Minimally-Invasive New Robotic Procedure Developed for Cervical Insufficiency

What is Cervical Incompetence?

Being unable to carry a baby to term can be devastating.  Women who have an incompetent cervix, or cervical tissue that is weak, causing or contributing to a miscarriage or premature birth, have a lot of potentially dangerous complications to face.  One treatment for cervical incompetence is a cervical cerclage, where the cervix is stitched closed in order to help reinforce the cervical muscle and help the cervix stay closed under the weight of the baby.  The residual tenderness of the surgery can last for weeks or longer.

Minimally-Invasive Robotic Surgery Treats Cervical Incompetence

newborn and motherRecently, surgeons have begun using a groundbreaking technique for treating an incompetent cervix.  The new procedure involves a robotically assisted, minimally invasive ultrasound-guided laparoscopic surgery.  With the dual visualization screen of the robotic surgical system, the physician can view a real-time ultrasound image on one screen and the operative field via scope camera on another screen, side by side, while performing the surgery.  The robotic system allows physicians to perform the cerclage surgery through a very small incision, which offers the benefits of faster recovery, smaller incisions and scarring, decreased infection risk, earlier return to normal activities, a shorter hospital stay and less pain.

The first woman to have the robotic cervical cerclage surgery said that her recovery was amazing, and she was able to sit on the floor and play with her toddler two days later.  She went on to give birth to a healthy baby that weighed almost seven pounds.  Comparing the robotic technique to her previous, traditional abdominal cerclage, the mother reported that her first surgery required a very long recovery time.  It severed her abdominal muscles, which meant she couldn’t perform many activities for several weeks and had a lot of soreness at the incision site.

Importance of Prompt Diagnosis and Treatment of Incompetent Cervix

Indeed, it is important for physicians to diagnose and treat an incompetent cervix.  Left untreated, a woman is at risk for premature rupture of the membranes and birth of a premature baby.  There are many complications associated with preterm birth, and sometimes a baby is born too early to survive.

There are times when a woman has few warning signs that her cervix is opening too early.  If any of the risk factors for cervical incompetence are present, the physician must closely monitor the mother and baby for any signs of an incompetent cervix.

Monitoring and diagnosis of cervical incompetence include the following:

  • History.  An important indicator of an incompetent cervix is if the woman has had a miscarriage between the fourteenth and twenty-eighth week of a previous, otherwise uneventful pregnancy.  This should alert the physician to an increased likelihood of cervical incompetence.  Other important questions for a physician to investigate are whether the woman has a history of DES exposure or congenital cervical weakness, and whether she has had prior trauma to the cervix from D & C procedures or cone biopsies.
  • Physical exam. A manual pelvic exam of the cervix during the second or third trimester can reveal partial opening of the cervix (dilation) with shortening and thinning of the vaginal part of the cervix (effacement), which would indicate cervical weakness.
  • Tests.  The physician should order serial transvaginal ultrasound studies (TVS) after the sixteenth week in a woman with a history suggesting cervical incompetence. Vaginal ultrasounds can help monitor the cervical length and determine if the cervix is opening. Ultrasound studies determine the length of the cervix, which in a weakened cervix may be shortened.

Cervical Incompetence and Medical Malpractice

Medical professionals must timely diagnose an incompetent cervix and treat it appropriately, or it is negligence. If you were diagnosed with an incompetent cervix and gave birth prematurely to a child that has been diagnosed with physicial, mental, and/or cognitive disabilities, Reiter & Walsh ABC Law Centers can help. We will review your medical records and determine if your child’s injuries were preventable. Email or call us at 888-419-2229.

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