The effect of therapeutic McDonald cerclage on cervical length as assessed by transvaginal ultrasonography, ,

Objective: Our goal was to study the effect of therapeutic McDonald cerclage on cervical length with the use of transvaginal ultrasonography. Study Design: Cervical length was measured serially in singleton pregnancies in which there were doubts regarding cervical competence. When shortening of the cervix was substantial before 27 weeks’ gestation a McDonald cerclage was applied. Wilcoxon signed rank test was used, and 1-tailed P< .05 was considered significant. Results: In the 34 pregnancies studied, the mean cervical length measured at a mean gestational age of 14 weeks had decreased significantly (P< .0001) from 42 mm (95% confidence interval 38-47) to 21 mm (95% confidence interval 19-23) at a mean gestational age of 20 weeks 5 days, when a cerclage was applied. After the cerclage the mean cervical length increased significantly (P< .0001) to 34 mm (95% confidence interval 30-38) at a mean gestational age of 22 weeks 1 day (95% confidence interval 21 weeks 1 day–23 weeks 2 days). Conclusions: Therapeutic McDonald cerclage results in a longer cervical length as measured by transvaginal ultrasonography. (Am J Obstet Gynecol 1999;180:366-70.)