Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 7, 2022; 10(1): 304-308
Published online Jan 7, 2022. doi: 10.12998/wjcc.v10.i1.304
Removal of laparoscopic cerclage stitches via laparotomy and rivanol-induced labour: A case report and literature review
Xin-Ni Na, Ben-Shuo Cai
Xin-Ni Na, Ben-Shuo Cai, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Na XN reviewed the literature and drafted the manuscript; Cai BS collected the patient’s information, provided the figure, and revised the manuscript; All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ben-Shuo Cai, MD, Doctor, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, Liaoning Province, China. caibenshuo_sj@vip.163.com
Received: May 22, 2021
Peer-review started: May 22, 2021
First decision: October 18, 2021
Revised: October 27, 2021
Accepted: November 24, 2021
Article in press: November 24, 2021
Published online: January 7, 2022
Processing time: 221 Days and 21.7 Hours
Abstract
BACKGROUND

Laparoscopic cervical cerclage is performed for patients with abnormal cervical anatomy and/or transvaginal cervical cerclage failure. However, the method of removing the stitches to allow labour induction remains controversial. According to published literature, stitches are removed through laparoscopic or transvaginal methods. Herein, we report, for the first time, a case of a patient who had undergone laparoscopic cerclage, and then underwent removal of stitches by laparotomy and labour induction in the third trimester of pregnancy.

CASE SUMMARY

A patient who underwent laparoscopic cervical cerclage due to cervical insufficiency became pregnant naturally following the operation. At 31 wk of pregnancy, severe foetal malformations were found. To successfully induce labour, cerclage stitches were removed via laparotomy, and rivanol was injected directly into the uterus. Following successful induction of labour, the patient delivered a dead foetus.

CONCLUSION

This report provides a reliable scheme of removing cerclage stitches for patients who have undergone laparoscopic cerclage but experience severe foetal malformations.

Keywords: Laparoscopic cerclage; Pregnancy; Induced labour; Stitch removal; Case report

Core Tip: To the best of our knowledge, this is the first report of a case in which a patient, who had undergone laparoscopic cerclage, underwent removal of cerclage stitches via laparotomy and labour induction in the third trimester of pregnancy. This report highlights the advantages of this technique over other available methods. Moreover, this report presents the rarity of foetal abnormality or death in the third trimester in a woman who had laparoscopic cervical cerclage.