Comparative Efficacy of Laparoscopic Transabdominal Cerclage and Transvaginal Cervical Cerclage in Women with Severe Cervical Insufficiency

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 411–422

DOI: 10.46882/2026/IJOG/000515

Original Research Article

Title: Comparative Efficacy of Laparoscopic Transabdominal Cerclage and Transvaginal Cervical Cerclage in Women with Severe Cervical Insufficiency

Names of Authors: Oluwaseun A. Adebayo¹, Chinedu O. Okafor², Aminat Z. Yusuf¹

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, College of Medicine, University of Lagos, Lagos, Nigeria
² Department of Maternal-Fetal Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria

Abstract:
Cervical insufficiency is a primary etiology of recurrent second-trimester pregnancy loss. This prospective comparative study evaluated the clinical efficacy, neonatal salvage rates, and maternal complication profiles of Laparoscopic Transabdominal Cerclage (TAC) performed pre-conceptually versus history-indicated Transvaginal Cervical Cerclage (TVCC) placed during early pregnancy. One hundred women with a history of at least two consecutive mid-trimester losses due to cervical insufficiency were assigned to undergo either pre-conceptual TAC (n = 50) or TVCC using the Shirodkar technique at 12 to 14 weeks of gestation (n = 50). All patients were followed longitudinally until delivery. The primary endpoint measured was the fetal survival rate. The fetal survival rate was significantly higher in the laparoscopic TAC group compared to the TVCC group (96.0% vs. 74.0%, p = 0.002). The mean gestational age at delivery was also significantly longer in the TAC cohort (37.2 ± 1.2 weeks vs. 33.4 ± 2.8 weeks, p < 0.001). Preterm birth rates before 32 weeks were lower in the TAC arm (2.0% vs. 20.0%, p = 0.004). Cesarean section was required for all deliveries in the TAC cohort, whereas 68.0% of the TVCC cohort achieved vaginal delivery after stitch removal. No major intraoperative or postoperative complications occurred in either arm (p > 0.05). In conclusion, pre-conceptual laparoscopic transabdominal cerclage yields superior neonatal salvage rates and significantly extends gestational age compared to traditional transvaginal placement in women with severe cervical insufficiency.

Keywords: Cervical Insufficiency; Transabdominal Cerclage; Laparoscopy; Transvaginal Cerclage; Fetal Survival; Preterm Birth.

Manuscript Timeline: Received: May 12, 2026; Revised: July 01, 2026; Accepted: July 20, 2026; Published: August 04, 2026.

Citation: Adebayo OA, Okafor CO, Yusuf AZ. Comparative Efficacy of Laparoscopic Transabdominal Cerclage and Transvaginal Cervical Cerclage in Women with Severe Cervical Insufficiency. International Journal of Obstetrics and Gynecology. 2026; 14(8): 411–422.

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