Robotic procedure helps 26 year old Iraqi woman conceive after multiple miscarriages
Gurugram: The team of expert doctors at CK Birla Hospital, Gurugram, has successfully treated a 26-year-old Iraqi woman suffering from cervical incompetence, a condition that had caused multiple miscarriages. After a series of failed pregnancies and numerous challenges, the patient has now given birth to a healthy baby following a breakthrough Robot-Assisted, minimally invasive surgical intervention.
The young woman had a distressing obstetric history, having conceived six times since the age of 20 but unable to carry any of her pregnancies beyond six months. Each time, the fetus was alive and healthy, yet the pregnancy would end in a miscarriage during the fifth or sixth month. Upon detailed examination, she was diagnosed with cervical incompetence, a condition characterized by a weak cervix (the mouth of the uterus), which could not hold the pregnancy to term.
Explaining about the patient’s condition, Dr. Aruna Kalra, Obstetrics and Gynecology Specialist at CK Birla Hospital, Gurugram, said “The patient had undergone several transvaginal cervical cerclage procedures, commonly known as cervical stitches, in four subsequent pregnancies at around the third to fourth month of pregnancy. Despite these efforts, she could not carry any of her pregnancies to term. Upon examination, her cervix was found to be torn, with no cervical tissue left due to the repeated cervical stitches. The tissue damage meant that the traditional method of cervical cerclage was no longer an option.”
The utilization of robotics played a pivotal role in making the cervical cerclage surgery successful, as it allowed for unparalleled precision and control, which is crucial in such delicate procedures. Robot-assisted surgery enabled the placement of the interval cerclage at the optimal anatomical position with minimal disruption to surrounding tissues. The enhanced visualization and dexterity provided by robotic instruments ensured that the procedure was performed with utmost accuracy, reducing the risk of complications and ensuring a more permanent solution to the patient’s cervical incompetence. This advanced approach not only helped preserve the patient’s reproductive potential but also paved the way for a successful full-term pregnancy and delivery.
Dr. Kalra further added “Given the extent of cervical damage, we decided that the best course of action was an interval cervical cerclage at the level of the internal os using minimally invasive surgery with robotic instruments. The patient was taken up for surgery in a non-pregnant state, and the cerclage was placed at the most anatomical position to provide a permanent solution to her cervical weakness. Since the procedure, she has conceived twice without the fear of miscarriage or preterm labor. However, due to the permanent nature of the stitch, she was delivered via a caesarean section.”
Cervical incompetence is a well-known condition in obstetrics, with an incidence of 0.1–1%, and is associated with a high risk of second-trimester abortion and/or preterm delivery. The diagnosis of cervical incompetence is often delayed because it is not associated with specific symptoms, but rather postulated on the basis of a patient’s poor obstetric history, such as repeated miscarriages or preterm deliveries. A short or even absent cervix due to previous surgeries or pregnancy failures significantly increases the risk of cervical incompetence.
Dr. Kalra emphasized that “in cases of cervical incompetence, fighting ascending infections is challenging due to reduced production of bacteriostatic cervical mucus. Changes in the collagen structure, reduced strength, and defective collagen also contribute to the risk of preterm delivery. Traditional surgical treatment consists of transvaginal placement of cervical stitches. However, in this case, the innovative interval cervical cerclage offered a more permanent and effective solution.”
The patient’s successful outcome after years of emotional and physical challenges offers new hope to many women suffering from similar conditions. CK Birla Hospital, Gurugram, continues to lead the way in advanced gynecological and obstetric care, utilizing the latest technology and expertise to provide the best possible outcomes for its patients.