{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:19:57Z","timestamp":1787653197222,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"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":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Repeated cervical conization can result in cervical shortening and substantial structural and functional impairment. A 35\u2010year\u2010old woman developed cervical stenosis and hematometra after undergoing two conizations. The vaginal cervix and external os were unidentifiable, drainage was unsuccessful, and laparoscopy\u2010assisted recanalization proved technically challenging as multiple false passages formed before achieving uterine access. Repeated dilation maintained cervical patency, and intrauterine insemination achieved pregnancy after cervical factor infertility was diagnosed. At 9\u2009weeks of gestation, the residual endocervical glandular region measured 11.9\u2009mm, and the vaginal cervix was nearly absent. As the cumulative clinical course demonstrated severe anatomical disruption that precluded transvaginal cerclage, laparoscopic transabdominal cervicoisthmic cerclage was performed at 13\u2009weeks and 3\u2009days of gestation. Uterine artery pulsatility indices remained within the reference range. A 2114\u2010g infant was delivered by cesarean section at 37\u2009weeks and 5\u2009days. Severe anatomical cervical defects may warrant transabdominal cerclage beyond conventional history\u2010based indications.<\/jats:p>","DOI":"10.1111\/jog.70456","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T04:03:21Z","timestamp":1786421001000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic Transabdominal Cerclage Despite the Absence of Prior Pregnancy Loss: A Case of Profound Acquired Cervical Anatomical Defects After Repeated Conization"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8560-589X","authenticated-orcid":false,"given":"Kensuke","family":"Suzuki","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine The University of Tokyo  Tokyo 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