Transabdominal cerclage (TAC) is a highly effective surgical treatment for incompetent cervix.
Pregnancy is a beautiful and transformative journey for many, but it comes with its own set of challenges. For some women, the riskof pregnancy loss due to cervical insufficiency can cast a shadow over this joyous time. However, advancements in medical science offer hope and solutions, and one such groundbreaking intervention is Transabdominal Cerclage (TAC).
Understanding Cervical Insufficiency:
Cervical insufficiency, also known as an incompetent cervix, is a condition where the cervix begins to open prematurely during pregnancy, often leading to mid-trimester pregnancy loss or preterm birth. This condition can be devastating for expectant parents, and traditional treatments such as cervical cerclage (a stitching procedure done through the vagina) may not be effective for all cases.
Enter Transabdominal Cerclage:
Transabdominal Cerclage (TAC) is a surgical procedure designed to address the limitations of traditional cervical cerclage. Unlike the transvaginal approach, TAC involves placing a strong, non-absorbable suture around the cervix through an abdominal incision. This strategic placement provides more structural support, reducing the risk of cervical insufficiency and subsequent pregnancy loss.
Advantages of TAC:
Higher Success Rates:
TAC has shown higher success rates compared to transvaginal cerclage, especially in cases where traditional methods have failed. The abdominal approach allows for a more secure closure of the cervix, minimizing the risk of complications.
Early Placement Option:
TAC can be placed prior to conception or early in pregnancy, providing proactive protection for women with a history of cervical insufficiency or pregnancy loss. This early intervention has the potential to significantly improve outcomes.
Reduced Risk of Infection:
The transabdominal approach reduces the risk of infection associated with the transvaginal procedure. This is particularly crucial for maintaining a healthy pregnancy and ensuring the well-being of both the mother and the baby.
Support for Multiple Pregnancies:
TAC is especially beneficial for women carrying multiple pregnancies (twins, triplets, etc.) where the cervix may undergo additional stress. The added support from TAC can help in preventing complications and ensuring a safer pregnancy.
Considerations and Risks:
While TAC has proven to be a valuable intervention, it's essential to consider individual factors and potential risks associated with any surgical procedure. Consultation with a healthcare professional is crucial to determine the suitability of TAC for each specific case. The estimated cost of an Insertion or Removal of Cervical Cerclage ranges from $4,185 to $6,055. As for recovery time, generally, patients are able to return to normal daily activities one week following laparoscopic abdominal cerclage compared with four to six weeks following open abdominal cerclage. The procedure is considered safe. But like all procedures, it carries some risks.
These include the following:
Bleeding
Infection
Premature contractions
Premature labor or delivery
Premature rupture of membranes
Pregnancy loss
Cervix tears or ruptures
Injury to bladder or other nearby organs
Risks of anesthesia
Actual Transabdominal Cerclage Procedure:
The Laparoscopic Transabdominal Cerclage (TAC) is a surgical procedure to treat cervical insufficiency. A suture is placed around the cervix at its uppermost part near the transition with the uterine body. This level cannot be reached from the vagina hence the abdominal approach.
Success Rate:
Eighty‐four (91.3%) of the 92 first pregnancies after first insertion had successful outcomes. All second and third pregnancies (24/24; 100%) were successful. Eight pregnancies did not achieve viability, two women (2/8) did however achieve a successful pregnancy after a subsequent repeat TAC procedure.
Transabdominal Cerclage is a pioneering solution that offers renewed hope for women at risk of pregnancy loss due to cervical insufficiency. As medical science continues to evolve, TAC stands as a testament to the commitment to improving maternal and fetal outcomes. Through early intervention and advanced surgical techniques, TAC has become a lifeline for many families, turning what was once a high-risk situation into a journey of hope and joy.