Once a cerclage, not always a cerclage.

A study was performed to evaluate the outcome of pregnancies in which the decision was not to repeat cerclage in women with a doubtful indication for the previous one. Thirty-five women with a history of at least one previous McDonald cerclage were followed prospectively. Pregnancy complications and outcome were compared to those in the previous pregnancy with a cerclage. These patients had 58 pregnancies with a cerclage and 52 pregnancies without. The pregnancies without a cerclage had fewer complications, were longer and resulted in the delivery of significantly larger infants (P < .05). Whereas all 52 cumulative pregnancies without a cerclage had a favorable outcome, there were nine perinatal losses in the 58 pregnancies with a cerclage (P < .05). The decision not to repeat a cervical cerclage, when the grounds for the previous procedure are doubtful, is a safe one.