Role of cervical cerclage and prolonged antibiotic therapy with azithromycin in patients with previous perinatal loss amnionitis

Abstract

In the group of 35 patients with cerclage, intermediate fetal mortality was reduced from 37.1% to 0 (p < 0.001); late fetal mortality rate from 8.5% to 2.8% (p = 0.606); prematurity from 65.7% to 5.7% (p < 0.001); newborn underweight from 11.4% to 5.7% (p = 0.671); newborns with very low weight from 34.2% to 0 (p < 0.001) and the abortion rate from 8.5% to 0 ( p < 0.001). In the group of 19 patients without buckling, intermediate fetal mortality was reduced from 26.3% to 10.5% (p = 402); late fetal mortality from 63.1% to 0 (p < 0.001); prematurity 78.9% to 31.5% (p < 0.009); the newborn of low weight from 31.5% to 10.5% (p = 0.234); newborns with very low weight from 68.4% to 15.7% (p < 0.003) and the abortion rate from 36.8 to 0 (p < 0.001). In conclusion, we believe the results of this study demonstrate the effectiveness of therapeutic and prophylactic cervical cerclage associated with prolonged antibiotic therapy.

Complications of pregnancy: premature rupture of membranes,chorioamnionitis, amnioinfusion, prenatal administration of surfactanct

“…This Protocol is associated with more than 90% of success in the reduction of the prematurity of infectious cause mainly in patients with perinatal loss by ovular infection before 30weeks. 38…”

“…There is evidence that treatment of asymptomatic patients with positive cervical cultures for Chlamydia, reduces the risk of presenting RPM. 38,40,41 The RPM mechanism involves the induction of an acute inflammatory reaction and the subsequent initiation of release of prostaglandins and cytokinas waterfall.…”