Thicker cervical stitch may up premature birth, mortality rate

Pregnant women who receive the cervical stitch to prevent miscarriage or premature birth with a thicker thread, can in fact have an increase in the rate of premature birth and baby death as compared with a thinner thread, says a study.

cervical stitch also known as cervical cerclage is a treatment for cervical incompetence or insufficiency, when the cervix starts to shorten and open too early during a pregnancy, causing either a late miscarriage or preterm birth, and is performed on around two million women a year globally.

Surgeons use one of two types of thread for the stitch — the majority use a thicker woven thread, and around 20 per cent use a thinner thread.

The results indicated that the thicker thread is associated with a three-fold increase in rate of baby death in the womb when compared to the thinner thread (15 per cent compared to 5 per cent).

The thicker thread was also associated with an increased rate of pre-term birth rate compared to the thinner thread — 28 per cent compared to 17 per cent.

Women who received a stitch with the thicker thread had increased inflammation around the cervix.

There was also increased blood flow, which is associated with the cervix opening before labour.

Women who received the thicker thread had more potentially harmful bacteria in the vagina and around the cervix.

“Although the cervical stitch procedure still holds benefits for women overall, our results suggest the thicker thread may encourage the growth of potentially dangerous bacteria in the cervix. This may lead to premature birth or even loss of the baby,” said lead author Phillip Bennett, Professor Imperial, Imperial College London in Britain.

For the study, the team analysed 671 women in Britain who received a cervical stitch procedure to prevent miscarriage or premature birth at five hospitals over the last ten years.

Switching to the thinner thread for all procedures could prevent 1,70,000 premature births globally every year, and 1,72,000 intrauterine baby deaths every year across the world, the researchers suggested in the study published in the journal Science Translational Medicine.

“It’s important that women who have this procedure ask their obstetrician about what stitch they will receive because clinical practice can take time to catch up with research findings,” they concluded.