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Monofilament Suture Not Superior for Vaginal Cervical Cerclage

No significant difference seen in percentage of women with pregnancy loss for those receiving monofilament suture, braided suture

WEDNESDAY, Oct. 26, 2022 (HealthDay News) — For women with a singleton pregnancy receiving vaginal cervical cerclage due to a history of pregnancy loss or premature birth, monofilament suture does not reduce the rate of pregnancy loss compared with suture thread, according to a study published in the Oct. 22 issue of The Lancet.

Victoria Hodgetts Morton, Ph.D., from the University of Birmingham in the United Kingdom, and colleagues conducted a pragmatic, randomized, superiority trial at 75 obstetric units in the United Kingdom. Women with a singleton pregnancy who received a vaginal cervical cerclage due to a history of pregnancy loss or premature birth or clinician concern based on ultrasound were randomly assigned to receive a monofilament suture or braided suture thread for their cervical cerclage (1,025 and 1,024, respectively).

The primary outcome was pregnancy loss, defined as miscarriage, stillbirth, or neonatal death in the first week of life, and was ascertained in 1,003 and 993 women in the monofilament suture group and the braided suture group, respectively. The researchers found that pregnancy loss occurred in 8.0 and 7.6 percent of women in the monofilament suture and braided suture groups, respectively (adjusted risk ratio, 1.05; 95 percent confidence interval, 0.79 to 1.40).

“Clinicians caring for women offered a vaginal cervical cerclage should use the result of this trial to facilitate discussions around the suture thread to optimize outcomes,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical and medical device industries.

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