The role of cervical cerclage in the management of uterine anomalies.

The effect of cervical cerclage on the survival rate of the fetus was studied in 86 pregnancies of women with congenital uterine anomalies and a random group of 106 pregnancies in women with normal shaped uteri. The uterine morphologic factors were determined in all by hysterosalpingography, and when necessary, hysteroscopy and laparoscopy were combined. The incidence of hysterosalpingography-proved cervical incompetence (23 per cent) was similar in both groups. Sixty-seven and 29 pregnancies were managed with cervical cerclage in each group, respectively. The fetal outcome was stratified by cervical incompetence and obstetric history. The percentage of viable newborns was significantly higher in women with malformed uteri who underwent cerclage (88 per cent) compared with those without cerclage (47 per cent). No statistically significant beneficial effect of cerclage was found for normal uteri, even when only those with a history of recurrent fetal loss were considered.