Early transvaginal ultrasonography versus early cerclage in women with an unclear history of incompetent cervix

OBJECTIVE: Our aim was to compare outcomes in women with a questionable his tory of incompetent cervix, followed up with early transvaginal ultrasonogr aphy, with outcomes in women who had early cerclage. STUDY DESIGN: Charts were reviewed and patients identified for incompetent cervix from our obstetric database from 1995 through 1997. We included wome n who had an unclear history of incompetent cervix as follows: second-trime ster loss or termination, greater than or equal to3 first-trimester termina tions, cone biopsy or loop electrosurgical excision, or exposure to diethyl stilbestrol. The primary outcome variable was gestational age at delivery. RESULTS: A total of 106 women were included, 45 in the early cerclage group and 61 in the early transvaginal ultrasonography group. The mean gestation al age at delivery was 35.1 weeks for the early cerclage group versus 36.1 weeks for the early transvaginal ultrasonography group. CONCLUSION: In women with an unclear history of incompetent cervix, early c erclage does not appear to offer significant benefit over early transvagina l ultrasonography.