Eradication of Cervical Canal Colonization In Treatment Associated With Prophylactic Cervical Cerclage: The LOOK FURTHER Study

BACKGROUND: The perioperative management of the cervical cerclage procedure is not unified. Controlling microbiome cervical status does not affect obstetric outcomes in general population, but it can be beneficial in cervical insufficiency. Eliminating cervical pathogens in those patients may increase the effectiveness, resulting in prevention of miscarriage or preterm labor and delivery of a baby capable of normal development.METHODS: Thirty five patients undergoing cervical cerclage at the 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, were included in the study. The procedure was performed only after receiving a negative culture from the cervical canal.RESULTS: Thirty one (88.5%) patients delivered after the 34th and 28 (80%) after the 37th week of gestation. The colonization of genital tract was found in 31% of patients prior to the procedure, 42% in the subsequent course of pregnancy and 48% before delivery. Eighty five percent of patients who had miscarriage or delivered prematurely had abnormal cervical cultures. In patients with normal cervical cultures 91.67% women delivered at term. There were no abnormalities in children’s development.CONCLUSIONS: Controlling microbiological status of the cervical canal results in better or similar outcomes to those reported by other authors in terms of obstetric and neonatal outcomes. Active eradication of the reproductive tract colonization potentially increases the effectiveness of the cervical cerclage placement.