Did you have cervical insufficiency or a cerclage placed? Transabdominal cervicoisthmic cerclage generally is reserved for patients in whom cerclage is indicated based on the diagnosis of cervical insufficiency but cannot be placed because of anatomical limitations (eg, after a trachelectomy), or in the case of failed transvaginal cervical cerclage procedures that resulted in second-trimester pregnancy loss. Transabdominal cerclage can be accomplished through open laparotomy or operative laparos