Use of braided suture in cervical cerclage associated with intrauterine death and preterm birth
FRIDAY, Aug. 5, 2016 (HealthDay News) — For women with short cervical length undergoing cervical cerclage, braided suture induces a persistent shift toward vaginal microbiome dysbiosis, and is associated with increased intrauterine death and preterm birth compared with monofilament suture, according to a study published online Aug. 3 in Science Translational Medicine.
Lindsay M. Kindinger, Ph.D., from Imperial College London, and colleagues assessed birth outcomes in a retrospective cohort of 678 women receiving cervical cerclage in five U.K. university hospitals.
The researchers found that, compared with monofilament suture, braided cerclage correlated with increased intrauterine death (15 versus 5 percent; P = 0.0001) and preterm birth (28 versus 17 percent; P = 0.0006). In a prospective, longitudinal study of the vaginal microbiome in women at risk for preterm birth who received braided or monofilament cerclage (25 and 24 women, respectively), braided suture correlated with a persistent shift toward vaginal microbiome dysbiosis, which was characterized by reduced Lactobacillus spp. and pathobiont enrichment. There were correlations for vaginal dysbiosis with inflammatory cytokine and interstitial collagenase excretion into cervicovaginal fluid and premature cervical remodeling. A comparatively minimal impact was seen for monofilament suture on the vaginal microbiome and its interactions with the host.
“These data provide in vivo evidence that a dynamic shift of the human vaginal microbiome toward dysbiosis correlates with preterm birth,” the authors write.
Two authors disclosed financial ties to the biopharmaceutical industry.
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