Transabdominal cervico-isthmic cerclage: state of the art

The aim of this study was to evaluate the long-term results of transabdominal cervico-isthmic cerclage according to the Vecchietti technique in patients with cervico-isthmic incompetency diagnosed by hysterosalpingography. The patient sample consisted of 36 women operated on in the Verona University Institute of Obstetrics and Gynaecology from 1975 to 1981 and 18 women operated on in the Clinic of Obstetrics and Gynaecology, Lyon. The results in the Verona study population show that in 28 cases (77.7%) the operation was crowned with success by the birth of live, viable neonates; intrauterine death occurred in 2 cases (5.5%), miscarriage in 3 (8.3%) and sterility in 3 (8.3%). The Lyon results show that in 15 cases (83.3%) the pregnancies resulted in the birth of live neonates, while sterility occurred in the other 3 (16.6%). Overall analysis of the 54 patients shows that the abdominal cerclage was successful in 43 cases (79.6%). Only in 11 cases were negative results obtained: 6 cases of sterility (11.1%), 3 miscarriages (5.5%) and 2 intrauterine deaths (3.7%). The data presented demonstrate the validity of the operation when performed in non-pregnant women in the presence of proven cervico-isthmic incompetency.