Revista chilena de obstetricia y ginecología
On-line version ISSN 0717-7526
OVALLE S, Alfredo et al. Cerclaje profiláctico en mujeres con nacimientos prematuros espontáneos previos, asociados con infección bacteriana ascendente. Rev. chil. obstet. ginecol. [online]. 2012, vol.77, n.2, pp.98-105. ISSN 0717-7526. http://dx.doi.org/10.4067/S0717-75262012000200004.
Aims: Determine the effectiveness of prophylactic cerclage in women with singleton pregnancies, cervix >25 mm and a history of spontaneous premature deliveries associated to ascending bacterial infection (ABI). Methods: Women with singleton pregnancies and history of preterm births, with no fullterm deliveries, associated to ABI. Cases with >25 mm cervical length at admission were included. Cervical cerclage performed on patients derived before 20 weeks of pregnancy was compared to the expectant management of women submitted at a later gestational stage with sustained cervical length of >25 mm. Pregnant women with <25 mm cervix at referral, with cervical shortening <25 mm at expectant management, and women with previous preterm birth without placental histology were excluded. Results: 51 patients were included, 23 with cerclage and 28 without cerclage. Prophylactic cerclage significantly reduced the frequency of premature birth <37 weeks, 4.3% vs 35.7% and <34 weeks, 4.3 % vs 28.6 % and histologic chorioamnionitis 4.3% vs 32.1% (9/28), OR (95%CI) 0.08 (0.09-0.70), 0.11(0.01-0.99) and 0.01 (0.01-0.83), respectively. Conclusions: In patients with preterm births associated to ABI, singleton pregnancy and cervical length >25 mm, prophylactic cerclage reduces the frequency of premature delivery <37 and <34 weeks as well as histologic chorioamnionitis.
Keywords : Cerclage; preterm birth; ascending bacterial infection; histologic chorioamnionitis.