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0% (95% CI 5.4-16.7%). Conclusions sCAS may be associated with increased risk of PTB, however the available data are largely case reports and series. Antepartum surveillance after viability can be considered due to risk of cord accidents. Prospective study is necessary to understand the clinical implications of sCAS. This article is protected by copyright. All rights reserved.We describe a practical approach to the management of complex anal fistula in an immunocompromised patient. We define our treatment motifs to close the internal