{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T08:05:25Z","timestamp":1777363525771,"version":"3.51.4"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,14]],"date-time":"2022-05-14T00:00:00Z","timestamp":1652486400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,14]],"date-time":"2022-05-14T00:00:00Z","timestamp":1652486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Scientific Research Project of Nantong Municipal Health Commission","award":["QA2021048"],"award-info":[{"award-number":["QA2021048"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To investigate the effects of vaginal microecology and immune status on the pregnancy outcome of cervical cerclage.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The clinical data of 125 patients with cervical incompetence who underwent transvaginal cervical cerclage in our hospital from January 2018 to January 2021 were collected, based on which the associations of vaginal microecology and related immune cytokines (IL-1\u03b2, IL-6, IL-8 and TNF-\u03b1) with the cervical cerclage outcome were explored.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>All of the 125 patients had singleton pregnancies, who were aged 20\u201343\u00a0years, with a mean of (32.34\u2009\u00b1\u20095.17) years. The surgery was successful in 104 patients (full-term delivery or survival of premature infants), while unsuccessful in 21 patients (late miscarriage or death of premature infants), revealing a success rate of 83.20%. There were 70 full-term deliveries, 34 premature deliveries (28 survived while 6 died), and 15 late miscarriages. Univariate analysis revealed statistically significant differences in the timing of surgery, gestational age of cerclage, preoperative cervical canal length, genital tract infections and preoperative invasive procedures between the successful and unsuccessful groups (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Insignificant differences were found in the pre-pregnancy body mass index (BMI) (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). According to the multivariate analysis results, cerclage timing and genital tract infections were independent risk factors for postoperative pregnancy failure (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The pathogen detection rates in the two groups of pregnant women were analyzed, finding significantly higher incidence of bacterial vaginosis (BV) in the unsuccessful group than in the successful group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Inter-group comparison revealed that the positive rates for vaginal microenvironmental factors (LE, NAG, SNA, H<jats:sub>2<\/jats:sub>O<jats:sub>2<\/jats:sub> and pH) were all significantly higher in the unsuccessful group than in the successful group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Besides, the immune cytokine levels in the cervicovaginal secretions were also all significantly higher in the unsuccessful group than in the successful group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The pregnancy outcome of patients undergoing cervical cerclage is associated with the imbalance of vaginal microecology and the levels of IL-1\u03b2, IL-6, IL-8 and TNF-\u03b1 in cervicovaginal secretions.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12905-022-01751-9","type":"journal-article","created":{"date-parts":[[2022,5,14]],"date-time":"2022-05-14T09:07:05Z","timestamp":1652519225000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effects of vaginal microecology and immunity on the pregnancy outcome of cervical cerclage"],"prefix":"10.1186","volume":"22","author":[{"given":"Shengnan","family":"Cai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanting","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiqian","family":"Ding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,14]]},"reference":[{"key":"1751_CR1","first-page":"D8991","volume":"6","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 Rev. 2017;6:D8991.","journal-title":"Cochrane Database Syst Rev"},{"issue":"22","key":"1751_CR2","doi-asserted-by":"publisher","first-page":"2670","DOI":"10.4103\/0366-6999.193451","volume":"129","author":"SW Wang","year":"2016","unstructured":"Wang SW, Ma LL, Huang S, et al. Role of cervical cerclage and vaginal progesterone in the treatment of cervical incompetence with\/without preterm birth history. Chin Med J (Engl). 2016;129(22):2670\u20135.","journal-title":"Chin Med J (Engl)"},{"issue":"2","key":"1751_CR3","first-page":"173","volume":"73","author":"S Tamada","year":"2019","unstructured":"Tamada S, Masuyama H, et al. Successful delivery after abdominal radical trachelectomy, using transabdominal cerclage in early pregnancy. 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BJOG Int J Obstet Gynaecol. 2019;126(7):916\u201325.","journal-title":"BJOG Int J Obstet Gynaecol"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-022-01751-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12905-022-01751-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-022-01751-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,14]],"date-time":"2022-05-14T09:08:15Z","timestamp":1652519295000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcwomenshealth.biomedcentral.com\/articles\/10.1186\/s12905-022-01751-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,14]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["1751"],"URL":"https:\/\/doi.org\/10.1186\/s12905-022-01751-9","relation":{},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,14]]},"assertion":[{"value":"25 March 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The experimental protocol was established, according to the ethical guidelines of the Helsinki Declaration and was approved by the Human Ethics Committee of Affiliated Matern & Child Care Hospital of Nantong University. Written informed consent was obtained from individual or guardian participants. I promise that all experimental protocols were approved by Affiliated Matern & Child Care Hospital of Nantong University.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"167"}}