Journal Health of Woman. 2026. 2(183): 20-26. doi: 10.15574/HW.2026.2(183).2026

Maharramov N. S.
Azerbaijan State Advanced Training Institute for Doctors named after A. Aliyev, Baku

For citation: Maharramov NS. (2026). Prevention and risk prediction of late miscarriages in the second trimester of pregnancy. Ukrainian Journal Health of Woman. 2(183): 20-26. doi: 10.15574/HW.2026.2(183).2026
Article received: Dec 17, 2025. Accepted for publication: Mar 22, 2026.

Isthmic-cervical insufficiency (ICI) is one of the leading causes of late spontaneous miscarriage and preterm birth during the second trimester of pregnancy. Laparoscopic cerclage is considered one of the modern surgical approaches for the correction of ICI.
Aim – to assess risk factors associated with late miscarriage in the second trimester of pregnancy and to evaluate the effectiveness of preventive measures for improving pregnancy outcomes.
Materials and methods. A prospective study was conducted involving 101 pregnant women with threatened pregnancy loss at 12-28 weeks of gestation (Main group). The Control group consisted of 25 women with physiologically normal pregnancies. The following parameters were assessed: obstetric and gynecological history, gestational age, clinical signs of threatened miscarriage, cervical length, cervical dilatation, and the presence of cervical funneling. Pregnancy outcomes, gestational age at delivery, and perinatal outcomes were also evaluated.
Results. The use of laparoscopic cerclage allowed for prolongation of pregnancy to 32-34 weeks of gestation and beyond, reducing the risk of extremely early preterm birth. No cases of perinatal mortality were observed in the Main group. The obtained results confirm the high effectiveness of laparoscopic cerclage as a method for preventing late miscarriage and preterm birth in high-risk patients. The laparoscopic approach using three trocars demonstrated good clinical efficacy and safety. The absence of differences in neonatal outcomes between delivery methods suggests that, in cases of extreme prematurity, gestational age and antenatal management play a more important role than the mode of delivery itself.
Conclusion. Laparoscopic cerclage is an effective method for the treatment of ICI, contributing to the prolongation of pregnancy in high-risk women. It improves obstetric outcomes in patients with threatened second-trimester pregnancy loss. The choice of delivery method in preterm birth should be based on individual obstetric indications.
The study was carried out in accordance with the principles of the Declaration of Helsinki. The informed consent of the patients was obtained for the study.
No conflict of interest was declared by the author.
Keywords: isthmic-cervical insufficiency, laparoscopic cerclage, preventive measures, risk of pregnancy loss, second-trimester pregnancy.

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