{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:56:29Z","timestamp":1792450589297,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,3,10]],"date-time":"2019-03-10T00:00:00Z","timestamp":1552176000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012156","name":"Genesis Research Trust","doi-asserted-by":"publisher","award":["P51389"],"award-info":[{"award-number":["P51389"]}],"id":[{"id":"10.13039\/100012156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["P45272"],"award-info":[{"award-number":["P45272"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/L009226\/1"],"award-info":[{"award-number":["MR\/L009226\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the relation between vaginal microbiota composition and outcome of rescue cervical cerclage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Queen Charlotte's and Chelsea Hospital, London.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Twenty singleton pregnancies undergoing a rescue cervical cerclage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Vaginal microbiota composition was analysed in women presenting with a dilated cervix and exposed fetal membranes before and 10\u00a0days following rescue cervical cerclage and was correlated with clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Composition of vaginal bacteria was characterised by culture\u2010independent next generation sequencing. Successful cerclage was defined as that resulting in the birth of a neonate discharged from hospital without morbidity. Unsuccessful cerclage was defined as procedures culminating in miscarriage, intrauterine death, neonatal death or significant neonatal morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Reduced\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      spp. relative abundance was observed in 40% of cases prior to rescue cerclage compared with 10% of gestation age\u2010matched controls (8\/20, 40% versus 3\/30, 10%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.017).\n                      <jats:italic>Gardnerella vaginalis<\/jats:italic>\n                      was over\u2010represented in women presenting with symptoms (3\/7, 43% versus 0\/13, 0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.03,\n                      <jats:styled-content style=\"fixed-case\">linear discriminant analysis, LDA<\/jats:styled-content>\n                      (log 10) and cases culminating in miscarriage (3\/6, 50% versus 0\/14, 0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.017). In the majority of cases (10\/14, 71%) bacterial composition was unchanged following cerclage insertion and perioperative interventions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Reduced relative abundance of\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      spp. is associated with premature cervical dilation, whereas high levels of G.\u00a0vaginalis are associated with unsuccessful rescue cerclage cases. The insertion of a rescue cerclage does not affect the underlying bacterial composition in the majority of cases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Tweetable abstract<\/jats:title>\n                    <jats:p>\n                      Preterm cervical dilatation associates with reduced\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      spp. Presence of\n                      <jats:italic>Gardnerella vaginalis<\/jats:italic>\n                      predicts rescue cerclage failure.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.15600","type":"journal-article","created":{"date-parts":[[2019,3,11]],"date-time":"2019-03-11T00:40:30Z","timestamp":1552264830000},"page":"916-925","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Prospective observational study of vaginal microbiota pre\u2010 and post\u2010rescue cervical cerclage"],"prefix":"10.1111","volume":"126","author":[{"given":"RG","family":"Brown","sequence":"first","affiliation":[{"name":"Queen Charlotte's &amp; Chelsea Hospital Imperial College Healthcare National Health Service Trust London UK"},{"name":"Imperial College Parturition Research Group Division of the Institute of Reproductive and Developmental Biology Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Chan","sequence":"additional","affiliation":[{"name":"Queen Charlotte's &amp; Chelsea Hospital Imperial College Healthcare National Health Service Trust London UK"},{"name":"Imperial College Parturition Research Group Division of the Institute of Reproductive and Developmental Biology Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Terzidou","sequence":"additional","affiliation":[{"name":"Imperial College Parturition Research Group Division of the Institute of Reproductive and Developmental Biology Imperial College London London UK"},{"name":"Chelsea &amp; Westminster Hospital Chelsea &amp; Westminster National Health Service Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YS","family":"Lee","sequence":"additional","affiliation":[{"name":"Imperial College Parturition Research Group Division of the Institute of Reproductive and Developmental Biology Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Smith","sequence":"additional","affiliation":[{"name":"School of Biosciences Cardiff University Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JR","family":"Marchesi","sequence":"additional","affiliation":[{"name":"School of Biosciences Cardiff University Cardiff UK"},{"name":"Centre for Digestive and Gut Health Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DA","family":"MacIntyre","sequence":"additional","affiliation":[{"name":"Imperial College Parturition Research Group Division of the Institute of Reproductive and Developmental Biology Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PR","family":"Bennett","sequence":"additional","affiliation":[{"name":"Queen Charlotte's &amp; 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