Laparoscopic Cervical Encerclage
Cervical incompetence is characterized by painless dilatation of the incompetent cervix and results in miscarriages and preterm delivery during second trimester.
Cervical incompetence occurs in 0.5% to 1% of all pregnancies and has a recurrence risk of 30%. Patients typically present with cervical dilatation in the absence of uterine activity after first trimester usually.
Cervical cerclage can be placed via transvaginal, open -transabdominal, or laparoscopic transabdominal approach, preferably before pregnancy.
A laparoscopic approach is superior to the transabdominal approach in terms of surgical outcomes, cost, and postoperative morbidity.
A laparoscopic approach to cervical cerclage placement is a potentially effective adjunct to the treatment of women at high risk of recurrent preterm birth.
Laparoscopic and transabdominal approaches both yield similar obstetric outcomes, and laparoscopic cerclage may be a superior method in terms of surgical outcomes, as suggested by several studies.
Laparoscopic surgical techniques have now increasingly replaced traditional abdominal approaches to gynecologic surgery.
laparoscopic cervical cerclage is a minimally invasive, extremely safe , cosmetically better pain and bleeding is lesser, intraabdominal adhesions are less, patient feels better postoperatively effective procedure in properly selected patients and should replace the traditional laparotomy technique.
When To Time Procedure ?
LAPAROSCOPIC cerclage placement can be performed prior to conception or in early pregnancy. Preconception placement provides optimum exposure and reduces risks of excessive bleeding and injury to the pregnancy
Is It better than a vaginal Approach ?
DEFINITELY .Time and again laparoscopy is the best method in treatment of various disease states in this modern medicine.
When the stitch has to be removed ?
The cerclage remains inside till delivery.it is released during the caesarean section in the operation theatre.
Will it harm the fetus?-
No it is necessary for the pregnancy to go on without which patient might end up in preterm delivery.
What Are The Risks Of Having A Cerclage Placed?
The likelihood of risks occurring is very minimal, and most health professionals feel a cerclage is a life-saving procedure that outweighs the possible risks involved.
what anaesthesia is given ?
its general anaeasthesia preferably.
What will be the recovery period?
Generally 2-3 days as with all the Laparoscopy procedures depending on your ability to recover.
who are the candidates for laparoscopic cerclage?
Previous failed vaginal cerclage with scarring or lacerations rendering vaginal cerclage technically very difficult or impossible.
Absent or very hypoplastic cervix with history of pregnancy loss fitting classical description of cervical insufficiency.
Which trimester it has to be planned?
The procedure is planned at the end of the first trimester or the early second trimester, after fetal viability has been documented and initial ultrasound evaluation of the pregnancy and preliminary blood tests have ruled out any major congenital malformation.
When not to have a cerclage?
Active labor.
Active vaginal bleeding.
Abruptio placenta.
Premature rupture of membranes.
Chorioamnionitis.
Prolapsed membranes.
Vaginal spotting .
What Can I Expect After The Procedure?
You may stay in the hospital for a few hours or overnight to be monitored for premature contractions or labor.
Immediately after the procedure, you may experience light bleeding and mild cramping, which should stop after a few days. This may be followed by an increased thick vaginal discharge, which may continue for the remainder of the pregnancy.
You may receive medication to prevent infection or preterm labor.
For 2-3 days after the procedure, plan to relax at home; avoid any unnecessary physical activity.
Your doctor will discuss with you when would be the appropriate time to resume regular activities.
Abstinence from sexual intercourse is often recommended.
what about postoperative care?
Elective cerclage is typically an ambulatory procedure. The patient is discharged after recovery from the anesthetic and when she is able to ambulate and void.
how to follow up?
Frequent visits as informed by your doctor report immediately in case of pain or spotting or bleedind or leaking.
What is the success rate?
Cervical cerclage helps prevent miscarriage or premature labor caused by cervical incompetence. The procedure is successful in 85% to 90% of cases. Cervical cerclage appears to be effective when true cervical incompetence exists
Why Doesn't Every Woman Who Has Had A Preterm Baby Need A Cerclage?
Only women with an abnormal or "incompetent" cervix can be helped by a cerclage. However, even with the help of a cerclage, other problems can cause labor to begin too early.
What About Future Pregnancies?
Most women who need a cerclage in one pregnancy will need to have a cerclage placed in future pregnancies.
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Cervical incompetence occurs in 0.5% to 1% of all pregnancies and has a recurrence risk of 30%. Patients typically present with cervical dilatation in the absence of uterine activity after first trimester usually.
