Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia.
Pregnancy Research Centre, The Royal Women's Hospital, Melbourne, Australia.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):9983-9990. doi: 10.1080/14767058.2022.2081802. Epub 2022 Jun 5.
To investigate abnormal vaginal and suture-based bacterial flora for associations with spontaneous preterm birth in high-risk singleton pregnancies with an ultrasound-indicated or emergency cervical cerclage.
A retrospective study of 196 singleton pregnancies with an ultrasound-indicated or emergency cerclage at the Royal Women's Hospital, Australia, from 2004 to 2018. High vaginal swabs were collected regularly between 14 and 26 weeks' gestation, including pre- and post-cerclage insertion, and sent for microscopy and culture. Cervical suture was cultured upon removal. Primary outcomes were spontaneous preterm birth <37, <34 and <30 weeks.
43.4% (85/196) of women delivered preterm. The acquisition and persistence of vaginal following cerclage insertion were independently associated with spontaneous preterm birth <37 weeks ( = .0225, = .0477). growth from the cervical suture upon removal was associated with spontaneous preterm birth <34 weeks ( = .0458). The acquisition of vaginal mixed anaerobes post-cerclage was independently associated with spontaneous preterm birth <34 weeks ( = .0480).
For singleton pregnancies with an ultrasound-indicated or emergency cerclage, the presence of vaginal or suture-based following cerclage insertion yields increased risk of cerclage failure and spontaneous preterm birth.
探讨高危单胎妊娠经超声指示或紧急宫颈环扎术后阴道和缝线相关细菌菌群异常与自发性早产的关系。
这是一项回顾性研究，纳入了 2004 年至 2018 年在澳大利亚皇家妇女医院接受超声指示或紧急宫颈环扎术的 196 例单胎妊娠。在 14 至 26 周妊娠期间定期采集阴道拭子，包括环扎术前和术后，并进行显微镜检查和培养。取出宫颈缝线时进行培养。主要结局为自发性早产<37 周、<34 周和<30 周。
43.4%（85/196）的女性早产。环扎术后阴道 定植的获得和持续与自发性早产<37 周有关（ = .0225， = .0477）。取出宫颈缝线时的 生长与自发性早产<34 周有关（ = .0458）。环扎术后阴道混合厌氧菌的获得与自发性早产<34 周有关（ = .0480）。
对于经超声指示或紧急宫颈环扎术的单胎妊娠，环扎术后阴道或缝线相关 定植与环扎术失败和自发性早产风险增加有关。
