Pregnancy outcomes with the reuse of the same suture in the history-indicated modified transvaginal cervicoisthmic cerclage

Cervical cerclage has been used for many years to treat cervical incompetence and reduce the rates of late abortion and preterm birth, and some women with history-indicated cerclage preferred to retain the suture in place during cesarean delivery. This study was designed to evaluate the obstetric outcomes of subsequent pregnancies in women with a prior history-indicated modified transvaginal cervicoisthmic cerclage, with particular emphasis on assessing the clinical efficacy of suture reuse. A retrospective observational study was performed from 2014 to 2021, consisted of 20 women who completed 2 pregnancies with the same cerclage suture in place. The study compared gestational age at delivery, term and post-34-week preterm delivery rates, neonatal birth weight, and survival rates between first and second pregnancies with the same suture. In the first pregnancies, the mean gestational age at delivery was 37.6 ± 0.9 weeks, with a term delivery rate of 90%, no preterm births before 34 weeks (0%), and a 100% neonatal survival rate. The second pregnancies had had a mean delivery gestational age of 36.7 ± 3.2 weeks, with a 75% term delivery rate, a 15% preterm birth rate before 34 weeks, while neonatal survival remained at 100%. The findings indicate that utilizing the same suture for history-indicated transvaginal cervicoisthmic cerclage can be effective for maintaining favorable pregnancy outcomes in both initial and subsequent pregnancies among women with cervical insufficiency. This approach may offer a viable option for preserving pregnancy outcomes in this high-risk population.