Improving the outcome of cervical cerclage by sonographic follow-up.

A total of 39 patients with the diagnosis of cervical incompetence were followed up with cervical sonography after placement of prophylactic McDonald cerclage. During the first year of study, 3 out of 12 patients treated with prophylactic cerclage demonstrated funneling of the internal cervical os when examined with cervical sonography; all 3 had premature deliveries. During the last 3 years of the study, 8 of 27 patients treated with prophylactic cerclage demonstrated funneling. With active intervention, neonatal survival improved to 100%. Sonography aids in the management of patients with cervical incompetence and improves outcome even after placement of cervical cerclage.