OPERATIVE TOTAL CERVIX OCCLUSION (TCO)

Operative Total Cen iu Occlusion (TCO), and in particular early TCO (E TCO), which we introduced in 1980, continues to be an important part o f the prematurity prevention program. We were therefore especially int erested in obtaining not only a general idea of where, on what scale a nd with what results TCO is being performed. but also information on t he operative technique used. the complication rate associated with it, and preoperative procedure. From the data of the 11 departments which participated in this inquiry it was established that the overall succ ess rate of all TCO procedures performed was over 80% (659 out of 819) . TCO thus enabled to substantially increase the number of infants who survived. This result is also reflected in a comparison of the pregna ncies preceding and following TCO. The infant survival rate was increa sed from below 21% to over 74%. One surprising result was that late oc clusion was performed more frequently than early occlusion at more tha n 50% of the clinics participating in the inquiry. This is presumably due to difficulties in defining early and late occlusion in retrospect ive data evaluation and probably also explains why, based on our exper ience, the success rate with late occlusions was too high. Two occlusi ons were performed in 43 patients and three or more in 9 (including cu rrent TCO). With 14 cases (1.7%) identified the rate of complications associated with TCO is very low.