Berghella Vincenzo, Szychowski Jeff M, Owen John, Hankins Gary, Iams Jay D, Sheffield Jeanne S, Perez-Delboy Annette, Wing Deborah A, Guzman Edwin R
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
J Matern Fetal Neonatal Med. 2012 Nov;25(11):2287-90. doi: 10.3109/14767058.2012.688081. Epub 2012 May 14.
To assess whether type of suture material affects cerclage efficacy for preterm birth (PTB) prevention.
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.
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).
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.
评估缝合材料类型是否会影响预防早产(PTB)的宫颈环扎术效果。
对一项关于超声提示宫颈短(CL)行宫颈环扎术的多中心试验进行二次分析,试验中孕16 - 33⁶/₇周有既往自发性PTB史、单胎妊娠且孕16 - 22⁶/₇周CL < 25mm的女性被随机分为接受麦克唐纳宫颈环扎术组或不进行宫颈环扎术组。对接受宫颈环扎术的女性的结局按缝合材料类型进行分析,将聚酯编织线(Mersilene™或Ethibond™)与Mersilene带™进行比较。主要结局为孕35周前早产。
138名女性接受了麦克唐纳宫颈环扎术:84名(61%)接受聚酯编织线,46名(33%)接受Mersilene带™。8名(6%)接受单丝缝线,被排除在分析之外。孕35周前早产率相似,聚酯编织线组为35%,Mersilene带™组为24%(p = 0.24)。两组间出生孕周也相似(p = 0.18)。
在CL短的高危女性中,缝合材料类型可能不影响超声提示的宫颈环扎术效果,但仍需进一步研究。聚酯编织线(Mersilene™或Ethibond™)和聚酯编织的Mersilene带™似乎具有相似的效果。