Single stranded suture threads reduces pregnancy infection complications: C-STICH trial

Women at risk of pregnancy loss who need a specialist surgical procedure could benefit from a single-stranded suture thread to reduce risk of infection, based on findings from the C-STICH clinical trial found.

The trial was the largest of its type and is published in The Lancet. It involved more than 2000 expectant mothers who needed a procedure called a cerclage, where a purse string suture is placed around the neck of the womb (the cervix) during their pregnancy. Women were randomly allocated to have the surgical procedure performed using either a single stranded thread or a braided thread.

Researchers tested whether there would be any difference in miscarriage or stillbirth, due to an increased risk of infection, from using a braided suture thread. The team led by researchers from the University of Birmingham and Birmingham Women's and Children's Hospital found that the mothers treated with single stranded threads had no differences in pregnancy loss or preterm birth but reported fewer instances of infection and sepsis. This could have important implications for the health outcomes of mothers and babies who are treated with a cervical cerclage in their pregnancy.

"Preterm birth is a significant problem, complicating approximately one in ten pregnancies around the world. The consequences of preterm birth may be significant with some babies being born too early to survive, and those that survive are at increased risk of health complications. One cause for preterm birth is cervical insufficiency, occurring in 0.5% to 1% of pregnant women for which the placement of a vaginal cervical cerclage can be an effective treatment."explained Dr Vicky Hodgetts-Morton.

Reference:

Dr Vicky Hodgetts-Morton et al,Monofilament suture versus braided suture thread to improve pregnancy outcomes after vaginal cervical cerclage (C-STICH): a pragmatic randomised, controlled, phase 3, superiority trial,The Lancet,DOI 10.1016/S0140-6736(22)01808-6