Trans-Abdominal Cerclage
Here at TriHealth, we are pioneers being the first to offer the full breadth of transabdominal cerclage surgical options within the region. Dr. William Schnettler, with TriHealth's Tristate Maternal-Fetal Medicine Associates, was the first and only maternal-fetal medicine physician in the region offering these surgical options for many years, and patients from all across the country travel to Cincinnati to have him perform this procedure.
Our goal is, and always has been, to provide preventative measures for at-risk patients before they suffer another tragic pregnancy loss.
To better serve our patients, we have streamlined our process so that patients who may be travelling from afar can come and have their procedure performed without needing to make several trips prior to or following surgery.
Learn more in the following video about the procedure, how to prepare for this surgical option and what comes next for patients.
Our team utilizes an advanced and collaborative approach to help women with cervical insufficiency or other congenital / acquired forms of uterine and cervical abnormalities achieve healthy pregnancy outcomes. Without assistance, such women face exceedingly heightened risk for pregnancy loss and extreme premature birth – the leading cause of mortality and health complications among infants. Our specialists share a passion for providing world-class care by incorporating the latest evidence-based approaches with the most advanced surgical and non-surgical therapies. We will work closely with referring providers to help outline and implement an individual management plan for each patient.
What is Cervical Insufficiency?
Cervical insufficiency (or cervical incompetence) is a condition where the uterine cervix has demonstrated the propensity to dilate prematurely and lead to early delivery of the fetus. The classic criteria includes at least two extremely premature deliveries that were NOT preceded by uterine contractions, cramping, leakage of amniotic fluid, or vaginal bleeding. However, there are many women that may not have endured two such adverse pregnancy outcomes but may still have some degree of cervical insufficiency. Our aim is to identify women prior to their second loss and help each one bring home a healthy baby every pregnancy.
What is a Trans-abdominal Cerclage?
Trans-abdominal cerclage is a surgical procedure where the upper portion of the cervix is reinforced with a sterile non-absorbable mersilene band. It can be performed by our surgeons in either an “open” or “minimally-invasive” fashion depending on a woman’s history and desire. The “minimally-invasive” approach utilizes the da Vinci® surgical platform and is performed as same-day surgery – meaning less recovery and time in the hospital. The band is permanent – meaning that it remains in place for all subsequent pregnancies once placed.
Are There Other Alternative Therapies Available?
Most pregnant women do not require trans-abdominal cerclage, and this procedure is typically reserved for women who have failed other forms of cervical cerclage or who may have anatomic characteristics that make placement of a “traditional” cervical cerclage less likely to succeed. Most of our patients who require trans-abdominal cerclage placement still receive ancillary preterm birth preventative measures such as supplemental progesterone, cervical length surveillance, and more frequent physician visits.