Results of cervical cerclage operations in pregnant women during a five-year period

During the five-year period from 1974 to 1978, 102 pregnancies (0.67% of all deliveries during this period) were treated with cerclage operations. The 16th week of pregnancy was the most common time for operation. In the majority of the cases the indication for surgery was strictly prophylactic; the women had a history of one or more second or early third trimester foetal losses, but there was no dilatation or effacement of the cervix at the time of surgery. No abortions were caused by the surgery. The most serious complication observed was a vesicovaginal fistula. Prior to their first cerclage operation the women investigated had an infant survival rate of 42% of their pregnancies. In the treated pregnancies the corresponding figure was 91%. It is concluded that cerclage operations performed mainly on the basis of prophylactic indications are justified since severe complications are rare and cerclage may be a useful tool to prolong pregnancies and thus improve the prognosis for infants of women with a history of second trimester foetal losses.