Vaginal Erosion of an Abdominal Cerclage 7 Years After Laparoscopic Placement

Abstract

In Brief BACKGROUND: With advances in minimally invasive approaches, laparoscopically placed abdominal cerclages are becoming more common. Although not meant to replace vaginally placed cerclages, one potential advantage is reuse in subsequent pregnancies. Their lifespan, potential remote complications, and long-term management remain unexplored. CASE: Reported is a patient with a laparoscopic abdominal cerclage who carried two pregnancies to term. Seven years after initial placement, 3 years after her last delivery, an abscess developed at the cerclage site. Erosion and subsequent expulsion of the cerclage followed. CONCLUSION: The longevity of abdominally placed cerclages is unknown. Placement in the peritoneal cavity reduces suture migration risk, yet tissue degradation may limit the lifespan. Patients with retained abdominal cerclages after completion of childbearing are at risk for remote complications. Closer long-term surveillance on an individual level and a collective level is warranted. Delayed erosion of a laparoscopically placed transabdominal cervical cerclage is a newly described complication prompting closer surveillance of cerclage integrity over repeated uses.