{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T17:12:54Z","timestamp":1794244374204,"version":"4.9.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T00:00:00Z","timestamp":1714089600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T00:00:00Z","timestamp":1714089600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["1803311N"],"award-info":[{"award-number":["1803311N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004497","name":"Onderzoeksraad, KU Leuven","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004497","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The leading hypothesis of the pathogenesis of cervical insufficiency suggests a role of cervical inflammation. Urogenital tract infections could play a causative role in this process. To test this hypothesis in women with a cervical cerclage, we aimed to retrospectively examine the relationship between gestational age (GA) at delivery and positive urogenital cultures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single center retrospective study reviewed the records of all women with a singleton pregnancy that underwent cervical cerclage (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009203) between 2010 and 2020 at the University Hospital of Leuven, Belgium. Transvaginal cerclages were categorized as history indicated (TVC I,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200994), ultrasound indicated (TVC II,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200979) and clinically indicated (TVC III,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920). Additionally, ten women received transabdominal cerclage (TAC). Urogenital cultures (vaginal and urine) were taken before and after cerclage with 4-week intervals. Urogenital cultures were reported \u2018positive\u2019 if urine and\/or vaginal cultures showed significant growth of a microorganism. Treatment decision depended on culture growth and clinical presentation. The primary aim was to evaluate the association between the urogenital culture results and the GA at delivery, for each of the cerclage groups. Secondarily, to investigate the effect of antibiotic treatment of positive cultures on GA at delivery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Positive pre-cerclage urogenital cultures were associated with lower GA at delivery in TVC III (positive culture 26w4d\u2009\u00b1\u200940d vs. negative 29w6d\u2009\u00b1\u200954d,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036). For TVC I, GA at delivery was longer when pre-cerclage urogenital cultures were positive (positive culture 38w0d\u2009\u00b1\u200926d vs. negative 35w4d\u2009\u00b1\u200942d,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035). Overall post-cerclage urogenital cultures status was not associated with a different GA at delivery. Treating patients with pre- or post-cerclage positive urogenital cultures did also not change GA at delivery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Positive urogenital cultures taken before clinically indicated cerclage intervention may be associated with lower GA at delivery. However, there seems to be no benefit of antibiotic treatment or routine urogenital cultures during follow-up of asymptomatic women after cerclage placement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12884-024-06509-9","type":"journal-article","created":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T06:02:51Z","timestamp":1714111371000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Urogenital cultures and preterm birth in women with cervical cerclage: a single center retrospective cohort study"],"prefix":"10.1186","volume":"24","author":[{"given":"Evelien","family":"Seys","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann-Sophie","family":"Page","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Deprest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lore","family":"Lannoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristel","family":"van Calsteren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Devlieger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"van der Merwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,26]]},"reference":[{"key":"6509_CR1","unstructured":"World Health Organization. WHO recommendations on interventions to improve preterm birth outcomes. 2015. https:\/\/www.who.int\/publications\/i\/item\/9789241508988. Accessed 12 March 2023."},{"key":"6509_CR2","unstructured":"Devlieger R, Goemaes R, Laubach M. Perinatale gezondheid in Vlaanderen \u2013 Jaar 2020. Brussel: Studiecentrum voor Perinatale Epidemiologie. 2021; 1\u201385."},{"key":"6509_CR3","first-page":"1","volume":"376","author":"AS Morgan","year":"2022","unstructured":"Morgan AS, Mendon\u00e7a M, Thiele N, David AL. Management and outcomes of extreme preterm birth. BMJ. 2022;376:1\u20139.","journal-title":"BMJ"},{"issue":"7","key":"6509_CR4","doi-asserted-by":"publisher","first-page":"1975","DOI":"10.1093\/humrep\/13.7.1975","volume":"13","author":"AJ Drakeley","year":"1998","unstructured":"Drakeley AJ, Quenby S, Farquharson RG. Mid-trimester loss - Appraisal of a screening protocol. Hum Reprod. 