Fertility outcome following transvaginal cervicoisthmic cerclage using a polypropylene sling

Abstract 

Objective

To report fertility and pregnancy outcomes following transvaginal cervicoisthmic cerclage with a polypropylene sling during a previous pregnancy.

Methods

A continuous series of 57 women who underwent prophylactic cervicoisthmic cerclage during a previous (reference) pregnancy were enrolled. Telephone interviews were carried out to evaluate each patient's subsequent fertility.

Results

Among the 57 women interviewed, 8 had an inadequate follow-up, 13 women were lost to follow-up, 1 woman required a hemostatic hysterectomy, and 2 women required removal of the sling. Nineteen women did not desire a subsequent pregnancy. Of the 14 women who did desire a subsequent pregnancy, 1 woman had previously known tubal infertility. Of the 13 remaining women, 7 subsequently became pregnant. One woman had a spontaneous abortion (11weeks of pregnancy); 1 woman delivered at 22weeks of pregnancy, after a spontaneous premature membrane rupture; 1 woman had a cesarean delivery at 25weeks of pregnancy; and 4 patients had a cesarean delivery after 37weeks of pregnancy. Median duration of the 4 subsequent pregnancies at delivery was 37weeks (interquartile range [IQR], 37–38weeks). Median birth weight was 3040g (IQR, 2500–3250g).

Conclusion

Subsequent pregnancy is possible after transvaginal cervicoisthmic cerclage using a synthetic sling.

Keywords: Cerclage, Fertility outcome, Transvaginal cervicoisthmic cerclage, Polypropylene sling