Indication for cerclage and complete occlusion of cervical canal and external os:  technique and retrospective study (PDF)

Ludwig Spätling, Alfons Kraus, Christina Pistofidou

Dept. of Obstetrics and Gynecology, Klinikum Fulda gAG, Germany


In case of cervical insufficiency, a cerclage prolong pregnancy. It should be answered if an additional complete occlusion of cervical canal and external os (COCCEO) improves the results.

Described in detail. In consecutive 10 years periods 69 patients were treated by a cerclage, 138 patients by an additional COCCEO. One abortion occurred in the cerclage group. No fetal mortality and only a minor morbidity of mother and newborn were observed in the COCCEO group. In the prophylactic and uncomplicated therapeutic groups no differences in outcome could be seen indicating no additional benefit of COCCEO. In case of exposed membranes both groups showed a prolongation of pregnancy by 11 weeks, although the patients of the COCCEO group had more risks. So, the latter group could profit by COCCEO. In case of late and complicated abortion in history COCCEO women could benefit from COCCEO.

Keywords: Cervical insufficiency, exposed membranes, cerclage, complete occlusion of the cervix