Abstract
Objective: To determine the risk factors for preterm delivery（PD）before 34 gestational weeks（GWs）following therapeutic cervical cerclages in pregnant women with cervical incompetence（CI）or those with cervical shortening at risk of CI.
Patients and Methods: In this retrospective study, fifty-one singleton pregnancies diagnosed with CI or those with cervical shortening at risk of CI, who underwent therapeutic cervical cerclage and delivered at our hospital between 2014 and 2022 were enrolled in the final analysis. The participants were divided into two groups: the group of PD ＜ 34 GWs（n＝13）and the group of delivery at 34 GWs or later（n＝38）. We determined the risk factors for PD ＜ 34 GWs following therapeutic cervical cerclages by logistic regression analysis,
Results: Multivariate logistic regression analysis revealed that the presence of amniotic fluid sludge〔Odds Ratio（OR）12.8［95％ Confidence Interval（CI）1.1-150.3］, p ＜ 0.05〕and the highest postoperative maternal blood white blood cell（WBC）count（x103 /μL）［OR 1.3（95％ CI 1.04-1.6）, p ＜ 0.05］were independent risk factors for PD ＜ 34 GWs following therapeutic cervical cerclages.
Conclusion: Pregnant women who had amniotic fluid sludge and high postoperative maternal blood WBC counts should be intensively managed to prevent PD after therapeutic cervical cerclages.
