Preterm premature rupture of membranes in the presence of cerclage: is the risk for intra-uterine infection and adverse neonatal outcome increased?

Abstract

Objective. To determine whether preterm premature rupture of membranes (PPROM) in the presence of a cerclage is associated with an increased incidence of intrauterine infection and/or adverse neonatal outcome compared to PPROM in the absence of cerclage.

Study design. Patients diagnosed with PPROM with a cerclage (cases) between 24–34 weeks were matched (1:2.6) for gestational age at PPROM, gestational number, and chorionicity with patients diagnosed with PPROM without a cerclage (controls).

Results. Pregnancy latency period was not different but the rates of chorioamnionitis [clinical (26.6% versus 13.5%) and histological (92.6% versus 65.4%)] and the rates of adverse perinatal outcome were higher following PPROM in the presence of a cerclage compared with no cerclage.

Conclusion. The presence of a cerclage in patients with PPROM appears to increase the risk of intra-uterine infection and affect neonatal outcome; it may not be justified to leave a cerclage in place in patients with PPROM.

Keywords:

• Cerclage
• PPROM
• chorioamnionitis