Positive vaginal culture at rescue cerclage predicts subsequent preterm delivery

Abstract

Purpose: This retrospective case-control study is aimed to extract predictors of preterm delivery after rescue cerclage.

Materials and methods: We collected the data from all the pregnant women who underwent rescue cerclage before 26⁺⁰ gestational weeks at our facility between July 2006 and July 2016. These women were divided into "delivery at <34 weeks" group (n = 12) and "delivery at ≥34 weeks" group (n = 12). Multiple factors that had been detected at the time of cerclage were compared between these two groups.

Results: "Gestational weeks at cerclage ≥23" and "positive vaginal culture at cerclage" were significantly more prevalent in the "delivery at <34 weeks" group than in the "delivery at ≥34 weeks" group. "Prolapsed membranes at cerclage" tended to be more prevalent in the "delivery at <34 weeks" group than in the "delivery at ≥34 weeks" group. "Positive vaginal culture at cerclage" was the only independent risk factor associated with eventual preterm delivery before 34 gestational weeks.

Conclusions: Simple aerobic bacterial culture of the vaginal swab sampled at the time of cerclage could be used as a reliable test to predict subsequent preterm delivery before 34 gestational weeks.

Keywords: Bacterial vaginosis; cervical cerclage; cervical incompetence; cervical insufficiency; emergency cerclage.