonates with available data; none weighed <1500 g. Five pregnancies (7.7%) required additional transvaginal cerclage. Exploratory subgroup comparisons showed no statistically significant differences but were limited by small groups. Conclusion: In conclusion, in this selected high-risk cohort, preconceptional LAC was associated with low recorded perioperative morbidity, a high proportion of pregnancies resulting in live birth, and infrequent delivery before 34 weeks. The absence of a concurrent comparison group and small clinically important subgroups require cautious interpretation. Prospective multicenter studies using standardized eligibility and outcome definitions are needed to refine patient selection and additional interventions after LAC.
