Every woman desires to become a mother, but not all of us can do so. There are many women who do not get their wish because of factors such as multiple miscarriages, and a major factor that leads to miscarriage is cervical insufficiency. What is cervical insufficiency? Let’s learn more about it. Cervical insufficiency is the inability of the cervix to sustain a pregnancy to full term due to anatomical or functional defects in the absence of contractions. The main causes of cervical insufficiency include 1 congenital cervical dysplasia, 2 cervical injury due to abortion or induction of labor, and 3 premature cervical maturation. The typical clinical presentation is painless dilatation of the cervix in mid- and late pregnancy, with a gestational sac bulging into the vagina. If left uncorrected, recurrent miscarriages occur. The diagnosis of cervical insufficiency relies mainly on:1 history of recurrent spontaneous miscarriage or preterm delivery in mid-pregnancy.2 Physical examination: no obvious abdominal pain in mid-pregnancy while the endocervical opening is more than 50px, shortening and softening of the cervical canal, especially softening is more important, sometimes the amniotic sac has protruded outside the cervical opening;3 transvaginal ultrasound measurement of the width of the endocervical opening and the length of the cervix. In contrast, cervical cerclage is a common treatment for cervical insufficiency, which improves fetal viability by extending the gestational week to a certain extent, bringing benefits to the majority of women as they wish. Cervical cerclage during pregnancy is an effective treatment for cervical insufficiency, with a success rate of 81%-87% when performed vaginally or transabdominally. With the rapid development of laparoscopic technology in recent years, the operation is becoming more and more mature and widely used with good results, and laparoscopic surgical techniques are now increasingly replacing traditional gynecological surgery. In 1998 Lesser et al. attempted to perform laparoscopic cervical cerclage with a success rate of 95.8%. Since the introduction of polypropylene ligatures, the use of ligatures for cervical cerclage has gradually increased. Advantages of trans-laparoscopic cervical cerclage: the placement of the band in the anatomical cervical orifice is very precise, avoiding the vaginal foreign body sensation of transvaginal cerclage and overcoming the technical problem of difficult suturing over the scarred and shortened cervix; minimally invasive features, allowing pregnancy as soon as possible after surgery; no intravaginal wound, avoiding infection; can still be performed in patients who have failed transvaginal cervical cerclage and during pregnancy It is also safe and effective during pregnancy; the patient does not need to be strictly bedridden during pregnancy and can take care of herself; the IUD does not need to be removed during cesarean section and can be used for another pregnancy. It is less invasive than transabdominal cervical cerclage and has the same effect as it does. Therefore, transabdominal cervical cerclage is a safe and effective alternative to transabdominal cervical cerclage. This method not only prolongs the gestational age, but is also safe and effective. The disadvantage of trans-laparoscopic cervical cerclage is that although the cervical band is tied with early abortion embryo expulsion in mind, midterm pregnancy fetal loss (stillbirth, premature rupture of membranes) still requires transabdominal or laparoscopic cutting of the Muslim cervical band for fetal delivery; full-term pregnancy requires cesarean delivery to remove the fetus; the cervical band can only be removed during cesarean delivery. The majority of patients still have high-risk pregnancies and have a tendency to deliver low-birth-quality children. It is clear that preconception trans-laparoscopic cervical cerclage can be an effective alternative to cervical incompetence cerclage in patients with a history of mid-pregnancy miscarriage and failed transvaginal cerclage. This procedure is indicated for all cervical incompetence as an indication for cervical ligation, but those with normal cervical length on transvaginal ultrasound do not require medical intervention unless there is a history of multiple premature abortions. Contraindications to surgery: chorioamnionitis, premature rupture of membranes, fetal malformations, intrauterine fetal death, and active uterine bleeding are absolute contraindications to cervical cerclage. Anterior placenta and fetal growth restriction are relative contraindications to cervical cerclage. Timing of surgery: Pre-pregnancy trans-laparoscopic cervical cerclage should be performed 3-7 days after menstrual cleansing. The operation time of post-pregnancy trans-laparoscopic cervical cerclage should be chosen to be performed in early pregnancy, usually at 6-8 weeks of gestation, and the operation should be performed only when the fetal heart is seen in the preoperative ultrasound examination; the larger the gestational week, the more difficult the operation. The second department of gynecology in our hospital recently carried out pre-pregnancy and post-pregnancy laparoscopic cervical cerclage, and it is the first of its kind in northern Henan. If you have such patients, please contact the Second Department of Gynecology, and all the medical staff of the Second Department of Gynecology will be happy to relieve your pain.