Value of cervical encirclage in the treatment of midtrimester abortion.

Cervical encirclage (McDonald's operation) was performed on 64 patients from 1974 to 1978 as a primary treatment of cervical incompetence. Diagnosis of incompetent cervix was made by history alone in 21 cases, by history and vaginal examination in 41 and by hysterosalpingogram alone in only two cases. Before suture, these 64 patients had had 246 pregnancies with successful pregnancy in 62, a success rate of 25.2%. If first trimester abortions were excluded, successful outcome had occurred in only 31.6%. Following suture reinforcement, the same patients achieved 64 conceptions with 45 successful pregnancies, a success rate of 70.3%. Cervical encirclage is useful and attractive because of its simplicity, bloodlessness and easy reproducibility during the same pregnancy.