Effect of 2 Stitches vs. 1 Stitch on the Prevention of Preterm Birth in Women With Singleton Pregnancies Who Undergo Cervical Cerclage

Cervical cerclage remains the preferred treatment for women with cervical insufficiency, but the best technique and timing for cerclage placement remain uncertain. This retrospective cohort study compared the use of a single stitch with 2 cerclage stitches in 150 women with singleton pregnancies. There were no baseline differences between the 112 patients given 1 stitch and the 38 given 2 stitches. These were consecutive pregnancies in women having cervical cerclage placement because of either a history of cervical insufficiency (habitual immature deliveries at 16–28 weeks’ gestation) or a sonographic cervical length less than 25 mm. All cerclages were placed before 24 weeks’ gestation.Nearly one-third of participants had complications following cerclage placement, but there were no significant differences in complication rates between the 2 surgical groups. There also was no significant difference between the 2 groups in gestational age at the time of delivery, either overall or for a given gestational age cutoff such as 37 weeks’ gestation. Five women in the single-stitch group (4.5%) and none of those in the 2-stitch group experienced pregnancy loss before 20 weeks’ gestation. The only outcomes that differed significantly were a longer duration of rupture of membranes and a longer time in the labor unit in the 2-stitch group. Logistic regression analysis confirmed a lack of significant difference in the relative risk of preterm birth between the 2-stitch and single-stitch groups.