title: Preterm premature rupture of membranes in the presence of cerclage: is the risk for intra-uterine infection and adverse neonatal outcome increased?
abstract: OBJECTIVE
  To determine whether preterm premature rupture of membranes (PPROM) in the presence of a cerclage is associated with an increased incidence of intrauterine infection and/or adverse neonatal outcome compared to PPROM in the absence of cerclage.
  
  
  METHODS
  Patients diagnosed with PPROM with a cerclage (cases) between 24-34 weeks were matched (1:2.6) for gestational age at PPROM, gestational number, and chorionicity with patients diagnosed with PPROM without a cerclage (controls).
  
  
  RESULTS
  Pregnancy latency period was not different but the rates of chorioamnionitis [clinical (26.6% versus 13.5%) and histological (92.6% versus 65.4%)] and the rates of adverse perinatal outcome were higher following PPROM in the presence of a cerclage compared with no cerclage.
  
  
  CONCLUSIONS
  The presence of a cerclage in patients with PPROM appears to increase the risk of intra-uterine infection and affect neonatal outcome; it may not be justified to leave a cerclage in place in patients with PPROM.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: D Laskin
authors.forename: Yoav
authors.initials: Y
authors.lastname: Yinon
authors.forename: Wendy L
authors.initials: WL
authors.lastname: Whittle
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D023802:Cerclage, Cervical / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000209:etiology*; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000209:etiology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015854:Up-Regulation; D014599:Uterus; D055815:Young Adult