Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fujian, People's Republic of China.
Nursing Department and Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fujian, People's Republic of China.
Int J Gynaecol Obstet. 2024 Nov;167(2):743-752. doi: 10.1002/ijgo.15715. Epub 2024 Jun 1.
Previous studies have indicated that there is an association between cervical cerclage and type of suture material. However, it is still unclear which suture material can provide the greatest benefit to patients who have undergone cerclage. This study investigated the effect of two different suture materials (Mersilene tape vs braided suture) used for transvaginal cervical cerclage placement on maternal outcomes of women with cervical insufficiency.
In this retrospective case-control study, 170 women who underwent history-, ultrasound-, or physical examination-indicated transvaginal cervical cerclage were categorized according to suture materials used for cerclage: a total of 96 received Mersilene tape and 74 received braided suture. Study participants received a transvaginal cervical cerclage before 28 weeks and were followed up until delivery to assess pregnancy and neonatal outcomes. The primary outcome was gestational age at delivery. Secondary outcomes included preterm premature rupture of membranes (PPROM), premature rupture of membranes (PROM), chorioamnionitis, neonatal survival rate, and neonatal morbidity.
Out of 170 eligible women, 74 (43.5%) received braided suture while 96 (56.5%) received Mersilene tape. Baseline characteristics were similar between the two groups. The group that received braided suture had a lower incidence of gestational age at delivery <37 weeks (29.2% vs 54.2%, P = 0.046), PPROM (9.5% vs 21.9%, P = 0.029) and PROM (17.6% vs 32.3%, P = 0.028) compared to the group that received Mersilene tape. However, there were no significant differences between the two groups in average gestational age at delivery, the rate of gestational age at delivery <24, <28, <32, and < 34 weeks, chorioamnionitis, and neonatal survival rate, as well as neonatal morbidity.
Compared to Mersilene tape, the utilization of braided suture has been significantly associated with a reduction in the incidence of gestational age at delivery <37 weeks, as well as a decreased risk of PPROM and PROM. However, the use of braided sutures did not result in discernible differences in the rates of chorioamnionitis or adverse neonatal outcomes.
既往研究表明,宫颈环扎术与缝线材料类型之间存在关联。然而,哪种缝线材料可为宫颈机能不全患者带来最大获益仍不明确。本研究旨在探讨经阴道宫颈环扎术中使用两种不同缝线材料(Mersilene 带与编织缝线)对宫颈机能不全患者母婴结局的影响。
本回顾性病例对照研究根据缝线材料将 170 例经病史、超声或体格检查确诊为经阴道宫颈环扎术的患者分为两组:Mersilene 带组 96 例,编织缝线组 74 例。所有患者均在 28 周前接受经阴道宫颈环扎术,并随访至分娩以评估妊娠和新生儿结局。主要结局为分娩时的孕周。次要结局包括早产胎膜早破(PPROM)、胎膜早破(PROM)、绒毛膜羊膜炎、新生儿存活率和新生儿发病率。
170 例符合条件的患者中,74 例(43.5%)接受编织缝线,96 例(56.5%)接受 Mersilene 带。两组患者的基线特征相似。与 Mersilene 带组相比,编织缝线组的分娩时孕周<37 周的发生率较低[29.2%比 54.2%,P=0.046],PPROM 发生率较低[9.5%比 21.9%,P=0.029],PROM 发生率较低[17.6%比 32.3%,P=0.028]。然而,两组间平均分娩时孕周、分娩时<24 周、<28 周、<32 周和<34 周的发生率、绒毛膜羊膜炎发生率以及新生儿存活率和新生儿发病率差异均无统计学意义。
与 Mersilene 带相比,编织缝线的使用与分娩时<37 周的发生率降低显著相关,且与 PPROM 和 PROM 风险降低相关。然而,编织缝线的使用并未导致绒毛膜羊膜炎或不良新生儿结局发生率出现明显差异。