Retrospective evaluation of transvaginal cervical cerclage cases in a tertiary reference center: comparison of indications and suture materials.

Abstract

Objective: To compare history-indicated cervical cerclage (HICC), ultrasound-indicated CC (UICC) and physical examination-indicated CC (PEICC) in terms of obstetric outcomes and to compare the outcomes related to braided and non-braided suture materials (Prolene suture vs. Mersilene tape).

Material and methods: We retrospectively evaluated 173 transvaginal CC procedures performed in a single center. Cases were classified based on procedure indications and the type of suture material used.

Results: Of the 173 cases reviewed, 103 (59.5%), 45 (26.0%) and 25 (14.4%) cases were in the HICC, UICC and PEICC groups, respectively. Patients in the PEICC group underwent cerclage at significantly later gestational weeks, had higher hospitalization rates, longer hospital stays following the procedure, a shorter interval between cerclage and delivery, and a higher rate of procedure-related pregnancy loss compared to the other groups (p<0.05 for all). Both the gestational age at delivery and the take-home baby rate were lower in this group compared to the other groups (p<0.05 for both). There were no significant differences identified in terms of suture materials used. Subgroup analyses revealed similar obstetric outcomes between different suture materials.

Conclusion: PEICC had worse perinatal outcomes compared to HICC and UICC procedures. CC indication was the major determinant of perinatal outcome in this cohort while suture material had no significant effect on perinatal outcomes.