Suture type and ultrasound-indicated cerclage efficacy

J Matern Fetal Neonatal Med. 2012 Nov;25(11):2287-90. doi: 10.3109/14767058.2012.688081. Epub 2012 May 14.

Abstract

Objective: To assess whether type of suture material affects cerclage efficacy for preterm birth (PTB) prevention.

Methods: Secondary analysis of a multicenter trial of ultrasound-indicated cerclage for short cervical length (CL), in which women with prior spontaneous PTB at 16-33 6/7 weeks, a singleton gestation and CL < 25 mm between 16-22 6/7 weeks, were randomized to McDonald cerclage or no cerclage. Outcomes of women who underwent cerclage were analyzed by type of suture material, comparing polyester braided thread (Mersilene™ or Ethibond™) to Mersilene tape™. Primary outcome was PTB < 35 weeks.

Results: 138 women underwent McDonald cerclage: 84 (61%) received polyester braided thread and 46 (33%) Mersilene tape™. Eight (6%) received monofilament suture and were excluded from analysis. Rates of PTB < 35 weeks were similar, 35% for polyester braided thread vs 24% for Mersilene tape™ (p = .24). Birth gestational age was also similar among the 2 groups (p = .18).

Conclusion: Type of suture material may not affect ultrasound-indicated cerclage efficacy in high-risk women with short CL, but further study is needed. Polyester braided thread (Mersilene™ or Ethibond™) and polyester braided Mersilene tape™ seem to have similar efficacy.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cerclage, Cervical / methods*
  • Cervix Uteri / pathology
  • Cervix Uteri / surgery
  • Female
  • Humans
  • Pregnancy
  • Premature Birth / prevention & control
  • Suture Techniques*
  • Sutures / classification
  • Treatment Outcome
  • Ultrasonography, Interventional
  • Ultrasonography, Prenatal
  • Uterine Cervical Incompetence / diagnostic imaging*
  • Uterine Cervical Incompetence / surgery*
  • Young Adult