{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:02:26Z","timestamp":1756339346052,"version":"3.44.0"},"reference-count":21,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,1,25]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:p>Transabdominal cerclage (TAC) is a recognised treatment for recurrent spontaneous late miscarriage or preterm birth due to cervical weakness. This can be performed via an open procedure before and during pregnancy, or a laparoscopic technique preconception. Complications include cerclage failure and suture migration. We present a case highlighting these complications where laparoscopic removal of an open TAC and replacement led to two successful term deliveries. A woman in her thirties with a fibroid uterus, adenomyosis and a history of three spontaneous mid-trimester losses, had an open TAC at 13 weeks of gestation. Preterm premature rupture of the membranes occurred shortly after and at 18 weeks of gestation she underwent surgical evacuation of the uterus. Subsequent hysteroscopy confirmed migration of the cerclage through the cervical canal. We demonstrate the application of endoscopic gynaecological surgery to remove and replace the TAC with two successful term births by Caesarean section in the ensuing pregnancies.<\/jats:p>","DOI":"10.1136\/bcr-2021-247757","type":"journal-article","created":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T10:51:00Z","timestamp":1646045460000},"page":"e247757","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic transabdominal cervical cerclage replacement after recurrent late miscarriage"],"prefix":"10.1136","volume":"15","author":[{"given":"Martin","family":"Hirsch","sequence":"first","affiliation":[{"name":"Oxford Endometriosis CaRe Centre, Oxford University, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9018-4621","authenticated-orcid":false,"given":"Dan","family":"Reisel","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Unit, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"EGA Institute for Women's Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ertan","family":"Saridogan","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Unit, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"EGA Institute for Women's Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna L","family":"David","sequence":"additional","affiliation":[{"name":"EGA Institute for Women's Health, University College London, London, UK"},{"name":"NIHR University College London Hospitals Biomedical Research Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,2,28]]},"reference":[{"key":"2025082623235174000_15.2.e247757.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.01.039"},{"key":"2025082623235174000_15.2.e247757.2","article-title":"Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy","volume":"6","author":"Alfirevic","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082623235174000_15.2.e247757.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.08.015"},{"key":"2025082623235174000_15.2.e247757.4","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1111\/aogs.13160","article-title":"Full dilation cesarean section: a risk factor for recurrent second-trimester loss and preterm birth","volume":"96","author":"Watson","year":"2017","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025082623235174000_15.2.e247757.5","first-page":"117","article-title":"The role of transabdominal cervical cerclage techniques in maternity care","volume":"18","author":"Gibb","year":"2016","journal-title":"Obstet Gynecol"},{"key":"2025082623235174000_15.2.e247757.6","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":"Saridogan","year":"2019","journal-title":"Facts Views Vis Obgyn"},{"key":"2025082623235174000_15.2.e247757.7","doi-asserted-by":"crossref","first-page":"261.e1","DOI":"10.1016\/j.ajog.2019.09.040","article-title":"MAVRIC: a multicenter randomized controlled trial of transabdominal vs transvaginal cervical cerclage","volume":"222","author":"Shennan","year":"2020","journal-title":"Am J Obstet Gynecol"},{"key":"2025082623235174000_15.2.e247757.8","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.ejogrb.2016.01.035","article-title":"Transabdominal cerclage: preconceptual versus first trimester insertion","volume":"199","author":"Dawood","year":"2016","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025082623235174000_15.2.e247757.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(97)00444-5"},{"key":"2025082623235174000_15.2.e247757.10","unstructured":"NICE guidance . 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