POSTCONCEPTIONAL CERVICAL CERCLAGE

OBJECTIVE: To determine the outcome and morbidity of pregnancies follo wing cervical cerclage. METHOD: Records were reviewed for 326 patients with 374 singleton pregnancies between 1980 and 1990. RESULT: McDonal d and Shirodkar procedures were carried out in 323 and 51 pregnancies, respectively. The procedure was classified as elective if based on pa st history (n = 330). In 44 pregnancies, cervical dilatation prompted operation. The overall fetal survival rate has increased from 17.7% to 79.1% after cervical cerclage. While the presence of cervical dilatat ion at suture placement had a prognostic value, the surgical technique , gestational age at suture placement and progestin therapy had no sig nificant effect on survival. Premature rupture of membranes and chorio amnionitis were found to be the leading causes of morbidity. CONCLUSIO N: Cervical cerclage seems to the treatment of choice in patients with cervical incompetence. Only the presence of cervical dilatation at op eration was found to have a prognostic value among the factors analyze d.