Laparoscopic abdominal cerclage in cervical insufficiency: single-centre outcomes

Objective: To evaluate surgical, maternal, and obstetric outcomes following laparoscopic abdominal cerclage (LAC) in women with severe or complex cervical insufficiency managed in a tertiary referral centre.Materials and Methods: This retrospective cohort study included women who underwent LAC between January 2018 and December 2025. Clinical and obstetric data were retrospectively extracted from a prospectively maintained institutional database. Eligibility criteria comprised recurrent mid-trimester pregnancy loss consistent with cervical insufficiency, prior failed transvaginal cerclage, significant cervical structural deficiency (including post-conisation), or congenital uterine/cervical anomalies predisposing to cervical weakness. Outcomes were analysed descriptively on both a per-patient and per-pregnancy basis. Continuous variables are presented as mean±SD or median (range) depending on distribution, and categorical variables as number (%).Results: Sixty-nine women underwent LAC. Fifty women (72.5%) achieved at least one pregnancy, yielding 64 post-cerclage pregnancies. Live birth occurred in 61 pregnancies (95.3%). Mean gestational age at delivery was 36.92±1.62 weeks. Preterm birth before 34 weeks occurred in four pregnancies (6.8%). Mean birthweight was 3016±602 g; no neonate had very low birthweight (