Continuous low-dose antibiotics and cerclage for recurrent second-trimester pregnancy loss

OBJECTIVE: To evaluate the role of continuous low-dose antibiotics in the prolongation of pregnancy in women at risk for recurrent second-trimester loss. METHODS: Only patients with a history of previous recurrent second-trimester losses associated with failed cervical cerclages were prospectively included in the study. Patients received low-dose antibiotics until delivery. Cerclage was performed at 14-24 weeks' gestation on the basis of transvaginal sonographic findings of cervical funneling. Outcome was evaluated by weeks of pregnancy gained in the current pregnancy as compared to the previous pregnancy. RESULTS: Ten patients were eligible for study after exclusions. All 10 achieved fetal viability. Pregnancy was prolonged by a mean of 13.4 +/- 4.2 weeks beyond the previous pregnancy. This was highly statistically significant (P <.001). CONCLUSION: Continuous low-dose antibiotics prolonged pregnancy in patients with recurrent second-trimester pregnancy losses and prior failed cerclage. Randomized clinical trials are needed to confirm the role of antibiotics in these high-risk pregnancies.