Continuous low-dose antibiotics and cerclage for recurrent second-trimester pregnancy loss.
OBJECTIVE
To evaluate the role of continuous low-dose antibiotics in the prolongation of pregnancy in women at risk for recurrent second-trimester loss.


METHODS
Only patients with a history of previous recurrent second-trimester losses associated with failed cervical cerclages were prospectively included in the study. Patients received low-dose antibiotics until delivery. Cerclage was performed at 14-24 weeks' gestation on the basis of transvaginal sonographic findings of cervical funneling. Outcome was evaluated by weeks of pregnancy gained in the current pregnancy as compared to the previous pregnancy.


RESULTS
Ten patients were eligible for study after exclusions. All 10 achieved fetal viability. Pregnancy was prolonged by a mean of 13.4 +/- 4.2 weeks beyond the previous pregnancy. This was highly statistically significant (P < .001).


CONCLUSIONS
Continuous low-dose antibiotics prolonged pregnancy in patients with recurrent second-trimester pregnancy losses and prior failed cerclage. Randomized clinical trials are needed to confirm the role of antibiotics in these high-risk pregnancies.
Shiffman
R L
RL
Department of Obstetrics and Gynecology, New York Methodist Hospital, Brooklyn 11210, USA.
D000022:Abortion, Spontaneous / Q000517:prevention & control*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012008:Recurrence; D012307:Risk Factors; D013537:Sutures; D002581:Uterine Cervical Incompetence / Q000473:pathology / Q000601:surgery*
D000900:Anti-Bacterial Agents