Imperial College London
Alternate

ProfessorJulianMarchesi

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Digestive Health
 
 
 
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Contact

 

+44 (0)20 3312 6197j.marchesi

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Brown:2019:10.1111/1471-0528.15600,
author = {Brown, R and Chan, D and Terzidou, V and Lee, Y and Smith, A and Marchesi, J and MacIntyre, D and Bennett, P},
doi = {10.1111/1471-0528.15600},
journal = {BJOG: An International Journal of Obstetrics and Gynaecology},
pages = {916--925},
title = {Prospective observational study of vaginal microbiota pre- and post-rescue cervical cerclage},
url = {http://dx.doi.org/10.1111/1471-0528.15600},
volume = {126},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - ObjectiveTo investigate the relationship between vaginal microbiota composition and outcome of rescue cervical cerclage.DesignProspective observational study.SettingQueen Charlotte’s and Chelsea Hospital, LondonPopulationTwenty singleton pregnancies undergoing a rescue cervical cerclage.MethodsVaginal microbiota composition was analysed in women presenting with a dilated cervix and exposed fetal membranes before and 10 days following rescue cervical cerclage and correlated with clinical outcomes.Main outcome measuresComposition of vaginal bacteria characterised by culture independent next generation sequencing.Successful cerclage, defined as those resulting in the birth of a neonate discharged from hospital without morbidity.Unsuccessful cerclage, defined as procedures culminating in miscarriage, intrauterine death, neonatal death or significant neonatal morbidity.ResultsReduced Lactobacillus spp. relative abundance was observed in 40% of cases prior to rescue cerclage compared to 10% of gestational age matched controls (8/20, 40% vs 3/30, 10%, P=0.017). Gardnerella vaginalis was over-represented in women presenting with symptoms (3/7, 43% vs 0/13, 0%, P=0.03, LDA (log 10) and casesculminating in miscarriage (3/6, 50% vs 0/14, 0%, P=0.017). In the majority of cases (10/14, 71%) bacterial composition was unchanged following cerclage insertionandperi-operative interventions.ConclusionsReduced relative abundance of Lactobacillus spp. is associated with premature cervical dilatation, whereas high levels of Gardnerella vaginalis are associated with unsuccessful rescue cerclage cases. The insertion of a rescue cerclage does not affect the underlying bacterial composition in the majority of cases.
AU  - Brown,R
AU  - Chan,D
AU  - Terzidou,V
AU  - Lee,Y
AU  - Smith,A
AU  - Marchesi,J
AU  - MacIntyre,D
AU  - Bennett,P
DO  - 10.1111/1471-0528.15600
EP  - 925
PY  - 2019///
SN  - 1470-0328
SP  - 916
TI  - Prospective observational study of vaginal microbiota pre- and post-rescue cervical cerclage
T2  - BJOG: An International Journal of Obstetrics and Gynaecology
UR  - http://dx.doi.org/10.1111/1471-0528.15600
UR  - http://hdl.handle.net/10044/1/66690
VL  - 126
ER  -
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