Successful outcome of transabdominal cerclage following two incidences of unsuccessful transvaginal cerclage: A case report in a multigravida with six previous mid-trimester miscarriages

Cervical cerclage is a treatment for fixing cervical incompetence and involves the application of a purse string stitch to reinforce the cervix. While transvaginal cerclage is mostly performed, it is not always feasible or successful. In such cases, transabdominal cerclage may be an effective alternative. This is a case of 39-year-old gravida ten, with three previous term deliveries, no preterm delivery, six previous abortions, and having two living children (G10 T3 P0 A6 L2). She has had two previous Cesarean sections and two unsuccessful attempts at insertion of cervical cerclage vaginally. She had transabdominal cerclage inserted during her 10th pregnancy at 14 weeks + 5 days of gestation. The transabdominal approach was successful in preventing pregnancy loss. She subsequently had an elective Cesarean section at 36 weeks and was delivered of a live female baby weighing 2.5 kg with good Apgar scores. This case has shown that transabdominal cerclage has a successful outcome in women with an extremely short cervix where transvaginal cerclage cannot be applied.