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In 80 pregnancies with clinical and ultrasonic signs of cervical incompetency, the length of the cervix and the thickness of the anterior wall of a lower uterine segment have been evaluated ultrasonically. We have also measured the width of the endocervical canal and studied the prolapse of fetal membranes (with fetal parts) into the endocervical canal. We evaluated these same parameters in 80 healthy pregnancies. The length of the cervix, the thickness of the anterior wall of a lower uterine segment, and the width of the endocervical canal were followed longitudinally in the patients from the 10th to the 36th gestation week. No statistically significant differences between age groups were found. In four age groups at risk for cervical incompetency, cervical lengths and wall thickness were significantly different (p less than 0.001) from those in comparable controls. Forty-five percent of the patients in the at-risk group, with cervical cerclage, delivered at 37.3 (range: 32 to 41) weeks and 6.25% of pregnancies ended in abortion when the amniotic membrane herniated into the cervical canal, with or without some part of the fetus.

In the past five years cerclage was performed at the Department in 265 pregnant women (1.87% of all births). The outcome of pregnancy is presented in fifteen pregnant women in whom cerclage was performed with the reposition of the prolapsed fetal membranes. In five patients pregnancy was terminated on time, while four of them gave birth to premature infants, and the infants are alive. The total survival rate is 60%. In three of the women pregnancy was effected between the 29th and the 31st weeks, and their newborns died, whereas the remaining three women aborted before the 28th gestation week. The results justify the operation even in such unfavorable cases, as an attempt to maintain pregnancy.