Laparoscopic Cerclage for Cervical Insufficiency in a Unicornuate Uterus with Previous Failed McDonald Cerclage: Successful Outcome

A report describes the case of a 28-year-old woman, with a unicornuate uterus and multiple mid-trimester losses, with two failed McDonald’s cerclage. She presented with the complaint of recurrent pregnancy losses with a history suggestive of cervical incompetence. Detailed investigation revealed she was ANA and anti-cardiolipin antibody positive and Rh negative. 

The patient underwent interval laparoscopic cervical cerclage and successfully delivered a healthy baby at 35 + 3 weeks by cesarean section after five previous pregnancy losses and two failed McDonald’s cerclage.

This report highlights that Cervical cerclage can be an effective method of preventing abortions in unicornuate uterus pregnancy. In contrast, laparoscopic cerclage would be better for patients with cervical incompetence with previously failed McDonald’s cerclage. The decision to deliver at the appropriate gestation period should be made for high-risk patients to avoid uterine rupture and premature birth.

Sodhi M, Gupta P, Kriplani I., et al. Laparoscopic Cerclage in a Case of Unicornuate Uterus with Cervical Insufficiency and Previous Failed Mc Donald Cerclage with a Successful Outcome: A Case Report. J Obstet Gynecol India. 2023. https://doi.org/10.1007/s13224-023-01798-0