An abdominal cerclage is a cerclage type that helps ensure the baby fully develops inside the mother’s womb before delivery. The procedure entails making incision(s) in the abdomen to access the cervix. Done usually around the 12th week of pregnancy, the cervix is stitched closed post the procedure. Thanks to this surgery, a vaginal birth in the future is completely ruled out. The risks to the procedure are similar to transvaginal cervical cerclage risks:  

  • Unexpected vaginal bleeding or spotting
  • Vagina fluid leak
  • Abdominal or back pain
  • Infection
  • Premature contractions
  • Premature delivery or labor
  • Premature membrane rupture  
  • Cervix rupture or tearing
  • Pregnancy loss
  • Bladder or nearby organ injury
  • Anesthesia complications

Prior to the procedure, the vagina should be devoid of any interactions, including sexual intercourse. The anesthesia administered before the procedure can set the patient in a drowsy, completely asleep or relaxed state.

Surgery Techniques

The operation could be performed either as a laparoscopy or open surgery.

A laparoscopy entails a few incisions in the abdomen to make way for a thin tube called laparoscope. The tube is inserted via one of the incisions. It transmits live pictures of the interiors onto a screen. Other surgical tools are worked in through the other incisions.

An open surgery, on the other hand, entails one major incision in the abdomen. The cut is substantial enough for the doctor to view the interiors with the naked eye.

Advantages

An abdominal cerclage facilitates a much secure stitch and mitigates the probabilities of foreign elements entering the vagina. Transabdominal cerclage’s success rate is much higher than other cerclage techniques, exceeding 90 percent.

Every surgery has infection risks, but abdominal cerclages are less prone to infections compared to a transvaginal cerclage. This is because the vagina has more bacteria compared to the abdomen.

Disadvantages

As aforementioned, the placement and nature of the cerclage means future deliveries will be through the caesarean technique. Besides, post-surgery pain is quite severe.  

Candidacy

Compared to traditional or vaginal cerclage, an abdominal cerclage is much more complex and gruesome. Therefore, the surgery is recommended only to those women who’ve had multiple failed transvaginal cerclages before, or if a vaginal cerclage is not feasible due to cervix scarring, shortening or laceration.