The influence of suture material selection on maternal and neonatal outcomes in cervical cerclage: A retrospective study

Vollständiger Abstract

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Abstract Purpose This study aims to compare the effects of different suture materials on pregnancy outcome after cervical cerclage, so as to provide basis for better guiding clinical treatment. Methods In this retrospective case–control study, 145 women who underwent history-, ultrasound-, or physical examination-indicated transvaginal cervical cerclage were categorized according to suture materials used for cerclage: a total of 76 received Mersilene tape and 69 received braided suture. The study participants received transvaginal cervical cerclage before 28 weeks and were followed up until delivery to assess pregnancy and neonatal outcomes. The primary outcome of interest is the duration of pregnancy following cervical cerclage surgery. Secondary outcomes encompass the incidence of preterm rupture of membranes (PROM) subsequent to cervical cerclage, placental abruption, cervical lacerations, chorioamnionitis, neonatal survival rates, and neonatal intensive care unit(NICU) admission rates. The study evaluated the effect of two types of suture materials on maternal and neonatal outcomes. Results In this study, compared with the women who used double-stranded braided, the average gestational age of women who used Mersilene cerclage material was prolonged(37.00weeks vs33.00weeks, P = 0.011), the pregnancy time after cerclage was prolonged and the length of cervical closed line after cerclage was longer(92days vs. 72days, P = 0.004), the occurrence of chorioamnionitis among patients utilizing Mersilene tape was markedly lower compared to the braided sutures cohort (5.6% vs. 17.5%, P = 0.030). The neonatal birth weight of patients who utilized the Mersilene tape was markedly greater than that of the braided sutures group (2551.04 ± 945.54 g vs. 2054.68 ± 1116.09 g, P = 0.007), and the neonatal mortality rate was considerably lower (6.9% vs. 23.0%, P = 0.009). But through multivariate logistic regression analyses shown that there are no significant association between cerclage materials and chorioamnionitis was found in this study (OR 0.392(0.022–7.109), P = 0.392). Conclusion This study demonstrates that the use of Mersilene tape for cervical cerclage offers benefits, including an extension of gestation, a reduction in infection rates, and an enhancement in neonatal outcomes. The retrospective nature of this study precludes definitive causal inferences, and findings should be interpreted with caution. Future research can explore different cerclage materials’ effects in larger populations.