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Case Reports in Obstetrics and Gynecology
Volume 2014, Article ID 519826, 4 pages
http://dx.doi.org/10.1155/2014/519826
Case Report

Abdominal Cerclage in Twin Pregnancy after Radical Surgical Conization

1Department of Prenatal and Perinatal Medicine, Clara Angela Foundation, Koenigsallee 36, 14193 Berlin, Germany
2Department of Pre- and Perinatal Medicine, Center of Mother and Child, University Hospital of Giessen and Marburg, Philipps University of Marburg, Campus Marburg, Baldinger Straße 1, 35043 Marburg, Germany
3Department of Obstetrics and Gynecology, Radboudumc, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands

Received 4 November 2013; Accepted 19 December 2013; Published 28 January 2014

Academic Editors: A. Fujimoto, H. Honnma, and O. Picone

Copyright © 2014 Ioannis Kyvernitakis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Radical and repeated cone biopsies are associated with a high risk of spontaneous preterm birth. A 30-year-old gravida 1 presented with a spontaneous dichorionic twin pregnancy. She had a history of two radical surgical conizations. By speculum examination, no cervical tissue was detected. A history-indicated transabdominal cervicoisthmic cerclage was performed at 12 + 4/7 gestational weeks because of assumed cervicoisthmic insufficiency. The pregnancy continued until 34 + 3/7 weeks when the patient developed preeclampsia indicating Cesarean delivery. Transabdominal cerclage in twin pregnancy has rarely been described, but it may be considered in case of extreme cervical shortening after radical cervical surgery, as it would in singleton pregnancy.