Abstract
Background
Cervical insufficiency (CI) may result in preterm delivery. We sought out to perform
this review and analysis to compare the efficacy of laparoscopic and open transabdominal
cerclage (TAC) in patients suffering with CI.
Methods
Our search included PubMed, Scopus, MEDLINE, ClinicalTrials.Gov, Cochrane and Web
of Science. We analyzed the data with Open Meta-Analyst Software as well as Review
Manager Software. We included observational and randomized controlled trials that
included patients with CI that underwent laparoscopic cerclage or TAC.
Results
We included a total of 43 studies. Laparoscopic and TAC had a positive effect by increasing
gestational age (GA); for the laparoscopic group (mean deviation (MD)) = 14.86 weeks
(W), 95% CI [10.67, 19.05], P < 0.001) and TAC (MD = 12.79 W, 95% CI [10.97, 14.61], P < 0.001). Furthermore, improvements in all outcomes assessed (total fetal survival
rate, neonatal weight, and prevention of delivery at a gestational age of<24 weeks)
were all significant with the exception of the prevention of all preterm deliveries<37 weeks;
for both laparoscopic at (RR = 0.116, 95% CI [-0.006, 0.238], P = 0.063) and TAC at (MD = 1, 95% CI [0.45, 2.24], P = 1), and for prevention of deliveries<34 weeks for the laparoscopic group (RR = 0.446,
95% CI [-0.323, 1.215], P = 0.256) only.
Conclusions
Although limited data prevented pregnancy and prepregnancy subgroups as well as a
head-to-head comparison, we still found that in patients suffering from CI, both TAC
and laparoscopic approaches to cerclage revealed a positive effect in preserving the
pregnancy.
Keywords
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Article info
Publication history
Published online: January 09, 2022
Accepted:
January 4,
2022
Received in revised form:
January 3,
2022
Received:
September 30,
2021
Identification
Copyright
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