TOPLINE

Women with permanent transabdominal cerclage placement reported health-related quality of life (QOL) comparable to those without the procedure, regardless of the mode of birth, and perceptions of overall health tended to improve with increasing time since cerclage placement.

METHODOLOGY

• Researchers conducted a nationwide cohort study in Denmark to assess the health-related QOL and late effects in women who underwent permanent transabdominal cerclage. 
• The analysis included 203 women (mean age, 41.6 years) who underwent permanent transabdominal cerclage between 2004 and 2025. Participants were matched with women who had caesarean births but did not undergo transabdominal cerclage (n = 90) and those who had vaginal births and no prior caesarean delivery but did not undergo transabdominal cerclage (n = 98).
• Participants completed questionnaires that incorporated validated instruments assessing QOL, anxiety and depression, pelvic pain, bladder discomfort, and sexual health.
• The primary outcome was the General Health Scale score — capturing how women perceive their health in everyday life — from the 36-item Short-Form Health Survey.

TAKEAWAY

• Women who underwent transabdominal cerclage had overall health perception comparable to those who had caesarean or vaginal births without the procedure (adjusted mean difference on the General Health Scale, -4.0 and -0.6 points, respectively).
• Women more than 10 years after transabdominal cerclage tended to report better perceived health than those within 5 years of the procedure.
• Mental health, bladder discomfort, pelvic pain, and sexual function were comparable between women with and without a transabdominal cerclage.
• Among 21 women who had their transabdominal cerclage removed, 15 underwent removal in conjunction with later hysterectomy, three underwent removal during pregnancy following a mid-trimester loss, and three underwent removal in a non-pregnant state due to cerclage-related complications.

IN PRACTICE

"Our findings suggest that transabdominal cerclage does not impose long-term morbidity. This data provides reassurance that women treated with a transabdominal cerclage do not need to be concerned about long-term health consequences," the authors wrote.

"These findings may guide counseling of women in need of a transabdominal cerclage," they added.

SOURCE

This study was led by Lea Kirstine Hansen, Aarhus University Hospital, Aarhus, Denmark. It was published online on August 04, 2026, in Acta Obstetricia et Gynecologica Scandinavica.

LIMITATIONS

Response rates differed significantly between women with and without a transabdominal cerclage, which may have introduced residual confounding and selection bias. Transabdominal cerclage was performed in only selected centres. Women who underwent transabdominal cerclage had given birth at least once following the procedure, potentially limiting generalisability to those who did not give birth after the procedure.

DISCLOSURES

This study received funding from the Novo Nordisk Foundation. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.