Cervical incompetence: diagnosis and outcome.

The results of 147 cervical cerclage procedures were reviewed in a retrospective study. Patient history and past reproductive performance were assessed to determine which factors were predictive of successful pregnancy outcome after cervical cerclage. A past history of spontaneous second trimester abortion or premature labor was associated with a better outcome than was a history classically associated with cervical incompetence. Morbidity immediately following the procedure was low, however significant morbidity related to cervical scarring occurred at the time of delivery. There was poor correlation between the clinical history, examination and adjunctive tests of cervical incompetence, and the pregnancy outcome following cerclage. These observations indicate the need for a prospective, randomized study of the efficacy of this procedure.