Cervical cerclage can be placed via transvaginal, open -transabdominal, or laparoscopic transabdominal approach, preferably before pregnancy.
A laparoscopic approach is superior to the transabdominal approach in terms of surgical outcomes, cost, and postoperative morbidity.
A laparoscopic approach to cervical cerclage placement is a potentially effective adjunct to the treatment of women at high risk of recurrent preterm birth.
Laparoscopic and transabdominal approaches both yield similar obstetric outcomes, and laparoscopic cerclage may be a superior method in terms of surgical outcomes, as suggested by several studies.
Laparoscopic surgical techniques have now increasingly replaced traditional abdominal approaches to gynecologic surgery.
laparoscopic cervical cerclage is a minimally invasive, extremely safe , cosmetically better pain and bleeding is lesser, intraabdominal adhesions are less, patient feels better postoperatively effective procedure in properly selected patients and should replace the traditional laparotomy technique.
When To Time Procedure ?
LAPAROSCOPIC cerclage placement can be performed prior to conception or in early pregnancy. Preconception placement provides optimum exposure and reduces risks of excessive bleeding and injury to the pregnancy
Is It better than a vaginal Approach ?
DEFINITELY .Time and again laparoscopy is the best method in treatment of various disease states in this modern medicine.
When the stitch has to be removed ?
The cerclage remains inside till delivery.it is released during the caesarean section in the operation theatre.
Will it harm the fetus?-
No it is necessary for the pregnancy to go on without which patient might end up in preterm delivery.
What Are The Risks Of Having A Cerclage Placed?
The likelihood of risks occurring is very minimal, and most health professionals feel a cerclage is a life-saving procedure that outweighs the possible risks involved.
what anaesthesia is given ?
its general anaeasthesia preferably.
What will be the recovery period?
Generally 2-3 days as with all the Laparoscopy procedures depending on your ability to recover.
who are the candidates for laparoscopic cerclage?
Previous failed vaginal cerclage with scarring or lacerations rendering vaginal cerclage technically very difficult or impossible.
Absent or very hypoplastic cervix with history of pregnancy loss fitting classical description of cervical insufficiency.
Which trimester it has to be planned?
The procedure is planned at the end of the first trimester or the early second trimester, after fetal viability has been documented and initial ultrasound evaluation of the pregnancy and preliminary blood tests have ruled out any major congenital malformation.
When not to have a cerclage?
Active labor.
Active vaginal bleeding.
Abruptio placenta.
Premature rupture of membranes.
Chorioamnionitis.
Prolapsed membranes.
Vaginal spotting .
What Can I Expect After The Procedure?
You may stay in the hospital for a few hours or overnight to be monitored for premature contractions or labor.
Immediately after the procedure, you may experience light bleeding and mild cramping, which should stop after a few days. This may be followed by an increased thick vaginal discharge, which may continue for the remainder of the pregnancy.
You may receive medication to prevent infection or preterm labor.
For 2-3 days after the procedure, plan to relax at home; avoid any unnecessary physical activity.
Your doctor will discuss with you when would be the appropriate time to resume regular activities.
Abstinence from sexual intercourse is often recommended.
what about postoperative care?
Elective cerclage is typically an ambulatory procedure. The patient is discharged after recovery from the anesthetic and when she is able to ambulate and void.
how to follow up?
Frequent visits as informed by your doctor report immediately in case of pain or spotting or bleedind or leaking.
What is the success rate?
Cervical cerclage helps prevent miscarriage or premature labor caused by cervical incompetence. The procedure is successful in 85% to 90% of cases. Cervical cerclage appears to be effective when true cervical incompetence exists
Why Doesn't Every Woman Who Has Had A Preterm Baby Need A Cerclage?
Only women with an abnormal or "incompetent" cervix can be helped by a cerclage. However, even with the help of a cerclage, other problems can cause labor to begin too early.
What About Future Pregnancies?
Most women who need a cerclage in one pregnancy will need to have a cerclage placed in future pregnancies.
Follow tags:
Fibroids Natural Treatment in Bangalore|Best Hospital in Bangalore for Laparoscopy|Fibroids Treatment in Bangalore|Gynaecology Clinic in Bangalore|Fibroids Surgery in Bangalore|Top Gynaecology Hospitals in Bangalore|Gynaecology Hospitals in Bangalore|IVF Treatment Centre in Bangalore|IVF Centre in Bangalore|Vaginal Hysterectomy Surgery in Bangalore|Gynaecology Hospitals in Bangalore|Maternity in RRnagar|
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Kumusta Selina
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