Cerclaje profiláctico en mujeres con nacimientos prematuros espontáneos previos, asociados con infección bacteriana ascendente

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.