A Clinical Study on the McDonald Operation for the Incompetent Internal Os of the Cervix

Lee, Yoon Jin; Yoon, Joo Hee; Kim, Hyun Young; Kwon, Ji Young; Jung, In Cheol; Ryu, Soon Won; Jo, Hyun Hee; Kim, Jin Hong

Abstract

OBJECTIVE
The aim of this study is to improve the pregnancy outcome and evaluate the prognostic factor after McDonald operation of IIOC patients.
METHODS
From January 1, 1995 to December 31, 1999, 230 cases of IIOC were admitted and treated with McDonald operation at department of Obstetrics and Gynecology, Medical college of Catholic university. Among these patients, 187 cases were analyzed. We classified the above patients into 4 groups by gestational weeks of the operation (1st group before 14weeks, 2nd group 14+1-16weeks, 3rd group 16+1-18weeks, 4th group after 18weeks), and we analyzed the mean age of the patients, parity, indications, operation time, delivery methods and fetal survival rate on each groups.
RESULTS
The fetal survival rate was 76.08%,and duration of pregnancy was 21.65weeks+/-6.39 in the 1st group, 78.5%, 19.24weeks+/-6.367 in the 2nd group, 88.2%,18.25weeks+/-5.15 in the 3rd group, 75.67%, 12.12weeks+/-7.19 in the 4th group. The 3rd group shows higher fetal survival rate with significantly.
CONCLUSION
We can have higher fetal survival rate and prolongation of duration of pregnancy in the IIOC patients when we do the McDonald operation in the 16+1-18th gestation weeks.