https://europepmc.org/article/med/27904309

Journal: Eur J Obstet Gynecol Reprod Biol 2019

Authors: Paul Tyan, Jamal Mourad, Brian Wright, Marc Winter, Devon Garza, Rachel Smith, Janel Brink, Chapman Wei, Gaby Moawad

High-risk pregnancy stratification and the use of Progesterone and prophylactic cerclage based on prior obstetrical outcomes and cervical length screening have been successful in curbing the impact of preterm birth. However, a large number of women will still suffer from preterm delivery even with optimal management. Experts agree that a transabdominal cerclage is the next best option for women who fail a transvaginal cerclage in a prior pregnancy. Our primary objective with this study is to assess the obstetric benefits and feasibility of robotic-assisted transabdominal cerclage in high-risk women projected to have poor obstetric outcomes.

The Robot-assisted Transabdominal cerclage influences an increase in gestational age and improves neonatal survival in women projected to have poor pregnancy outcomes. These cerclages provide excellent obstetric outcomes without the morbidity of open surgery or the technical challenges associated with a conventional straight-stick laparoscopy. This procedure is not intended to replace any other minimally invasive modality for cerclage placement but rather increase awareness of a less technically challenging option for transabdominal cerclage placement to help propagate the procedure to more patients.