Successful Vaginal Delivery following an Abdominal Cerclage Removal in Pre-Term Labour

TY - JOUR

T1 - Successful Vaginal Delivery following an Abdominal Cerclage Removal in Pre-Term Labour

AU - Carlisle, Naomi Helen

AU - Ridout, Alexandra Elizabeth

AU - Shennan, Andrew Hoseason

PY - 2017/12/15

Y1 - 2017/12/15

N2 - Case study of a woman who went into spontaneous preterm labour with atrans-abdominal cerclage (TAC) in situ at 33 weeks’ gestation. In view of a riskof uterine rupture, she was taken to theatre for examination under anesthesia ±caesarean section. Under spinal analgesia the TAC sutures were palpable on VE,having pulled through the now soft and shortened posterior wall of the cervix.They were therefore cut and removed vaginally. She went on to have a vaginaldelivery of a healthy female infant. There are no published cases of women whohave had their TAC removed vaginally, allowing spontaneous vaginal delivery tobe achieved. In our experience it is not uncommon that the abdominal cerclage is found within the internal os at the time of scheduled caesarean section. This can occur even when the woman has been asymptomatic. This provides evidence that removal through the internal os is feasible and can prevent the need for caesarean delivery in rare cases. It also supports the need for careful ultrasound assessment prior to future conception, confirming the TAC is still in-tact.

AB - Case study of a woman who went into spontaneous preterm labour with atrans-abdominal cerclage (TAC) in situ at 33 weeks’ gestation. In view of a riskof uterine rupture, she was taken to theatre for examination under anesthesia ±caesarean section. Under spinal analgesia the TAC sutures were palpable on VE,having pulled through the now soft and shortened posterior wall of the cervix.They were therefore cut and removed vaginally. She went on to have a vaginaldelivery of a healthy female infant. There are no published cases of women whohave had their TAC removed vaginally, allowing spontaneous vaginal delivery tobe achieved. In our experience it is not uncommon that the abdominal cerclage is found within the internal os at the time of scheduled caesarean section. This can occur even when the woman has been asymptomatic. This provides evidence that removal through the internal os is feasible and can prevent the need for caesarean delivery in rare cases. It also supports the need for careful ultrasound assessment prior to future conception, confirming the TAC is still in-tact.

M3 - Article

VL - 1

JO - International Journal of Obstetrics and Gynaecology Study

JF - International Journal of Obstetrics and Gynaecology Study

IS - 1

ER -