A COMPARATIVE ANALYSIS OF PREGNANCY AND NEONATAL OUTCOMES IN TRANSVAGINAL CERVICAL CERCLAGE: EVALUATING THE INFLUENCE OF SUTURE MATERIAL - MERSILENE VERSUS PROLENE SUTURE TYPES

Abstract

Introduction: Cervical cerclage is performed to prevent the loss of pregnancy due to cervical insufficiency as well as spontaneous preterm deliveries. Different materials can be used for cervical cerclage, however, the outcomes concerning pregnancy and neonatal development remain unclear. So, this study is designed to compare the pregnancy and neonate outcome in cases of cervical cerclage with Mersilene and Prolene suture.

Objective: To compare pregnancy and neonatal outcomes in relation to Mersilene versus Prolene suture material used during the Transvaginal Cervical Cerclage procedure.

Study design: Randomized clinical trial

Place and duration of study:  This clinical trial was conducted at the Department of Obstetrics and Gynecology, Ziauddin Medical University & Hospital, Karachi from July 2024 to December 2024. 

Methodology: This trial was conducted among pregnant women who underwent cervical cerclage. The participants were randomly allocated into two equal groups that underwent cervical cerclage with either Prolene or Mersilene material. Preterm deliveries, birth weight, and Apgar scores were compared between the groups.

Results: The mean age in group P was 29.07±2.59 years, whereas group M had patients aged 30.00 ± 26.00 years. In particular, group M showed a lower gestational age at delivery, which in turn demonstrated significant differences regarding the number of preterm births (35.77 ± 2.27 vs. 37.57 ± 4.32 weeks; p = 0.048). Furthermore, the birth weight has also considerably decreased (median weight was 2.3 vs. 2.38 kg; p=0.003). The Apgar scores of the neonates were also significantly different between the studied groups (P< 0.014).

Conclusion: Prolene sutures were associated with a lower rate of preterm birth and more favorable neonatal outcomes compared with conventional Mersilene sutures. These findings suggest that Prolene may be a promising alternative for cervical cerclage; however, larger, well-designed randomized controlled trials are needed to confirm the potential benefits of suture material on cerclage outcomes.