{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T07:21:31Z","timestamp":1789802491580,"version":"4.0.1"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Spontaneous preterm birth is mainly caused by cervical incompetence. Cervical cerclage is the gold standard for preventing mid\u2010trimester losses and preterm deliveries. If cervical cerclage fails, cervico\u2010isthmic cerclage may be indicated. This procedure can be performed via an abdominal or vaginal approach and allows for a neonatal survival rate of around 90%. If a cervico\u2010isthmic cerclage fails, there is no gold standard. Total cervical occlusion (TCO) could be an option. The present study aimed to analyze the efficacy of TCO using the Saling technique in cases where cervico\u2010isthmic cerclage has failed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Here, we present the surgical technique and our results in a small series of five cases. This single\u2010center study was conducted between 2009 and 2023, involving women who underwent a TCO after the first trimester of pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five women underwent this TCO: three for late miscarriage after a cervico\u2010isthmic cerclage during a previous pregnancy from which no child was born, and two for threatened late miscarriage in the current pregnancy (median gestational age: 17 and 21.2\u2009weeks). All of the women had already undergone a cervico\u2010isthmic cerclage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This occlusion was effective in prolonging pregnancy for all five women. The mean gestational age at delivery was 32.5\u2009weeks (range: 24.1\u201337.2\u2009weeks). On average, TCO prolonged pregnancy by 11.7\u2009weeks (minimum 3, maximum 16).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70974","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:54:32Z","timestamp":1774612472000},"page":"1595-1600","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Total cervical occlusion: A solution after cervico\u2010isthmic cerclage failure"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6860-9726","authenticated-orcid":false,"given":"D\u00e9borah","family":"Couet","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics CHU de Bic\u00eatre, AP\u2010HP, DMU2  Le Kremlin\u2010Bic\u00eatre France"},{"name":"University Paris\u2010Saclay  Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Ga\u00eblle","family":"Pourcelot","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics CHU de Bic\u00eatre, AP\u2010HP, DMU2  Le Kremlin\u2010Bic\u00eatre France"},{"name":"University Paris\u2010Saclay  Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Szmulevicz","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics CHU de Bic\u00eatre, AP\u2010HP, DMU2  Le Kremlin\u2010Bic\u00eatre France"},{"name":"University Paris\u2010Saclay  Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perrine","family":"Capmas","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics CHU de Bic\u00eatre, AP\u2010HP, DMU2  Le Kremlin\u2010Bic\u00eatre France"},{"name":"University Paris\u2010Saclay  Le Kremlin\u2010Bic\u00eatre France"},{"name":"CESP\u2010Inserm U1018 \u201cReproduction et D\u00e9veloppement de l'Enfant\u201d  Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herv\u00e9","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics CHU de Bic\u00eatre, AP\u2010HP, DMU2  Le Kremlin\u2010Bic\u00eatre France"},{"name":"University Paris\u2010Saclay  Le Kremlin\u2010Bic\u00eatre France"},{"name":"CESP\u2010Inserm U1018 \u201cReproduction et D\u00e9veloppement de l'Enfant\u201d  Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9lodie","family":"Debras","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics CHU de Bic\u00eatre, AP\u2010HP, DMU2  Le Kremlin\u2010Bic\u00eatre France"},{"name":"University Paris\u2010Saclay  Le Kremlin\u2010Bic\u00eatre France"},{"name":"University Paris\u2010Saclay, UVSQ, INRAE, BREED  Jouy\u2010en\u2010Josas France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"EPOP\u00e91. 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