Laparoscopic Cervical Cerclage During Pregnancy in a Woman With Recurrent Second-Trimester Pregnancy Loss and a Previous Failed McDonald Suture: A Case Report

Cervical insufficiency is a leading cause of second-trimester pregnancy loss and extreme preterm birth. Transvaginal cerclage (McDonald or Shirodkar) is the standard treatment; however, some high-risk patients continue to experience failure despite intervention. Laparoscopic cervical cerclage (LCC) offers an alternative for high-risk patients with prior cerclage failure. A 27-year-old woman with a history of three second-trimester losses and one failed McDonald cerclage underwent LCC during the first trimester of pregnancy at 13.2 weeks. The procedure was successful, and she subsequently achieved a viable pregnancy, delivering at 36.4 weeks via caesarean section. As LCC offers better obstetric outcomes with minimal morbidity, it can be considered a viable option for patients with refractory cervical insufficiency with prior failed transvaginal cerclage.