Cerclage and Toxic Shock Syndrome

Patient

Q: I have been advised to get a cerclage (cervical stitch) in a future pregnancy after a preterm pregnancy loss at 23 weeks. I have also survived toxic shock syndrome when I was a teenager. I am wondering if having a cerclage can cause toxic shock syndrome to recur. I am hoping a cerclage will allow me to carry a baby full term in the future. Thanks for any information you can help me with.

Doctor

A:   I understand your concern about Cerclage and Toxic shock syndrome. Cerclage might be recommended in cases of incompetent cervix and it is not a risk factor for Toxic Shock Syndrome. Toxic shock Syndrome is caused by a Staph aureus preformed toxin; it is commonly presented in young women who have used tampons during menses. Your previous TSS event does not increase your chances of recurrence.
Cerclage might increase the risk for cervical infections but with a different entity, part of the procedure is to prescribe antibiotics in some cases to prevent this.
The patient is also regularly checked and controlled and generally the thread is removed at the 37th week of pregnancy, but it can be removed before if a woman’s water breaks or contractions start. Most stitches are removed in the doctor’s office without any problems. I wish you the best.

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