ONCE A CERCLAGE, NOT ALWAYS A CERCLAGE

A study was performed to evluate the outcome of pegnancies in which th e decision was not to repeat cerclage in women with a doubtful indicat ion for the previous one. Thirty-five women with a history of at least one previous McDonald cerclage were followed prospectively. Pregnancy complications and outcome were compared to those in the previous preg nancy with a cerclage. These patients had 58 pregnancies with a cercla ge and 52 pregnancies without. The pregnancies without a cerclage had fewer complications, were longer and resulted in the delivery of signi ficantly larger infants (P <.05). Whereas all 52 cummulative pregnanci es without a cerclage had a favorable outcome, there were nine perinat al losses in the 58 pregnancies with a cerclage (P <.05). The decision not to repeat a cervical cerclage, when the grounds for the previous procedure are doubtful, is a safe one.