1998;13(7):1975\u201380.","journal-title":"Hum Reprod"},{"issue":"24","key":"6509_CR5","doi-asserted-by":"publisher","first-page":"4698","DOI":"10.1080\/14767058.2020.1861600","volume":"35","author":"M Joubert","year":"2022","unstructured":"Joubert M, Sibiude J, Bounan S, Mandelbrot L. Mid-trimester miscarriage and subsequent pregnancy outcomes: the role of cervical insufficiency in a cohort of 175 cases. J Matern Neonatal Med. 2022;35(24):4698\u2013703.","journal-title":"J Matern Neonatal Med"},{"issue":"4","key":"6509_CR6","doi-asserted-by":"publisher","first-page":"35","DOI":"10.3109\/00016349409013390","volume":"37","author":"O Lidegaard","year":"1994","unstructured":"Lidegaard O. Cervical incompetence and cerclage in Denmark 1980\u20131990 a register based epidemiological survey. Acta Obstet Gynecol Scand. 1994;37(4):35\u20138.","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"13","key":"6509_CR7","doi-asserted-by":"publisher","first-page":"2071","DOI":"10.1080\/14767058.2019.1656195","volume":"34","author":"SV Barinov","year":"2021","unstructured":"Barinov SV, Artymuk NV, Novikova ON, Shamina IV, Tirskaya YI, Belinina AA, et al. Analysis of risk factors and predictors of pregnancy loss and strategies for the management of cervical insufficiency in pregnant women at a high risk of preterm birth. J Matern Neonatal Med. 2021;34(13):2071\u20139.","journal-title":"J Matern Neonatal Med"},{"issue":"2","key":"6509_CR8","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.siny.2015.12.009","volume":"21","author":"J Vink","year":"2016","unstructured":"Vink J, Feltovich H. Cervical etiology of spontaneous preterm birth. Semin Fetal Neonatal Med. 2016;21(2):106\u201312.","journal-title":"Semin Fetal Neonatal Med"},{"issue":"2","key":"6509_CR9","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1097\/GRF.0000000000000184","volume":"59","author":"A Roman","year":"2016","unstructured":"Roman A, Suhag A, Berghella V. Overview of cervical insufficiency: diagnosis, etiologies, and risk factors. Clin Obstet Gynecol. 2016;59(2):237\u201340.","journal-title":"Clin Obstet Gynecol"},{"key":"6509_CR10","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1097\/QCO.0b013e328360dc31","volume":"26","author":"M Cunnington","year":"2013","unstructured":"Cunnington M, Kortsalioudaki C, Heath P. Genitourinary pathogens and preterm birth. Curr Opin Infect Dis. 2013;26:219\u201330.","journal-title":"Curr Opin Infect Dis"},{"key":"6509_CR11","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.1056\/NEJM200005183422007","volume":"342","author":"R Obert","year":"2000","unstructured":"Obert R, Oldenberg LG, Ohn J, Auth CH, Ndrews WA. Intrauterine infection and Preterm Delivery. N Engl J Med. 2000;342:1500\u20137.","journal-title":"N Engl J Med"},{"issue":"5","key":"6509_CR12","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1515\/jpm.2010.076","volume":"38","author":"DB Digiulio","year":"2010","unstructured":"Digiulio DB, Gervasi M, Romero R, Vaisbuch E, Mazaki-Tovi S, Kusanovic JP, et al. Microbial invasion of the amniotic cavity in pregnancies with small-for-gestational-age fetuses. J Perinat Med. 2010;38(5):495\u2013502.","journal-title":"J Perinat Med"},{"issue":"8","key":"6509_CR13","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1097\/01.ogx.0000852904.48412.13","volume":"77","author":"A Care","year":"2022","unstructured":"Care A, Nevitt SJ, Medley N, Donegan S, Goodfellow L, Hampson L, et al. Interventions to prevent spontaneous Preterm Birth in women with singleton pregnancy who are at high risk: systematic review and network Meta-analysis. Obstet Gynecol Surv. 2022;77(8):463\u20134.","journal-title":"Obstet Gynecol Surv"},{"issue":"6","key":"6509_CR14","first-page":"CD008991","volume":"2017","author":"Z Alfirevic","year":"2017","unstructured":"Alfirevic Z, Stampalija T, Medley N. Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy. Cochrane Database Syst Reviews. 2017;2017(6):CD008991.","journal-title":"Cochrane Database Syst Reviews"},{"key":"6509_CR15","doi-asserted-by":"crossref","unstructured":"Shennan A, Chandiramani M, Bennett P, David AL, Girling J, Ridout A et al. MAVRIC: a multicenter randomized controlled trial of transabdominal vs transvaginal cervical cerclage. Am J Obstet Gynecol. 2020;222(3):261.e1-261.e9.","DOI":"10.1016\/j.ajog.2019.09.040"},{"issue":"11","key":"6509_CR16","doi-asserted-by":"publisher","first-page":"1444","DOI":"10.1111\/aogs.13968","volume":"99","author":"C Chatzakis","year":"2020","unstructured":"Chatzakis C, Efthymiou A, Sotiriadis A, Makrydimas G. Emergency cerclage in singleton pregnancies with painless cervical dilatation: a meta-analysis. Acta Obstet Gynecol Scand. 