Risk factors for preterm premature rupture of membranes after transvaginal cervical cerclage: a retrospective cohort study
10.3760/cma.j.cn113903-20230821-00134
- VernacularTitle:经阴道宫颈环扎术后发生未足月胎膜早破危险因素的回顾性队列研究
- Author:
Jun ZHANG
1
;
Zhimin XU
;
Jing LIU
;
Lin ZHANG
;
Mian PAN
Author Information
1. 福建省妇幼保健院（福建医科大学妇儿临床医学院）妇产科，福州 350001
- Keywords:
Cervical incompetence;
Cerclage, cervical;
Fetal membranes, premature rupture;
Risk factors;
Cohort studies
- From:
Chinese Journal of Perinatal Medicine
2023;26(10):839-846
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the incidence and risk factors associated with preterm premature rupture of membranes (PPROM) following transvaginal cervical cerclage.Methods:This retrospective cohort study involved 170 singleton pregnancies with cervical incompetence who underwent vaginal cervical cerclage at Fujian Maternity and Child Health Hospital from January 2021 to January 2022. Based on the onset of PPROM after cervical cerclage, the patients were divided into the PPROM group ( n=28) and the non-PPROM group ( n=142). Independent samples t-test, rank-sum test, Chi-square test, or Fisher's exact test were used to compare the general condition, pre- and postoperative data, pregnancy complications or comorbidities between the two groups, with a significance level at α=0.1. Multiple logistic regression analysis was conducted to identify the risk factors for PPROM after cerclage surgery. Results:The overall incidence of PPROM after vaginal cervical cerclage was 16.5% (28/170). Logistic regression analysis showed that a history of cervical conization ( OR=11.966, 95% CI:1.695-84.468), the use of Mersilene RS22 tape as the suture material ( OR=3.318, 95% CI:1.064-9.252), cervical length<2.5 cm after cerclage ( OR=3.486, 95% CI:1.116-10.888), and Mycoplasma genitalium- positive results for cervical secretion culture after surgery ( OR=4.856, 95% CI:1.487-15.861) were the independent risk factors for PPROM after cervical cerclage (all P<0.05). Conclusions:The incidence of PPROM following vaginal cervical cerclage is relatively high and can have unfavorable effects on pregnancy outcomes. Factors such as a history of cervical conization, the use of Mersilene RS22 tape for cerclage, cervical length<2.5 cm after cerclage, and Mycoplasma genitalium-positive results for cervical secretion culture after surgery may increase the risk of PPROM after cerclage.
