title: Suture type and ultrasound-indicated cerclage efficacy.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA 19107, USA. vincenzo.berghella@jefferson.edu
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Berghella
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Szychowski
authors.forename: John
authors.initials: J
authors.lastname: Owen
authors.forename: Gary
authors.initials: G
authors.lastname: Hankins
authors.forename: Jay D
authors.initials: JD
authors.lastname: Iams
authors.forename: Jeanne S
authors.initials: JS
authors.lastname: Sheffield
authors.forename: Annette
authors.initials: A
authors.lastname: Perez-Delboy
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Wing
authors.forename: Edwin R
authors.initials: ER
authors.lastname: Guzman
mesh_terms: D000328:Adult; D023802:Cerclage, Cervical / Q000379:methods*; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control; D013536:Suture Techniques; D013537:Sutures / Q000145:classification; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D016216:Ultrasonography, Prenatal; D002581:Uterine Cervical Incompetence / Q000000981:diagnostic imaging* / Q000601:surgery*; D055815:Young Adult