[Total surgical cervical occlusion. Conclusions from data of several clinica, which use total surgical cervical...

Operative Total Cervix Occlusion (TCO), and in particular early TCO (ETCO), which we introduced in 1980, continues to be an important part of the prematurity prevention program. We were therefore especially interested in obtaining not only a general idea of where, on what scale and with what results TCO is being performed, but also information on the operative technique used, the complication rate associated with it, and preoperative procedure. From the data of the 11 departments which participated in this inquiry it was established that the overall success rate of all TCO procedures performed was over 80% (659 out of 819). TCO thus enabled to substantially increase the number of infants who survived. This result is also reflected in a comparison of the pregnancies preceding and following TCO. The infant survival rate was increased from below 21% to over 74%. One surprising result was that late occlusion was performed more frequently than early occlusion at more than 50% of the clinics participating in the inquiry. This is presumably due to difficulties in defining early and late occlusion in retrospective data evaluation, and probably also explains why, based on our experience, the success rate with late occlusions was too high. Two occlusions were performed in 43 patients and three or more in 9 (including current TCO). With 14 cases (1.7%) identified the rate of complications associated with TCO is very low.