2020;99(11):1444\u201357.","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"8","key":"6509_CR17","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1111\/jog.12059","volume":"39","author":"SR Gundabattula","year":"2013","unstructured":"Gundabattula SR, Marakani LR, Dasari S, Surampudi K, Pochiraju M, Nirmalan PK. Outcomes of pregnancy in women who had rescue cerclage for cervical insufficiency: a single-center retrospective study. J Obstet Gynaecol Res. 2013;39(8):1293\u2013300.","journal-title":"J Obstet Gynaecol Res"},{"issue":"9","key":"6509_CR18","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.1080\/14767058.2017.1311313","volume":"31","author":"S Kanbayashi","year":"2018","unstructured":"Kanbayashi S, Sato Y, Taga A, Satake Y, Emoto I, Maruyama S, et al. Positive vaginal culture at rescue cerclage predicts subsequent preterm delivery. J maternal-fetal Neonatal Med. 2018;31(9):1161\u20135.","journal-title":"J maternal-fetal Neonatal Med"},{"issue":"25","key":"6509_CR19","doi-asserted-by":"publisher","first-page":"9983","DOI":"10.1080\/14767058.2022.2081802","volume":"35","author":"W Jin","year":"2022","unstructured":"Jin W, Hughes K, Sim S, Shemer S, Sheehan PM. Abnormal vaginal flora and spontaneous preterm birth in high-risk singleton pregnancies with cervical cerclage. J maternal-fetal Neonatal Med. 2022;35(25):9983\u201390.","journal-title":"J maternal-fetal Neonatal Med"},{"key":"6509_CR20","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.ejogrb.2020.05.027","volume":"251","author":"Y Kunpalin","year":"2020","unstructured":"Kunpalin Y, Burul G, Greenwold N, Tetteh A, Casagrandi D, Warner D, et al. Factors associated with preterm birth in women undergoing cervical cerclage. Eur J Obstet Gynecol Reproductive Biology. 2020;251:141\u20135.","journal-title":"Eur J Obstet Gynecol Reproductive Biology"},{"issue":"2","key":"6509_CR21","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1111\/j.1365-2362.2008.02009.x","volume":"38","author":"J Schnarr","year":"2008","unstructured":"Schnarr J, Smaill F. Asymptomatic bacteriuria and symptomatic urinary tract infections in pregnancy. Eur J Clin Invest. 2008;38(2):50\u20137.","journal-title":"Eur J Clin Invest"},{"issue":"12","key":"6509_CR22","doi-asserted-by":"publisher","first-page":"3087","DOI":"10.1111\/jog.15428","volume":"48","author":"K Akeno","year":"2022","unstructured":"Akeno K, Ohashi M, Furukawa S, Sameshima H. Cerclage in surgically shortened uterine cervix and pregnancy outcome: a retrospective comparison between the abdominal and vaginal procedures. J Obstet Gynaecol Res. 2022;48(12):3087\u201392.","journal-title":"J Obstet Gynaecol Res"},{"issue":"3","key":"6509_CR23","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1097\/QCO.0b013e328360dc31","volume":"26","author":"M Cunnington","year":"2013","unstructured":"Cunnington M, Kortsalioudaki C, Heath P. Genitourinary pathogens and preterm birth. Curr Opin Infect Dis. 2013;26(3):219\u201330.","journal-title":"Curr Opin Infect Dis"},{"issue":"1","key":"6509_CR24","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1111\/1471-0528.14209","volume":"124","author":"D Nasioudis","year":"2017","unstructured":"Nasioudis D, Linhares IM, Ledger WJ, Witkin SS. Bacterial vaginosis: a critical analysis of current knowledge. BJOG: Int J Obstet Gynecol. 2017;124(1):61\u20139.","journal-title":"BJOG: Int J Obstet Gynecol"},{"issue":"1","key":"6509_CR25","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1067\/mob.2003.339","volume":"189","author":"H Leitich","year":"2003","unstructured":"Leitich H, Bodner-Adler B, Brunbauer M, Kaider A, Egarter C, Husslein P. Bacterial vaginosis as a risk factor for preterm delivery: a meta-analysis. Am J Obstet Gynecol. 2003;189(1):139\u201347.","journal-title":"Am J Obstet Gynecol"},{"key":"6509_CR26","doi-asserted-by":"crossref","unstructured":"Brocklehurst P, Gordon A, Heatley E, Milan SJ. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database Syst Rev. 2013.","DOI":"10.1002\/14651858.CD000262.pub4"},{"issue":"5","key":"6509_CR27","doi-asserted-by":"publisher","first-page":"2636","DOI":"10.3390\/ijerph19052636","volume":"19","author":"M G\u00f3mez-Castellano","year":"2022","unstructured":"G\u00f3mez-Castellano M, Sabonet-Morente L, Gonz\u00e1lez-Mesa E, Jim\u00e9nez-L\u00f3pez JS. A Three-Step Procedure for Emergency Cerclage: gestational and neonatal outcomes. Int J Environ Res Public Health. 2022;19(5):2636.","journal-title":"Int J Environ Res Public Health"}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-024-06509-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12884-024-06509-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-024-06509-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T06:09:52Z","timestamp":1714111792000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-024-06509-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,26]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["6509"],"URL":"https:\/\/doi.org\/10.1186\/s12884-024-06509-9","relation":{},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,26]]},"assertion":[{"value":"8 April 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Committee Research UZ \/ KU Leuven, Belgium (MP017199). All experiments were performed in accordance with relevant guidelines and regulations (such as the Declaration of Helsinki). The need for informed consent was waived by the Ethics Committee Research UZ \/ KU Leuven due to retrospective nature of the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patients for publication of the cases.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"324"}}