{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T11:00:36Z","timestamp":1764241236993,"version":"3.46.0"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"10","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geburtshilfe Frauenheilkd"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The aim of the study was to describe the preventive option and safety of laparoscopic transabdominal emergency cerclage in pregnant women with advanced cervical shortening after failed vaginal cerclage or in whom vaginal cerclage is no longer possible.<\/jats:p>\n                  <jats:p>Laparoscopic isthmo-cervical emergency cerclage was carried out in two patients at 13+0 and 15+5 weeks of gestation (GW) respectively. Both patients had cervical shortening and it was no longer possible to expose the cervix after conization or re-conization. The attempts to carry out transvaginal cerclage were unsuccessful. The technical aspects, feasibility, safety, and pregnancy outcomes after laparoscopic transabdominal cerclage are presented here, based on two case reports.<\/jats:p>\n                  <jats:p>The cerclages were placed after blunt dissection of the uterine vessels and careful introduction of a KELLY forceps through the avascular space between the ascending and descending branches of the uterine vessels without using a needle. The operating times were 93 and 134 minutes (min), respectively. The estimated blood loss during the procedure was less than 50\u00a0ml and neither perioperative nor postoperative complications occurred. The subsequent course of both pregnancies was uneventful and fetal development in both cases was normal. In the first case, the baby was delivered by secondary cesarean section following premature rupture of membranes in week 35+4 of gestation. The baby had a birthweight of 2786\u00a0g, APGAR scores of 8\/9\/10 and an umbilical cord arterial pH of 7.36. In the second case, delivery was by primary cesarean section in week 39+5 of gestation. The infant had a birth weight of 4160\u00a0g, APGAR scores of 5\/9\/10 and an umbilical cord arterial pH of 7.20.<\/jats:p>\n                  <jats:p>Laparoscopic transabdominal cerclage is a safe and effective treatment option, even early in the second trimester of pregnancy, for patients in whom transvaginal cerclage is no longer possible due to anatomical factors. The method is technically very feasible and is associated with positive obstetric outcomes. The overall risk of perioperative complications is within acceptable limits.<\/jats:p>","DOI":"10.1055\/a-2373-0639","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T18:48:12Z","timestamp":1727808492000},"page":"989-998","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic Transabdominal Needle-free Emergency Cerclage in the Early Second Trimester of Pregnancy after Failed Transvaginal Cerclage: Two Case Reports and a Review of the Literature"],"prefix":"10.1055","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1589-2016","authenticated-orcid":false,"given":"Davut","family":"Dayan","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Frauenheilkunde und Geburtshilfe, Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4890-4986","authenticated-orcid":false,"given":"Marinus","family":"Schmid","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Frauenheilkunde und Geburtshilfe, Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2066-5344","authenticated-orcid":false,"given":"Florian K.","family":"Ebner","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Frauenheilkunde und Geburtshilfe, Universit\u00e4tsklinikum Ulm, Ulm, Germany"},{"name":"Abteilung f\u00fcr Frauenheilkunde und Geburtshilfe, Alb-Donau Klinikum Ehingen, Ehingen (Donau), Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5911-2400","authenticated-orcid":false,"given":"Wolfgang","family":"Janni","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Frauenheilkunde und Geburtshilfe, Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Reister","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Frauenheilkunde und Geburtshilfe, Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9169-5642","authenticated-orcid":false,"given":"Beate","family":"H\u00fcner","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Frauenheilkunde und Geburtshilfe, Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krisztian","family":"Lato","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Frauenheilkunde und Geburtshilfe, Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1882-9741","authenticated-orcid":false,"given":"Ulrike","family":"Friebe-Hoffmann","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Frauenheilkunde und Geburtshilfe, Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9336-2267","authenticated-orcid":false,"given":"Stefan","family":"Lukac","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Frauenheilkunde und Geburtshilfe, Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,10,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1055\/a-2044-0345","article-title":"Prevention and Therapy of Preterm Birth. 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Conclusions from data of several clinica, which use total surgical cervical occlusion]","volume":"200","author":"E Saling","year":"1996","journal-title":"Z Geburtshilfe Neonatol"},{"key":"ref7","first-page":"43","article-title":"Preconception laparoscopic transabdominal cervical cerclage for the prevention of midtrimester pregnancy loss and preterm birth: a single centre experience","volume":"11","author":"E Saridogan","year":"2019","journal-title":"Facts Views Vis Obgyn"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.ejogrb.2020.11.007","article-title":"Laparoscopic emergency cervicoisthmic cerclage in second trimester of pregnancy: A case series report","volume":"256","author":"A Kavallaris","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"364.e1","DOI":"10.1016\/j.ajog.2009.07.018","article-title":"Laparoscopic cervico-isthmic cerclage: surgical technique and obstetric 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Ades","year":"2018","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"ref17","first-page":"7710","article-title":"Therapeutic effect and safety of laparoscopic cervical cerclage for treatment of cervical insufficiency in first trimester or non-pregnant phase","volume":"8","author":"Y Chen","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"100757","DOI":"10.1016\/j.ajogmf.2022.100757","article-title":"The effectiveness of transabdominal cerclage placement via laparoscopy or laparotomy: a systematic review and meta-analysis","volume":"5","author":"CC Hulshoff","year":"2023","journal-title":"Am J Obstet Gynecol MFM"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"693","DOI":"10.3390\/jcm10040693","article-title":"Modified Laparoscopic Transabdominal Cervicoisthmic Cerclage for the Surgical Management of Recurrent Pregnancy Loss due to Cervical Factors","volume":"10","author":"H 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Zhao","year":"2022","journal-title":"Am J Obstet Gynecol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.ajog.2022.03.038","article-title":"Laparoscopic abdominal cerclage during pregnancy: a simplified approach","volume":"227","author":"B Zhao","year":"2022","journal-title":"Am J Obstet Gynecol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1055\/s-0028-1090591","article-title":"Robotic-assisted laparoscopic placement of transabdominal cerclage during pregnancy","volume":"25","author":"L Wolfe","year":"2008","journal-title":"Am J Perinatol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"111.e1","DOI":"10.1016\/j.ajog.2009.05.033","article-title":"Abdominal cerclage for the treatment of recurrent cervical insufficiency: laparoscopy or laparotomy?","volume":"201","author":"JF Carter","year":"2009","journal-title":"Am J Obstet Gynecol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1186\/s12884-022-05108-w","article-title":"Comparison of transvaginal cervical cerclage versus laparoscopic abdominal cervical cerclage in cervical insufficiency: a retrospective study from a single centre","volume":"22","author":"G Huang","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref31","first-page":"e158","article-title":"Laparoscopic placement of cervical cerclage","volume":"5","author":"OA Tusheva","year":"2012","journal-title":"Rev Obstet Gynecol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1016\/j.jmig.2014.05.015","article-title":"Pre and post-conceptional abdominal cerclage by laparoscopy or laparotomy","volume":"21","author":"T Tulandi","year":"2014","journal-title":"J Minim Invasive Gynecol"}],"container-title":["Geburtshilfe und Frauenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2373-0639.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T10:57:46Z","timestamp":1764241066000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2373-0639"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":32,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10,1]]},"published-print":{"date-parts":[[2024,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2373-0639","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0016-5751","1438-8804"],"issn-type":[{"type":"print","value":"0016-5751"},{"type":"electronic","value":"1438-8804"}],"subject":[],"published":{"date-parts":[[2024,10]]}}}