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  • Effectiveness of cerclage for the prevention of premature birth depending on the suture material used

    Редактор | 2020, Practical medicine part 18 №5. 2020, Practical medicine part 18 №6. 2020 | 30 ноября, 2020

    O.V. YAKOVLEVA, A.G. YASHCHUK, A.V. MASLENNIKOV, A.A. TYURINA, R.R. ZAGIDULLINA

    Bashkir State Medical University, Ufa

    Contact details:

    Yakovleva O.V. — post-graduate student of the Department of Obstetrics and Gynecology with an IDPO course

    Address: 3 Lenin St., Russian Federation, Ufa, 450000, tel.: +7-927-637-75-00, e-mail: olgayakov-leva@mail.ru

    The purpose — to compare the effectiveness of cerclage to reduce the frequency of preterm birth when using non-absorbable suture material in the form of a braided silk thread (4 mm) and a braided tape (5 mm), as well as to identify the frequency of complications when using them.

    Material and methods. A retrospective analysis of cases and childbirth was conducted, as well as the analysis of own experience of applying cerclage with various suture materials in patients with isthmic-cervical insufficiency. A total of 157 patients were examined. Pregnancy outcomes, neonatal outcomes, and post-suture complications were evaluated.

    Results. 157 women were given cerclage at gestation periods of 14 to 23 weeks. There was no significant difference in the choice of suture material relative to the duration of pregnancy. Cerclage with thread was performed in 92 patients (58,6%) — group 1 and 65 patients were sutured with tape (41,4%) — group 2. Preterm birth occurred in 28 patients of the 2nd comparison group (18%) and 45 patients of the 1st group (29%). The duration of pregnancy in preterm birth was comparable in both groups.

    Conclusions. The study found that preterm birth after cerclage using a braided tape occurred less frequently than with the use of a braided silk thread. There were no significant differences in neonatal outcomes in the comparison groups. Complications after cerclage, such as suture and cervical rupture, were found only in the group of women who underwent surgery using a woven silk thread.

    Key words: cerclage of the cervix, cerclage tape, cerclage thread, premature birth.

    REFERENCES

    1. Szmulewicz C., Neveu M.E., Vigoureux S., Fernandez H., Capmas P. Emergency vaginal cervico-isthmic cerclage. J Gynecol Obstet Hum Reprod, 2019, vol. 6 (48), pp. 391–394. DOI: 10.1016/j. jogoh.2019.03.023
    2. Nasyrova S.F., Ziganshin A.M., Vdovina T.R. On methods of diagnosing the state of the cervix in patients with post-traumatic disorders. Sovremennye problemy nauki i obrazovaniya, 2015, no. 6, p. 237 (in Russ.).
    3. Berghella V., Ciardulli A., Rust O.A. et al. Cerclage for sonographic short cervix in singleton gestations without prior spontaneous preterm birth: systematic review and meta-analysis of randomized controlled trials using individual patient-level data. Ultrasound Obstet Gynecol, 2017, vol. 5 (50), pp. 569–577.
    4. Frolov A.L., Kulavskiy V.A., Nikiforova M.V. The role of connective tissue dysplasia markers in the development of isthmic-cervical insufficiency during pregnancy. Mat’ i ditya v Kuzbasse, 2014, no. 3 (58), pp. 54–56 (in Russ.).
    5. Basbug A., Bayrak M., Doğan O., Ellibeş Kaya A., Goynumer G. McDonald versus modified Shirodkar rescue cerclage in women with prolapsed fetal membranes. J Matern Fetal Neonatal Med, 2020, vol. 7 (33), pp. 1075–1079. DOI: 10.1080/14767058.2018.1514378
    6. Monsanto S.P., Daher S., Ono E., Pendeloski K.P.T., Trainá É., Mattar R., Tayade C. Cervical cerclage placement decreases local levels of proinflammatory cytokines in patients with cervical insufficiency. Am J Obstet Gynecol, 2017, vol. 4 (217), rr. 455.e1–455.e8.
    7. Yakovleva O.V., Yashchuk A.G., Tyurina A.A., Maslennikov A.V., Tyurin A.V. Experience of surgical correction of anatomical insufficiency of the cervix outside of pregnancy. Prakticheskaya meditsina, 2019, vol. 17, no. 4, pp. 97–101 (in Russ.).
    8. Yuka Sato, Nobuhiro Hidaka, Takahiro Nakano, Saki Kido, Masahiro Hachisuga, Yasuyuki Fujita, Kiyoko Kato. Efficacy of an Emergency Cervical Cerclage Using Absorbable Monofilament Sutures. Pregnancy, 2018, vol. 4 (20), rr. 430–438. DOI: 10.1155/2018/4049792
    9. Vincenzo B., Jeff M.S., John O., Gary H., Jay D.I., Jeanne S.S., Annette Perez-Delboy, Deborah A. Suture type and ultrasound-indicated cerclage efficacy. The Journal of Maternal-Fetal and Neonatal Medicine, 2012, vol. 11 (25), rr. 2287–2290. DOI: 10.3109/14767058.2012.688081

    Метки: 2020, A.A. TYURINA, A.G. YASHCHUK, A.V. MASLENNIKOV, cerclage of the cervix, cerclage tape, cerclage thread, O.V. YAKOVLEVA, Practical medicine part 18 №6. 2020, premature birth, R.R. ZAGIDULLINA

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