{
    "abstract": "The leading hypothesis of the pathogenesis of cervical insufficiency suggests a role of cervical inflammation. Urogenital tract infections could play a causative role in this process. To test this hypothesis in women with a cervical cerclage, we aimed to retrospectively examine the relationship between gestational age (GA) at delivery and positive urogenital cultures.\nThis single center retrospective study reviewed the records of all women with a singleton pregnancy that underwent cervical cerclage (n\u2009=\u2009203) between 2010 and 2020 at the University Hospital of Leuven, Belgium. Transvaginal cerclages were categorized as history indicated (TVC I, n\u2009=\u200994), ultrasound indicated (TVC II, n\u2009=\u200979) and clinically indicated (TVC III, n\u2009=\u200920). Additionally, ten women received transabdominal cerclage (TAC). Urogenital cultures (vaginal and urine) were taken before and after cerclage with 4-week intervals. Urogenital cultures were reported 'positive' if urine and/or vaginal cultures showed significant growth of a microorganism. Treatment decision depended on culture growth and clinical presentation. The primary aim was to evaluate the association between the urogenital culture results and the GA at delivery, for each of the cerclage groups. Secondarily, to investigate the effect of antibiotic treatment of positive cultures on GA at delivery.\nPositive pre-cerclage urogenital cultures were associated with lower GA at delivery in TVC III (positive culture 26w4d\u2009\u00b1\u200940d vs. negative 29w6d\u2009\u00b1\u200954d, p\u2009=\u20090.036). For TVC I, GA at delivery was longer when pre-cerclage urogenital cultures were positive (positive culture 38w0d\u2009\u00b1\u200926d vs. negative 35w4d\u2009\u00b1\u200942d, p\u2009=\u20090.035). Overall post-cerclage urogenital cultures status was not associated with a different GA at delivery. Treating patients with pre- or post-cerclage positive urogenital cultures did also not change GA at delivery.\nPositive urogenital cultures taken before clinically indicated cerclage intervention may be associated with lower GA at delivery. However, there seems to be no benefit of antibiotic treatment or routine urogenital cultures during follow-up of asymptomatic women after cerclage placement.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics and Gynecology, Division Woman and Child, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium.",
            "firstname": "Evelien",
            "initials": "E",
            "lastname": "Seys"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Division Woman and Child, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium.",
            "firstname": "Ann-Sophie",
            "initials": "AS",
            "lastname": "Page"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Division Woman and Child, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium.\nCluster Woman and Child, Department of Development and Regeneration, Group Biomedical Sciences, KU Leuven Herestraat 49, Leuven, 3000, Belgium.",
            "firstname": "Jan",
            "initials": "J",
            "lastname": "Deprest"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Division Woman and Child, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium.\nCluster Woman and Child, Department of Development and Regeneration, Group Biomedical Sciences, KU Leuven Herestraat 49, Leuven, 3000, Belgium.",
            "firstname": "Lore",
            "initials": "L",
            "lastname": "Lannoo"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Division Woman and Child, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium.\nCluster Woman and Child, Department of Development and Regeneration, Group Biomedical Sciences, KU Leuven Herestraat 49, Leuven, 3000, Belgium.",
            "firstname": "Kristel",
            "initials": "K",
            "lastname": "van Calsteren"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Division Woman and Child, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium.\nCluster Woman and Child, Department of Development and Regeneration, Group Biomedical Sciences, KU Leuven Herestraat 49, Leuven, 3000, Belgium.",
            "firstname": "Roland",
            "initials": "R",
            "lastname": "Devlieger"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Division Woman and Child, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium. hannes.vandermerwe@uzleuven.be.\nCluster Woman and Child, Department of Development and Regeneration, Group Biomedical Sciences, KU Leuven Herestraat 49, Leuven, 3000, Belgium. hannes.vandermerwe@uzleuven.be.",
            "firstname": "Johannes",
            "initials": "J",
            "lastname": "van der Merwe"
        }
    ],
    "conclusions": "Positive urogenital cultures taken before clinically indicated cerclage intervention may be associated with lower GA at delivery. However, there seems to be no benefit of antibiotic treatment or routine urogenital cultures during follow-up of asymptomatic women after cerclage placement.",
    "copyrights": "\u00a9 2024. The Author(s).",
    "doi": "10.1186/s12884-024-06509-9\n10.1093/humrep/13.7.1975\n10.1080/14767058.2020.1861600\n10.3109/00016349409013390\n10.1080/14767058.2019.1656195\n10.1016/j.siny.2015.12.009\n10.1097/GRF.0000000000000184\n10.1097/QCO.0b013e328360dc31\n10.1056/NEJM200005183422007\n10.1515/jpm.2010.076\n10.1097/01.ogx.0000852904.48412.13\n10.1111/aogs.13968\n10.1111/jog.12059\n10.1080/14767058.2017.1311313\n10.1080/14767058.2022.2081802\n10.1016/j.ejogrb.2020.05.027\n10.1111/j.1365-2362.2008.02009.x\n10.1111/jog.15428\n10.1097/QCO.0b013e328360dc31\n10.1111/1471-0528.14209\n10.1067/mob.2003.339\n10.3390/ijerph19052636",
    "journal": "BMC pregnancy and childbirth",
    "keywords": [
        "Cervical cerclage",
        "Preterm birth",
        "Urine culture",
        "Vaginal culture"
    ],
    "methods": null,
    "publication_date": "2024-04-27",
    "pubmed_id": "38671377\n26447264\n35012942\n9740460\n33588670\n8304022\n31409178\n26776146\n27015229\n23612500\n10816189\n20482466\n35168930\n28586127\n31585096\n32757297\n23800290\n28335652\n35686697\n32505054\n18826482\n36110090\n23612500\n27396541\n12861153\n23440777\n35270320",
    "results": "Positive pre-cerclage urogenital cultures were associated with lower GA at delivery in TVC III (positive culture 26w4d\u2009\u00b1\u200940d vs. negative 29w6d\u2009\u00b1\u200954d, p\u2009=\u20090.036). For TVC I, GA at delivery was longer when pre-cerclage urogenital cultures were positive (positive culture 38w0d\u2009\u00b1\u200926d vs. negative 35w4d\u2009\u00b1\u200942d, p\u2009=\u20090.035). Overall post-cerclage urogenital cultures status was not associated with a different GA at delivery. Treating patients with pre- or post-cerclage positive urogenital cultures did also not change GA at delivery.",
    "title": "Urogenital cultures and preterm birth in women with cervical cerclage: a single center retrospective cohort study.",
    "xml": "<Element 'PubmedArticle' at 0x788502845f80>"
}