[Decrease in cerclage incidence in multiple pregnancies by vaginal ultrasound monitoring].

Cervical insufficiency is a frequent complication particularly in case of multiple pregnancy and is often considered to be an indication for cerclage operation. We performed a vaginosonographic monitoring prospectively in 35 cases with multiple pregnancy in order to diagnose cervical insufficiency early and to perform cerclage operation when indicated. The results were compared with a group of 41 patients with multiple pregnancy who received prophylactic cerclage in other hospitals. No significant difference occurred concerning the duration of the pregnancy. In patients without prophylactic cerclage the frequency of preterm contractions was significantly lower, the frequency of premature rupture of membranes, however, was higher. Our results confirm the hypothesis that the application of a prophylactic cerclage does not improve fetal outcome in case of multiple pregnancy. Vaginosonographic as a single monitoring procedure seems to sufficient for the early diagnosis of cervical insufficiency.