Transabdominal Cervical Cerclage in Aotearoa New Zealand-A Retrospective Observational Study of 16 Years' Experience.

BACKGROUND:Transabdominal cervical cerclage (TACC) may be used for those at very high risk of spontaneous preterm birth, where transvaginal cerclage has been ineffective previously or is not possible. High-quality randomised evidence supports the use of this relatively uncommon procedure, but there is no published experience of its use in Aotearoa New Zealand. AIMS:To review all cases of TACC performed in a tertiary hospital that receives referrals from across Aotearoa New Zealand. MATERIALS AND METHODS:This is a single-centre retrospective observational study. All TACC performed at National Women's Health, Auckland City Hospital, Auckland between 1st January 2007 and 31st August 2023 were included. Cases were identified from hospital theatre records. Data were obtained from medical records and perinatal databases. Outcomes for the index and all subsequent births up to 31st October 2024 were included. RESULTS:Forty people received a TACC. The most common indication was obstetric history (27, 62.5%), followed by extensive cervical surgery (13, 32.5%). There were 47 pregnancies in 33 people, including five early miscarriages and one pregnancy termination for foetal anomalies. In the remaining 41 pregnancies, 37 (90.2%) resulted in a live birth ≥ 24 weeks, with a mean gestation at birth of 36 + 1 weeks. All 37 neonates were alive at hospital discharge with low rates of complications. CONCLUSIONS:This study demonstrates favourable perinatal outcomes following TACC in those at high risk of spontaneous preterm birth in Aotearoa New Zealand.