Analysis Of Cervical Cerclage And Change Of Vaginal Microbiome

Objective: To prospectively study the relationship between cervical cerclage and vaginal microbiome.Methods: Single born pregnant women who diagnosed cervical insufficiency from December 2017 to January 2019 and performed cervical cerclage at the International Peace Institute of Maternal and Child Health,affiliated to the School of Medicine of Shanghai Jiaotong University,were selected as the trial group(n=25).Single pregnant women who did not have the high risk factors of premature delivery and were examined in our hospital as control group(n = 28).Vaginal secretions were collected from pregnant women in the trial group 1 day or early morning before cerclage,2 to 4 weeks after operation,34 weeks after pregnancy,respectively.In the control group,vaginal secretions were collected at 14-20 weeks and34 weeks after pregnancy.All secretions were used for detection of BV by sialidase,wet sheet method used to detect trichomonas and spores(and/or hyphae),Gram staining smear and aerobic culture.Evaluation of vaginal microecology using the above results.Results:1)The vaginal microecological imbalance rate of A1 group was40.0% and that of B1 group was 42.9%,the vaginal microecological imbalance rate of A2 group was 63.6% and that of A3 group was 55.0%.2)Among the cases with vaginal microecological imbalance in group A1,40% were simple imbalance,57.1% in group A2 and 81.8% in group A3.3)In the trial group,BV was detected in 5 cases,of which 1 case continued until 34 weeks of pregnancy,the other 4 cases disappeared naturally after 34 weeks of pregnancy.4)In the trial group,3 cases of VVC were detected before operation,including 1 case of spontaneous abortion,1 case of continuous pregnancy,and 1 case of spontaneous regression after 34 weeks of pregnancy.Conclusion:1) Although the rate of vaginal microecological imbalance in late pregnancy is higher than that in early pregnancy,it is mostly simple vaginal microecological disorder;2)cervical cerclage can reduce BV infection;3)VVC infection may reduce the success of cervical cerclage.