ObjectiveThis study aimed to investigate the obstetric outcomes of transabdominal cerclage (TAC) in Japan.MethodsQuestionnaires on TAC were sent to 183 institutions performing high‐quality perinatal management in Japan. As a first‐step questionnaire, we asked whether TAC was performed between January 1, 2011, and December 31, 2022. In the second step of the questionnaire, the characteristics of all cases were asked from all institutions in which TAC was performed.ResultsThe response rate for the first survey was 59% (108/183). Of the 108 institutions, 27 performed TAC (25%) in 133 pregnancies. Of these 27 institutions, 19 responded to the second survey. One hundred twenty‐five pregnancies were included in this study, five of which were aborted (gestational weeks <22 weeks), and 69 babies were born after 37 gestational weeks (55%). Eighty‐two open abdominal cerclages were performed at 17 institutions and 43 laparoscopic TACs at three institutions. There were no differences in the age at TAC, gestational weeks at TAC, operative time of TAC, gestational weeks at delivery, incidence rate of second‐trimester loss, or preterm delivery (before 37 gestational weeks) rate between the two groups. However, blood loss during open TAC was greater than that during laparoscopic TAC.ConclusionTAC is a rare surgery for cervical insufficiency in Japan. TAC may be a safe and useful method for preventing second‐trimester loss and preterm delivery in high‐risk patients. TAC may also be a key option in Japan to improve perinatal outcomes in patients with cervical insufficiency.

中文翻译：

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经腹环扎术的产科结局： 日本的一项回顾性观察性研究


目的本研究旨在调查日本经腹环扎术 （TAC） 的产科结局，方法向日本 183 家进行高质量围产期管理的机构发送 TAC 问卷。作为第一步问卷，我们询问是否在 2011 年 1 月 1 日至 2022 年 12 月 31 日期间进行了 TAC。在问卷的第二步中，从进行 TAC 的所有机构询问了所有病例的特征。结果第一次调查的回复率为 59% （108/183）。在 108 个机构中，27 个机构 （25%） 对 133 例妊娠进行了 TAC。在这 27 所机构中，有 19 所对第二次调查做出了回应。本研究包括 125 例妊娠，其中 5 例流产 （妊娠周 <22 周），69 例婴儿在 37 孕周后出生 （55%）。在 17 个机构进行了 82 例开腹环扎术，在 3 个机构进行了 43 例腹腔镜环扎术。两组在 TAC 年龄、TAC 孕周数、TAC 手术时间、分娩孕周数、孕中期流产发生率或早产 （37 孕周前） 率方面无差异。然而，开放 TAC 期间的失血量大于腹腔镜 TAC 期间的失血量。结论TAC 是日本罕见的宫颈机能不全手术。TAC 可能是预防高危患者孕中期流产和早产的一种安全有效的方法。TAC 在日本也可能是改善宫颈机能不全患者围产期结局的关键选择。