Transabdominal Cerclage (TAC) Referral
Transabdominal Cerclage (TAC) is a specialized surgical procedure performed to treat severe cervical insufficiency (an incompetent cervix) to prevent mid-trimester pregnancy loss or premature birth.
University of Utah Health is home to the only surgeon performing transabdominal cerclage in the Mountain West, with approximately 20 procedures performed annually. Our maternal-fetal medicine and minimally invasive gynecologic surgery specialists provide coordinated evaluation, individualized surgical planning, and laparoscopic or robotic placement when appropriate.
We partner closely with referring providers and return patients to their established care team following the procedure, with clear communication and recommendations for ongoing pregnancy management. This specialized regional expertise gives patients access to comprehensive transabdominal cerclage care closer to home while preserving continuity with the providers they know and trust.
When to Refer for Transabdominal Cerclage
Refer patients with cervical insufficiency who have the following:
- Experienced a failed transvaginal cerclage resulting in second-trimester pregnancy loss or early preterm birth
- Severe cervical shortening or insufficient cervical tissue for transvaginal cerclage placement
- Cervical damage or altered anatomy due to a cone biopsy, LEEP, trachelectomy, cervical laceration, or other prior cervical procedure
- An anatomic limitation that makes transvaginal cerclage technically difficult or unfeasible
Patients May Require Referral Before Pregnancy
Refer patients before conception whenever possible. Preconception transabdominal cerclage is the standard approach because it is more effective, carries fewer maternal and pregnancy-related risks, and can typically be performed as a minimally invasive outpatient procedure using laparoscopic or robotic surgery.
If the patient is already pregnant, refer as early as possible. First-trimester placement may be an option following evaluation by maternal-fetal medicine and minimally invasive gynecologic surgery specialists.
Second-trimester placement is reserved for select circumstances because it carries substantially higher risks of surgical complications and pregnancy loss. Placement during pregnancy may also require an open abdominal procedure.
Information to Include with a Referral
Please provide:
- The specific reason for referral
- Obstetric history, including gestational age and outcomes of prior pregnancies
- Current pregnancy status and gestational age
- Details and operative reports from previous transvaginal cerclage attempts (if available)
- History of cervical procedures, surgeries, trauma, or lacerations
- Relevant pelvic or obstetric ultrasound reports and images (if available)
A pelvic ultrasound is helpful but not required to initiate a referral.
Refer a patient through our form at healthcare.utah.edu/womens-health/refer
Fax applicable records to: 801-585-5146
Office hours: 8 am–5 pm