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Trans-abdominal Cerclage

  1. Incidence - between 1/100 to 1/200 pregnancies have incompetent cervix. Incompetent cervix is almost always found by losing one infant at 16-23 weeks gestation.
  2. Vaginal cerclage has at least a 15% failure rate.
  3. Abdominal cerclage has a 97-99% success rate (1-3% failure rate)
  4. Laparoscopic abdominal cerclage vs open laparotomy abdominal cerclage is superior in results, cost, complication rates, and recovery time.
  5. Laparoscopic abdominal cerclage can be done between pregnancies, early in pregnancy, or as a rescue cerclage when early dilation has started.
  6. Rescue cerclage has a much higher failure rate and is very dependent on how dilated the cervix is. This makes rescue cerclage very time sensitive and an urgent or emergency procedure.
  7. Laparoscopic abdominal cerclage in pregnancy is more technically challenging and the difficulty and increases with advancing pregnancy duration.
  8. There are very limited locations that have significant experience and perform this procedure. The locations for cerclage during pregnancy are further limited and rescue cerclage are even further diminished.
  9. As more patients discover the advantages of laparoscopic abdominal cerclage through forums such as, the demand has been growing.
  10. There is no CPT code for laparoscopic abdominal cerclage and insurance reimbursement has been very limited and unpredictable.

Click on the links below to learn more about Trans-abdominal Cerclage:

Abdominal Cerclage Triplets (PDF)



Patient Reviews:

Simply put, Dr. Ted Fogwell is truly world class. He is a caring, skillful, succinct, and compassionate physician. Cristi Sutton, WHNP and his entire TAC team exude warmth and sincerity as they manage every detail. I came from AZ for a TAC in the fall of 2022 after learning I was at risk of miscarriage at 16w2d. Because of my gestation, Dr. Fogwell was the only surgeon willing to consider my case. Thanks to him, I brought a healthy, incredible daughter into the world at full term that following spring. We all rejoiced! Our experience in Dallas was top flight — I am a *stickler* for this and I was blown away. All coordination was seamless at Texas Health – they worked with us to coordinate everything. All our needs were handled right on campus, from pre/post-op visits, ultrasounds, the operation, and the overnight stay – even meals and post-op lodging for me and my husband! Bottom line: Dr. Fogwell and the TAC team are second to none. I would do it again (but thankfully, I won’t need to).