Pregnancy Outcomes in Cervical Incompetence Patients with Abnormal Vaginal Flora Treated with Cervical Cerclage

Objective: To explore whether cervical cerclage can improve pregnancy outcomes in patients with abnormal vaginal flora during pregnancy. Methods: : Total of 1,261 pregnant women participated in study. According to the diagnosis, they were divided into cervical insufficiency group (CIC group) and normal pregnancy group (NP group). The CIC group patients were randomly received cervical cerclage (CIC-C group) or expectation therapy (CIC-E group). Vaginal secretion samples of the patients in the groups were collected and analyzed in the laboratory. Meanwhile, through the results of vaginal flora, CIC-C group and CIC-E group were further divided into normal vaginal flora groups (CIC-C-N group, CIC-E-N group) and abnormal vaginal flora groups (CIC-C-A group, CIC-E-A group). All groups are processed accordingly and analyzed on pregnancy outcomes. Results: Among 1261 vaginal secretion specimens, the positive rate of pathogenic bacteria was 21.9%. The pathogen detection rates in CIC group and NP group were 32.9% (229/696) and 8.5% (48/565). 23 types of vaginal flora were detected in CIC group, and 9 were detected in NP group. The proportions of women who had term birth were 75.94% in the CIC-C group, 70.03% in the CIC-E group, and 87.79% in the NP group. The rates of preterm birth and pregnancy complications in CIC-E group were higher than in CIC-C group (19.87% vs. 15.54%, 9.09% vs. 6.51%, p<0.05). Compared with the CIC-C-A group, the CIC-E-A group had a lower term delivery rate (61.84% vs. 77.78%) and a higher incidence of pregnancy complications (22.37% vs. 9.15%). Conclusions: Cervical incompetence is associated with vaginal flora diversity. Cervical cerclage can improve pregnancy outcomes in cervical incompetence patients with abnormal vaginal flora.