Management of cervical cerclage and preterm premature rupture of the membranes: Should the stitch be removed?

OBJECTIVE: Our aim was to determine whether retention of cerclage after pre term premature rupture of the membranes occurring before 34 completed weeks ' gestation influences pregnancy outcome. STUDY DESIGN: Singleton pregnancies with cerclage and premature rupture of the membranes between 24.0 and 34.9 weeks were reviewed. Women were exclude d it they were first seen in labor, had chorioamnionitis, or were delivered within 48 hours. Control subjects consisted of women with premature ruptur e of the membranes without cerclage. RESULTS: Eighty-one cases of cerclage with premature rupture of the membran es met criteria for inclusion: 30 women (37%) had their cerclage removed at presentation, and 51 (63%) retained the cerclage until delivery. Cases wer e similar in terms of gestational age at placement and gestational age at p remature rupture of the membranes. There was no significant difference betw een the retained, removed, or control groups in terms of latency gestationa l age at delivery, chorioamnionitis, or neonatal morbidity and mortality. CONCLUSIONS: Retention of cervical cerclage after premature rupture of the membranes occurring before 34 completed weeks' gestation is associated with comparable clinical outcomes with respect to latency and perinatal outcome , when compared with removal of the cerclage.