VAGINOSONOGRAPHIC MONITORING FOR THE REDU CTION OF THE FREQUENCY OF CERCLAGE OPERATION IN MULTIPLE PREGNANCIES

Cervical insufficiency is a frequent complication particularly in case of multiple pregnancy and is often considered to be an indication for cerclage operation. We performed a vaginosonographic monitoring prosp ectively in 35 cases with multiple pregnancy in order to diagnose cerv ical insufficiency early and to perform cerclage operation when indica ted. The results were compared with a group of 41 patients with multip le pregnancy who received prophylactic cerclage in other hospitals. No significant difference occured concerning the duration of the pregnan cy. In patients without prophylactic cerclage the frequency of preterm contractions was significantly lower, the frequency of premature rupt ure of membranes, however, was higher. Our results confirm the hypothe sis that the application of a prophylactic cerclage does not improve f etal outcome in case of multiple pregnancy. Vaginosonographic as a sin gle monitoring procedure seems to sufficient for the early diagnosis o f cervical insufficiency.