Suture reinforcement of the incompetent cervix: Experience at the Lutheran Hospital of Milwaukee

Abstract

A modified McDonald procedure, used to correct cervical incompetence, was performed on 44 patients after all other conservative methods for the prevention of late abortion had failed. Diagnosis was established by the history of previous reproductive failure in the early second trimester of pregnancy. Before suture reinforcement, these 44 patients had had 174 conceptions with successful outcome of pregnancy in 37. If the first trimester abortions are deleted, successful outcome had occurred in only 25 per cent of this series. Following suture reinforcement, the same 44 patients reported 72 conceptions with 45 successful pregnancies; a success rate of 63 per cent. Suture reinforcement of the incompetent cervix is a useful procedure but should, however, be performed only as a last resort. Emphasis should be placed on the importance of accurate diagnosis, with other causes of abortion and prematurity first being eliminated.