目的:先前的研究表明宫颈环扎术与缝合材料的类型有关。然而,目前尚不清楚哪种缝合材料可以为环扎术患者提供最大的益处。这项研究调查了两种不同的缝合材料(Mersilene胶带与编织缝合线)用于经阴道宫颈环扎术对宫颈机能不全妇女产妇结局的影响。
方法:在这项回顾性病例对照研究中,170名妇女经历了历史,超声波-,或体格检查指示的经阴道宫颈环扎术根据用于环扎的缝合材料进行分类:共有96例接受Mersilene胶带,74例接受编织缝合线.研究参与者在28周前接受了经阴道宫颈环扎术,并随访至分娩以评估妊娠和新生儿结局。主要结果是分娩时的胎龄。次要结果包括早产胎膜早破(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。
结果:在170名符合条件的女性中,74(43.5%)接受编织缝合线,而96(56.5%)接受Mersilene胶带。两组的基线特征相似。接受编织缝合术的组分娩时孕龄<37周时的发生率较低(29.2%vs54.2%,P=0.046),PPROM(9.5%对21.9%,P=0.029)和PROM(17.6%vs32.3%,P=0.028)与接受Mersilene胶带的组相比。然而,两组在分娩时的平均胎龄没有显著差异,分娩时的胎龄率<24、<28、<32和<34周,绒毛膜羊膜炎,和新生儿存活率,以及新生儿发病率。
结论:与Mersilene胶带相比,编织缝合线的使用与分娩<37周时胎龄的发生率降低显着相关,以及降低PPROM和PROM的风险。然而,使用编织缝合线不会导致绒毛膜羊膜炎或不良新生儿结局的发生率出现明显差异.
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.