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  2. Vol 28, No 6 (2024)
  3. Damalie

Double cervical cerclage for cervical insufficiency: Case report

Francis J.M.K. Damalie(1), Charles M. Senaya(2), Edward T. Dassah(3), Thomas O. Konney(4), Emmanuel Ameyaw(5), Roderick Larsen-Reindorf(6), Gerald O. Asubonteng(7),


(1) Department of Obstetrics and Gynecology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Directorate of Obstetrics and Gynecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
(2) Department of Obstetrics and Gynecology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Directorate of Obstetrics and Gynecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
(3) Directorate of Obstetrics and Gynecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana2. Department of Population, Family and Reproductive Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
(4) Department of Obstetrics and Gynecology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Directorate of Obstetrics and Gynecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
(5) Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
(6) Department of Obstetrics and Gynecology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Directorate of Obstetrics and Gynecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
(7) Department of Obstetrics and Gynecology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Directorate of Obstetrics and Gynecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
Corresponding Author

Abstract


Recurrent pregnancy loss devastates parents and frustrates doctors, especially when the pregnancy progresses to the second trimester. Cervical insufficiency is the most common cause of second–trimester pregnancy loss. Abdominal cerclage is the treatment option for women with failed vaginally applied cervical cerclage. We report a 33-year-old para 0 with a history of nine second-trimester pregnancy losses. She had six failed transvaginal cerclages using McDonald's procedure. A vaginal double cervical cerclage was placed in her index pregnancy. Two mersilene tape purse-string sutures were placed in the submucosal layer of the cervix; the first 1cm below and the second at the level of the internal os. Both sutures were knotted at the 12 O'Clock position on the cervix. She carried her pregnancy to almost term and delivered a healthy baby girl weighing 2.5kg. We recommend a transvaginal double cervical cerclage with mersilene tape using a modified McDonald's technique as a viable alternative to abdominal cervical cerclage.

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