A Rare Case Report of Sepsis and Intrauterine Fetal Demise Triggered by Chronic Villitis of Unknown Etiology Following Cervical Cerclage and Its Clinical Implications

Background Cervical cerclage is a common intervention for cervical insufficiency aimed at preventing preterm birth. However, this procedure may be associated with infection risks, such as sepsis, which, although low in incidence, can lead to severe adverse pregnancy outcomes. Chronic villitis of unknown etiology (VUE) is an inflammatory placental disorder, and its association with post-cerclage infection and sepsis has not been fully explored. Case Presentation This case report presents a pregnant woman who underwent cervical cerclage in the second trimester and subsequently developed VUE of unknown etiology, leading to sepsis and ultimately intrauterine fetal death. The patient's clinical symptoms included contractions and signs of infection, but these manifestations were misinterpreted as physiological phenomena of natural labor, resulting in delayed diagnosis. Despite medical interventions, an adverse pregnancy outcome occurred. Conclusion This case highlights the importance of VUE as a potential trigger for sepsis after cervical cerclage, as its symptoms are easily confused with physiological contractions, making early identification difficult. It is recommended to strengthen infection surveillance in perinatal management and establish prevention and early diagnosis protocols for sepsis, with particular consideration of the influence of VUE. Future studies require more case collection and analysis to clarify the relationships between cervical cerclage, VUE, and sepsis, thereby improving maternal and neonatal outcomes.